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Massive pulmonary embolism

Antonio Borzelli, Andrea Paladini, Francesco Giurazza, Salvatore Tecame, Flavio Giordano, Enrico Cavaglià, Francesco Amodio, Fabio Corvino, Daniela Beomonte Zobel, Giulia Frauenfelder, Anna Giacoma Tucci, Raffaella Niola
Pulmonary sequestration is a congenital malformation characterized by dysplastic pulmonary tissue which receives blood supply by arterial systemic system, not in communication with tracheobronchial tree. Although it could be asymptomatic, it can also cause recurrent infections and hemoptysis, rarely massive and fatal. The conventional treatment consists in surgical resection of the pulmonary sequestration, but in the last few years endovascular embolization has been proposed as a valid therapeutic alternative...
February 2018: Radiology Case Reports
Hu-Lin Christina Wang, Jia-Hao Zhang, Cheng-Hung How
BACKGROUND: Pulmonary arteriovenous malformations are rare vascular abnormalities that permit direct communication between the pulmonary artery and vein. During pregnancy, pulmonary arteriovenous malformation carries an increased risk of enlargement and rupture, which could lead to life-threatening hemothorax. This is the first case reporting successful thoracoscopic surgery for a pregnant woman with pulmonary arteriovenous malformation rupture-related hemothorax. CASE PRESENTATION: We present a case of a 32-year-old pregnant Asian woman (31 weeks' gestation) whose pulmonary arteriovenous malformation ruptured, leading to right-sided spontaneous tension hemothorax...
March 19, 2018: Journal of Medical Case Reports
Yu Meng, FangGen Lu, Lin Shi, MeiChu Cheng, Jie Zhang
RATIONALE: The use of anticoagulants is a contributor to gastrointestinal (GI) bleeding. Most bleeding patients on anticoagulant therapy such as warfarin commonly have basic lesions existing in their GI mucosa. PATIENT CONCERNS: We report a case of major GI bleeding following the use of anticoagulants in a patient with hookworm infection. DIAGNOSES: The patient was diagnosed with nephrotic syndrome with pulmonary embolism. INTERVENTIONS: He was treated with anticoagulants and suffered from acute major GI bleeding during the treatment...
March 2018: Medicine (Baltimore)
Mahir Elder, Nimrod Blank, Amir Kaki, M Chadi Alraies, Cindy L Grines, Marvin Kajy, Reema Hasan, Tamam Mohamad, Theodore Schreiber
BACKGROUND: Right ventricular (RV) failure due to pulmonary embolism (PE) increases morbidity and mortality and contributes to prolonged hospital length of stay and higher costs of care. RV mechanical circulatory support (MCS) including Impella RP devices have been increasingly used in hemodynamically compromised PE patients who are refractory to intravascular volume expansion and inotropic therapy. However, effectiveness and safety of Impella RP, in hemodynamically unstable PE patients is unknown...
March 7, 2018: Journal of Interventional Cardiology
Ali Çoner, Davran Çiçek, Serhat Balcıoğlu, Sinan Akıncı, Haldun Müderrisoğlu
Unexpected and unexplained out-of-hospital cardiac arrests have a poor prognosis. Difficulties encountered during the differential diagnosis phase may delay the administration of specific treatment for treatable and reversible causes of cardiac arrest. Massive pulmonary embolism is a reversible cause of cardiac arrest, but without proper management it has a high mortality rate. Presently described is the case of a 53-year-old female patient with a massive pulmonary embolism.
March 2018: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
Ayako Kukida, Yasushi Takasaki, Mio Nakata, Tasuku Nishihara, Sakiko Kitamura, Sonoko Fujii, Yuji Watanabe, Toshihiro Yorozuya
RATIONALE: Although an inferior vena cave (IVC) filter is placed to prevent fatal pulmonary embolism (PE), several complications associated with an IVC filter have been reported. We describe a case with symptomatic PE, of which the origin was an occlusive IVC thrombus that developed from the placement of an IVC filer after a laparoscopy-assisted total gastrectomy (LATG). PATIENT CONCERNS: A 71-year-old man underwent LATG under general anesthesia alone. He had an IVC filter implanted 13 years ago...
