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Pulmonary embolism

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https://www.readbyqxmd.com/read/28921591/treatment-of-a-mobile-intracardiac-thrombus-using-ultra-slow-low-dose-tissue-plasminogen-activator-in-combination-with-heparin
#1
C B Polen, H N Mullins Busch, P D Ratliff
WHAT IS KNOWN AND OBJECTIVE: Free-floating thrombi in the right heart occur in a subset of patients with pulmonary embolism with high rates of mortality if untreated. Treatment of choice is controversial and likely patient specific as studies have failed to consistently show a significant difference in mortality between options. CASE SUMMARY: We present a case of a 45-year-old female with a mobile right heart thrombus treated with ultra-slow, low-dose t-PA infusion in combination with heparin...
September 17, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28920554/a-pulmonary-embolism-response-team-s-initial-20-month-experience-treating-87-patients-with-submassive-and-massive-pulmonary-embolism
#2
Akhilesh K Sista, Oren A Friedman, Eda Dou, Brendan Denvir, Gulce Askin, Jamie Stern, Jaclyn Estes, Arash Salemi, Ronald S Winokur, James M Horowitz
Pulmonary Embolism Response Teams (PERTs) have emerged to provide rapid multidisciplinary assessment and treatment of PE patients. However, descriptive institutional experience and preliminary outcomes data from such teams are sparse. PERT activations were identified through a retrospective review. Only confirmed submassive or massive PEs were included in the data analysis. In addition to baseline variables, the therapeutic intervention, length of stay (LOS), in-hospital mortality, and bleeding rate/severity were recorded...
September 1, 2017: Vascular Medicine
https://www.readbyqxmd.com/read/28920131/reversible-causes-in-cardiovascular-collapse-at-the-emergency-department-using-ultrasonography-revive-us
#3
Mui Teng Chua, Gene Wh Chan, Win Sen Kuan
INTRODUCTION: Ultrasonographic evaluation of patients in cardiac arrest is currently not protocolised in the advanced cardiac life support (ACLS) algorithm. Potentially reversible causes may be identified using bedside ultrasonography that is ubiquitous in most emergency departments (EDs). This study aimed to evaluate the incidence of sonographically detectable reversible causes of cardiac arrest by incorporating an ultrasonography protocol into the ACLS algorithm. Secondary objectives include rates of survival to hospital admission, hospital discharge, and 30-day mortality...
August 2017: Annals of the Academy of Medicine, Singapore
https://www.readbyqxmd.com/read/28918335/modern-diagnosis-of-chronic-thromboembolic-pulmonary-hypertension
#4
Aileen Kharat, Anne-Lise Hachulla, Stéphane Noble, Frédéric Lador
Chronic thromboembolic pulmonary hypertension (CTEPH) should be suspected in patients presenting persistent dyspnea three months after a pulmonary embolism or in patients presenting with acute pulmonary embolism and suggestive images on the CT-scan. For these patients, a specific diagnostic work-up should be performed. First step consists of the ventilation/perfusion (V/Q) scan which is a good screening test due to its high sensitivity and high negative predictive value. Pulmonary angiography remains the gold standard approach for the confirmation of the diagnosis and pre-surgical evaluation of CTEPH...
September 9, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28917494/early-dislodgment-and-migration-of-a-left-atrial-appendage-closure-device
#5
Mohamed Sanhoury, Gaetano Fassini, Antonio Dello Russo, Giuseppe Lumia, Antonio Bartorelli
A 68-year-old man underwent pulmonary vein isolation with cryoballoon combined with left atrial appendage closure using a LAmbre device. The device was dislodged and embolized early after implantation with no symptoms, and it was retrieved percutaneously. An early in-hospital check of the device position after implantation is important for early recognition of any possible device-related complication.
August 9, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28914829/-circular-tracheal-resection-for-cicatrical-stenosis-and-functioning-tracheostomy
#6
V D Parshin, V A Titov, V V Parshin, A V Parshin, Z Berikkhanov, D M Amangeldiev
AIM: To analyze the results of tracheal resection for cicatricial stenosis depending on the presence of tracheostomy. MATERIAL AND METHODS: 1128 patients with tracheal cicatricial stenosis were treated for the period 1963-2015. The first group consisted of 297 patients for the period 1963-2000, the second group - 831 patients for the period 2001-2015. Most of them 684 (60.6%) were young and able-bodied (age from 21 to 50 years). In the first group 139 (46.8%) out of 297 patients had functioning tracheostomy...
2017: Khirurgiia
https://www.readbyqxmd.com/read/28913711/emergency-neurological-life-support-resuscitation-following-cardiac-arrest
#7
Jonathan Elmer, Kees H Polderman
Cardiac arrest is the most common cause of death in North America. An organized bundle of neurocritical care interventions can improve chances of survival and neurological recovery in patients who are successfully resuscitated from cardiac arrest. Therefore, resuscitation following cardiac arrest was chosen as an Emergency Neurological Life Support protocol. Key aspects of successful early post-arrest management include: prevention of secondary brain injury; identification of treatable causes of arrest in need of emergent intervention; and, delayed neurological prognostication...