January 2018: Medicine (Baltimore)
Yongzheng Wang, Haiyang Chang, Wujie Wang, Wei Wang, Bin Liu, Zheng Li, Yuliang Li
RATIONALE: Pulmonary embolization is a life-threatening condition. The deployment of inferior vena cava (IVC) filter is the first choice for preventing embolus from the lower extremity. However, IVC filter complications are rare but not to be neglected. Penetration of the arterial wall may result in catastrophic damages. This case report describes a woman who suffered from retroperitoneal hemorrhage after placement of an IVC filter due to a pulmonary embolization. Her filter was found to have penetrated the right lumbar artery and caused the massive bleeding...
January 2018: Medicine (Baltimore)
Mazen S Albaghdadi, David M Dudzinski, Nicholas Giordano, Christopher Kabrhel, Brian Ghoshhajra, Michael R Jaff, Ido Weinberg, Aaron Baggish
BACKGROUND: Little data exist regarding the functional capacity of patients following acute pulmonary embolism. We sought to characterize the natural history of symptom burden, right ventricular (RV) structure and function, and exercise capacity among survivors of massive and submassive pulmonary embolism. METHODS AND RESULTS: Survivors of submassive or massive pulmonary embolism (n=20, age 57±13.3 years, 8/20 female) underwent clinical evaluation, transthoracic echocardiography, and cardiopulmonary exercise testing at 1 and 6 months following hospital discharge...
March 3, 2018: Journal of the American Heart Association
Maria Roberto, Vadim Meytes, Shinban Liu
Polyarteritis nodosa (PAN) is an inflammatory vasculitis that creates regions of stenosis and aneurysm formation. The authors describe a 66-year-old female with hepatic artery rupture as the first presentation of undiagnosed PAN, presenting with abdominal pain followed by hemorrhagic shock. This aneurysm was suture ligated with a successful outcome. A mesenteric arteriogram demonstrated lesions consistent with PAN including aneurysms of the left gastric branches, right and left hepatic arteries, and beaded appearance of the iliac artery...
February 2018: Oxford Medical Case Reports
Danica Cvetković, Vladimir Živković, Slobodan Nikolić
A 75-year-old woman was admitted to the emergency room with chest pain and vomiting. An electrocardiogram and laboratory results were suggestive for myocardial infarction of the posterior cardiac wall. Echocardiography was indicative of aortic dissection, and a CT scan of the thoracic arteries showed a massive pulmonary thromboembolism and thrombotic occlusion of the right coronary artery (RCA). The woman died shortly after admission. Autopsy confirmed the presence of thromboemboli in the right pulmonary artery and its lobar branches...
February 27, 2018: Forensic Science, Medicine, and Pathology
Steve M Nelson, Steven H Craig
Pulmonary embolism is a life-threatening condition treated with anticoagulation and systemic thrombolysis when appropriate. In patients with contraindications to thrombolysis, catheter-directed thrombolysis may be considered. Here, we present a patient with massive pulmonary embolus and 3 contraindications to systemic thrombolysis who was successfully treated with pharmacomechanical thrombolysis using the Ekosonic Endovascular System.
February 2018: Radiology Case Reports
Hardik S Sheth, Fabien Maldonado, Robert J Lentz
RATIONALE: Dieulafoy lesions are aberrantly large submucosal arteries most frequently associated with gastrointestinal hemorrhage. They are rarely identified in the bronchial submucosa and can cause massive hemoptysis. PATIENT CONCERNS: We present three episodes of massive hemoptysis in two patients, the first with comorbid Alagille syndrome including multiple cardiac and pulmonary vascular abnormalities and the second with thyroid cancer metastatic to the mediastinum...
February 2018: Medicine (Baltimore)
Sreelakshmi P Leeladharan, Jessin P Jayashankar, Brijesh P Kottayil, Mahesh Kappanayil, Krishnakumar Raman, Rakhi Balachandran
We report a neonate with transposition of great arteries and intact ventricular septum who had a massive pulmonary hemorrhage soon after an arterial switch operation. An emergency cardiac catheterization revealed a large bronchial collateral artery from the descending aorta feeding the right lung. The hemorrhage was controlled by coil embolization of the collateral, and the patient recovered after prolonged intensive care.
March 2018: Annals of Thoracic Surgery
Chetan Pasrija, Anthony Kronfli, Michael Rouse, Maxwell Raithel, Gregory J Bittle, Sheelagh Pousatis, Mehrdad Ghoreishi, James S Gammie, Bartley P Griffith, Pablo G Sanchez, Zachary N Kon
OBJECTIVES: Ideal treatment strategies for submassive and massive pulmonary embolism remain unclear. Recent reports of surgical pulmonary embolectomy have demonstrated improved outcomes, but surgical technique and postoperative outcomes continue to be refined. The aim of this study is to describe in-hospital survival and right ventricular function after surgical pulmonary embolectomy for submassive and massive pulmonary embolism with excessive predicted mortality (≥5%). METHODS: All patients undergoing surgical pulmonary embolectomy (2011-2015) were retrospectively reviewed...