September 14, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28913590/challenges-of-anticoagulation-therapy-in-pregnancy
#8
REVIEW
Annemarie E Fogerty
Thrombotic complications in pregnancy represent a major cause of morbidity and mortality. Pregnancy is a primary hypercoagulable state due to enhanced production of clotting factors, a decrease in protein S activity, and inhibition of fibrinolysis. These physiologic changes will yield a collective rate of venous thromboembolism (VTE) of about 1-2 in 1000 pregnancies for the general obstetric population, which represents a five- to tenfold increased risk in pregnancy compared to age-matched non-pregnant peers...
September 14, 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28912870/eosinophilic-biomarkers-for-detection-of-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-with-or-without-pulmonary-embolism
#9
Qiong-Fang Yang, Ting-Ting Lu, Cai-Min Shu, Lan-Fang Feng, Hao-Teng Chang, Qiao-Ying Ji
Eosinophilia has been implicated in the pathophysiology of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). However, the role of eosinophil activation in the development of AECOPD remains unclear. In the present study, the reliability of plasma levels of eosinophil activation markers, including eosinophil cationic protein (ECP), major basic protein (MBP), eosinophil-derived neurotoxin (EDN) and eosinophil peroxidase (EPX), were measured and used as diagnostic biomarkers of AECOPD with or without pulmonary embolism (PE)...
October 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28911997/heart-type-fatty-acid-binding-protein-in-cardiovascular-disease-a-systemic-review
#10
REVIEW
Yoichiro Otaki, Tetsu Watanabe, Isao Kubota
Fatty acid-binding proteins, whose clinical applications have been studied, are a family of proteins that reflect tissue injury. Heart-type fatty acid-binding protein (H-FABP) is a marker of ongoing myocardial damage and useful for early diagnosis of acute myocardial infarction (AMI). In the past decade, compared to other cardiac enzymes, H-FABP has shown more promise as an early detection marker for AMI. However, the role of H-FABP is being re-examined due to recent refinement in the search for newer biomarkers, and greater understanding of the role of high-sensitivity troponin...
September 11, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/28911787/pulmonary-embolism-severity-assessment-and-prognostication
#11
Deisy Barrios, Raquel Morillo, Roger D Yusen, David Jiménez
For patients who have acute symptomatic pulmonary embolism (PE), risk of short-term death and adverse outcomes should drive the initial treatment decisions. Practice guidelines recommend that patients who have a high-risk of PE-related death and adverse outcomes, determined by the presence of haemodynamic instability (i.e., shock or hypotension), should receive systemically administered thrombolytic therapy. Intermediate-high risk patients might benefit from close observation, and some should undergo escalation of therapy beyond standard anticoagulation, particularly if haemodynamic deterioration occurs...
September 8, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28910912/-percutaneous-catheterization-for-extracorporeal-membrane-oxygenation-a-retrospective-case-series
#12
X Y Li, H Y He, X Tang, R Wang, C Y Zhang, S Q Wang, B Sun, Z H Tong
Objective: To review the experience of percutaneous catheterization for extracorporeal membrane oxygenation (ECMO) by respiratory intensivists at a single institution. Methods: A retrospective review of 87 patients undergoing percutaneous catheterization for ECMO in Department of Respiratory and Critical Care Medicine of Beijing Chaoyang Hospital from November 2009 to January 2017. Subject demographics, type of support, cannulation configuration, types of cannulas, use of imaging modalities, and complications were recorded and summarized...
September 12, 2017: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/28906388/retrospective-cause-analysis-of-troponin-i-elevation-in-non-cad-patients-special-emphasis-on-sepsis
#13
Chien-Wen Yang, Huijun Li, Lisa Thomas, Manuel Ramos, Po-Hong Liu, Thomas Roe, Ravinder Valadri, Michael C Kiel, Vincent Yi-Fong Su, Qi Shi
BACKGROUND: Troponin I is one of the most commonly tested biochemical markers in the emergency room (ER) and in the hospital setting. Besides coronary artery disease (CAD), demand ischemia with underlying tachycardia, anemia, hypertensive emergency, congestive heart failure, kidney disease, sepsis, and pulmonary embolism have also been reported to cause troponin I elevations. Few reports have excluded patients with CAD, and no study has summarized the proportion of these factors relative to an increased troponin I level...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28906373/predictive-value-of-insufficient-contrast-medium-filling-in-pulmonary-veins-in-patients-with-acute-pulmonary-embolism
#14
Hong Zhang, Yanhe Ma, Zhenchun Song, Jun Lv, Yapeng Yang
This study is to investigate the predictive value of insufficient contrast medium filling (ICMF) in patients with acute pulmonary embolism (PE).A total of 108 PE patients were enrolled and divided into group A and group B according to the presence of ICMF. PE index and ventricul araxial lengths were measured. Heart cavity volumes were examined and right ventricle (RV) to left ventricle (LV) diameter ratio (RV/LV(d)) and volume ratio (RV/LV(V)) and right atrium (RA) to left atrium (LA) volume ratio (RA/LA(V)) were calculated and compared...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28906275/vv-ecmo-assisted-high-risk-endobronchial-stenting-as-rescue-for-asphyxiating-mediastinal-mass
#15
Brandon T Nokes, Laszlo Vaszar, Jama Jahanyar, Karen L Swanson
The use of venovenous extracorporeal membrane oxygenation (VV-ECMO) has traditionally been limited to a narrow set of clinical circumstances, such as acute hypoxic respiratory failure, submassive pulmonary embolism, and cardiopulmonary collapse. Within the pediatric population, there have been cases of VV-ECMO in the context of extrinsic airway compression by a mediastinal mass, typically in the setting of either a lymphoma or germ cell tumors. However, the use of VV-ECMO for adults with extrinsic airway compression is comparatively limited...