March 2018: Journal of Thoracic and Cardiovascular Surgery
Burr Fong, Daniel Novak, Michael Dalley, Gregory Alfred
BACKGROUND: Deep vein thrombosis (DVT) is a common disease that is diagnosed in approximately 1 in 1000 adults annually. Extensive DVT can lead to life- or limb-threatening diagnoses such as phlegmasia cerulea dolens (PCD), phlegmasia alba dolens, and venous gangrene. PCD, also known as massive iliofemoral venous thrombosis, is rare, and a severe complication of DVT. CASE REPORT: We report a case of a 94-year-old bedridden woman with past medical history of dementia, hypertension, pulmonary embolism, DVT, and atrial fibrillation...
February 12, 2018: Journal of Emergency Medicine
Stjepan Hmelik, Margareta Dobrenić, Dražen Huić
Pulmonary artery sarcomas (PAS's) are extremely rare malignant tumors that arise from the endothelial lining of the pulmonary arteries. On CT scans PAS's appear as intraluminal filling defects in the pulmonary arteries, mimicking pulmonary embolism (PE). Due to the similarities in radiographic features as well as in clinical presentation, PAS's are usually misdiagnosed as pulmonary embolism. Since PASs are F-18 FDG avid, F-18 FDG PET/CT scan is a useful imaging tool for differentiating between these two conditions, as shown in this case report...
2018: Nuclear Medicine Review. Central & Eastern Europe
Cynthia Wong
A 47-year-old woman presented to her GP (general practitioner) surgery with a left leg pain of 4 days duration after a recent 4-hour flight. She was taking the oral combined contraceptive pill and had no past medical history. She had a low predictive Wells score for deep vein thrombosis, but her D-dimer was positive, so she had a proximal lower limb vein ultrasound scan as per the National Institute for Clinical Excellence guidelines, which was negative. Two days later, she presented to the emergency department with a collapse and dyspnea...
January 2018: Journal of Investigative Medicine High Impact Case Reports
Savaş Sedat Özsu, Zerrin Gürel Durmuş, Mustafa Buğra Coşkuner, Yılmaz Bülbül, Funda Öztuna, Tevfik Özlü
OBJECTIVES: In the last 20 years, with the use of computed tomography (CT) angiography, the number of patients diagnosed with pulmonary thromboembolism (PTE) has increased. At the same time, data show that pulmonary embolism mortality has also reduced in this duration. MATERIAL AND METHODS: In this study, we analyzed records of patients with PTE (using ICD's) in the hospital automation system from 2001 to 2013. Data regarding age, sex, date of diagnosis, diagnosis of cancer, hemodynamic status, initial and maintenance treatment, hospital length of stay, and hospital mortality were recorded...
July 2017: Turkish Thoracic Journal
Sailen G Naidu, Martha-Gracia Knuttinen, J Scott Kriegshauser, William G Eversman, Rahmi Oklu
Pulmonary embolism (PE) is a widespread health concern associated with major morbidity and mortality. Catheter directed therapy (CDT) has emerged as a treatment option for acute PE adding to the current potential options of systemic thrombolysis or anticoagulation. The purpose of this review is to understand the rationale and indications for CDT in patients with PE. While numerous studies have shown the benefits of systemic thrombolysis compared to standard anticoagulation, these are balanced by the increased risk of major bleeding...
December 2017: Cardiovascular Diagnosis and Therapy
Naiem Nassiri, Lauren A Huntress, Mitchell Simon, Susan Murphy
OBJECTIVE: No standardized therapeutic algorithm or embolic agent of choice has yet been identified for management of congenital peripheral venous malformations (VMs). Treatment options and reported outcomes therefore vary widely. Herein, we present an institution-wide algorithm for management of symptomatic congenital peripheral VMs using a single embolotherapeutic modality. METHODS: During 36 months, patients with symptomatic congenital peripheral VMs underwent contrast-enhanced magnetic resonance imaging...
January 29, 2018: Journal of Vascular Surgery. Venous and Lymphatic Disorders
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