September 12, 2017: Journal of Bronchology & Interventional Pulmonology
https://www.readbyqxmd.com/read/28904659/-pulmonary-embolism-at-the-university-hospital-campus-of-lome-togo-a-retrospective-study-about-51-cases
#16
Soulemane Pessinaba, Yaovi Dodzi Molba Atti, Soodougoua Baragou, Machihude Pio, Yaovi Afassinou, Mohamed Kpélafia, Edem Goeh-Akué, Findibé Damorou
INTRODUCTION: This study provides an analysis of the evolutionary, clinical and epidemiological aspects of pulmonary embolism at the University Hospital Campus of Lome. METHODS: We conducted a retrospective, analytic and descriptive study over a period of 39 months (November 1 , 2011- January 31, 2015). All the medical records of patients hospitalized for PE in the Department of Cardiology at the University Hospital Campus were analyzed. RESULTS: The prevalence of PE was 3...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28902808/-anticoagulant-therapy-of-venous-thromboembolic-complications-balancing-between-risks
#17
K V Lobastov, S V Sapelkin
This article is a review of the literature, related to the problem of recurrence of venous thromboembolic complications and the possibilities of their secondary prevention. The problems of determining the rational duration of anticoagulant therapy on the basis of an individual assessment of its benefit and risk are considered. The information on modern prognostic models allowing quantitative assessment of the probability of hemorrhagic and thrombotic events occurrence is presented (Vienna prediction model, DASH, HAS-BLED, stratification according to ACCP 2016)...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/28902651/anticoagulant-therapy-for-acute-venous-thromboembolism
#18
Hilal Ermiş, Necip Ermiş
Deep vein thrombosis (DVT) and pulmonary embolism (PE) are currently defined as venous thromboembolism (VTE) since they share pathophysiological features and the treatment is similar in many respects. It has been determined that more than 90% of PE cases originate from DVT in the legs. PE, which is difficult to diagnose, has a mortality rate of 12% when untreated. The worldwide increase in obesity, cancer diseases, and average survival time also contribute to the increase in the incidence of VTE. Traditional treatment of VTE includes heparin, low-molecular-weight heparin, and warfarin...
September 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28902645/-a-rare-cause-of-cyanosis-in-childhood-pulmonary-arteriovenous-malformation
#19
Osman Güvenç, Murat Saygı, İbrahim Halil Demir, Ender Ödemiş
Pulmonary arteriovenous malformation, which is defined as the presence of an ab-normal connection between the pulmonary artery and pulmonary vein, is rarely seen. Although it generally presents as a congenital condition, it may be accompanied by hereditary hemorrhagic telangiectasia. Clinical signs vary according to the amount of shunt in proportion to the number and size of the fistulae. Patients may present with cyanosis and respiratory trouble. If the disease remains untreated, it may result in cardiac failure and ineffective endocarditis, thereby leading to the rupture of the an-eurysmal fistula...
September 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28902590/long-term-outcomes-of-patent-foramen-ovale-closure-or-medical-therapy-after-stroke
#20
Jeffrey L Saver, John D Carroll, David E Thaler, Richard W Smalling, Lee A MacDonald, David S Marks, David L Tirschwell
Background Whether closure of a patent foramen ovale reduces the risk of recurrence of ischemic stroke in patients who have had a cryptogenic ischemic stroke is unknown. Methods In a multicenter, randomized, open-label trial, with blinded adjudication of end-point events, we randomly assigned patients 18 to 60 years of age who had a patent foramen ovale (PFO) and had had a cryptogenic ischemic stroke to undergo closure of the PFO (PFO closure group) or to receive medical therapy alone (aspirin, warfarin, clopidogrel, or aspirin combined with extended-release dipyridamole; medical-therapy group)...
September 14, 2017: New England Journal of Medicine
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