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Massive pulmonary embolism

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https://www.readbyqxmd.com/read/28290856/-chronic-heart-failure-with-preserved-systolic-function-and-reversible-dilatation-of-cardiac-chambers
#1
O V Blagova, S V Volkov, A V Nedostup, A O Korobkov, I V Mostovoy, N G Sergushina, N V Gagarina, E A Mershina
Diagnosis of dilation (D) cardiomyopathy (CMP) requires exclusion not only of inflammatory and genetically determined forms but also of some rare diseases. This 51 year old patient with history of moderate arterial hypertension approached a cardiologist because of new onset atrial fibrillation and dyspnea. Echocardiography detected dilation of all cardiac chambers with relatively preserved ejection fraction, causing suspicion of DCMP. Among conditions excluded were coronary atherosclerosis, congenital heart defect with left to right shunt, primary pulmonary hypertension, pulmonary embolism, hypertensive heart, tachycardia induced CMP, arrhythmogenic right ventricular dysplasia, noncompaction myocardium...
June 2016: Kardiologiia
https://www.readbyqxmd.com/read/28289598/massive-hemoptysis-in-a-patient-with-pulmonary-embolism-a-real-therapeutic-conundrum
#2
Yiolanda Herodotou, Andriana I Papaioannou, Anna Karakatsani, Lazaros Reppas, Effrosyni D Manali, Vasiliki Apollonatou, Ioannis Tomos, Elias Brountzos, Spyros Papiris
Massive Hemoptysis and pulmonary embolism are two very severe and potentially fatal pulmonary emergencies requiring completely different treatments. We present the case of a 45-year old male transmitted to our Hospital for massive hemoptysis who at the same time was found to suffer from pulmonary embolism. Hemoptysis was treated with bronchial artery embolization which resulted in cessation of haemorrhage and allowed the administration of anticoagulant therapy a few days later. This case report gives an answer on how to manage a real therapeutic conundrum which is the coexistence of a massive hemoptysis and a concomitant pulmonary embolism...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28289497/interventional-therapy-for-pulmonary-embolism
#3
Alan B Lumsden, Erik Suarez
Patients with pulmonary embolism (PE) present with highly variable clinical symptoms and often have accompanying comorbidities. Timely diagnosis and treatment are critical to help prevent recurrence and increased morbidity/mortality. While open surgical thrombectomy was once reserved only for those with massive PE and hemodynamic compromise, it has been reevaluated with a focus on careful patient selection and early intervention. Lately, there has been increased interest in catheter-based interventions and in combining these with an open surgical component to decrease the magnitude of the intervention-for example, direct placement of large-bore thrombectomy devices directly into the right ventricle via sternotomy or subxiphoid approaches...
October 2016: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/28265125/pulmonary-embolism-the-astute-interventional-radiology-clinician
#4
REVIEW
Akhilesh K Sista
There has been a resurgence of interest in defining the optimal treatment for severe pulmonary embolism (PE), fueled by pivotal and provocative trials, new catheter-based medical devices, and growing evidence of deleterious short- and long-term outcomes. In this environment, and especially given the multidisciplinary nature of PE care, the interventional radiologist (IR) needs to become an astute, disease-specific expert. This review article describes the following "steps" an IR can take to reach this level: (1) understand PE stratification and epidemiology; (2) recognize the treatment goals for massive PE; (3) recognize the wide range of attitudes toward therapeutic escalation for submassive PE; (4) recognize what we do not know about the treatment of submassive PE and the limitations of current studies; (5) know the literature surrounding inferior vena cava filter insertion for severe PE; (6) integrate into the longitudinal care of the patient; and (7) be at the leading edge of new trials and technologies...
March 2017: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/28250929/ambiguous-presentation-of-mycobacterium-avium-complex-associated-rasmussen-aneurysm
#5
Hsin-Wei Chiu, Shu-Hung Kuo, Ruay-Sheng Lai, Ming-Ting Wu, Hsiu-Fu Wu
A 77-year-old man with a progressively dry cough (two months duration) was admitted with hemoptysis. Chest computed tomography (CT) revealed left lingular lobe consolidation and one thick-walled cavity lesion over the left lower lobe, which was accompanied by satellite micro-nodules in a tree-in-bud pattern. CT-guided biopsy confirmed mycobacterial infection, and subsequent culture yielded Mycobacterium avium complex (MAC). Unremitting hemoptysis was present despite treatment (14 days) with ethambutol, rifampin, clarithromycin, and streptomycin...
May 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28248851/acute-kidney-injury-in-patients-with-pulmonary-embolism-a-population-based-cohort-study
#6
Chih-Hsiang Chang, Chung-Ming Fu, Pei-Chun Fan, Shao-Wei Chen, Su-Wei Chang, Chun-Tai Mao, Ya-Chung Tian, Yung-Chang Chen, Pao-Hsien Chu, Tien-Hsing Chen
Acute kidney injury (AKI) is overlooked in patients with pulmonary embolism (PE). Risk factors for and long-term outcomes of this complication remain unknown. This study evaluated the predictors and prognosis of AKI in patients with PE.This retrospective cohort study used Taiwan's National Health Insurance Research Database. We enrolled a total of 7588 patients who were admitted to a hospital for PE from January1997 to December 2011 and administered anticoagulation or thrombolytic agents. All demographic data, risk factors, and outcomes were analyzed...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28246560/saddle-pulmonary-embolism-with-thrombus-in-transit-across-a-patent-foramen-ovale
#7
Fitzgerald Shepherd, Ashley White-Stern, Oloruntobi Rahaman, Damian Kurian, Karen Simon
This is the case of a 25-year-old obese man who presented with acute shortness of breath, chest pain, and palpitations. Of note, he lives a sedentary lifestyle and was recently hospitalized for incision and drainage of a left foot abscess. On presentation he was tachypnoeic, tachycardiac, and hypoxic but blood pressure was stable. Laboratory studies were significant for elevated D-dimer and mildly increased troponin. On further investigation he was found to have a saddle pulmonary embolism with massive clot burden...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28243013/early-ultrasonographic-detection-of-massive-pulmonary-embolism
#8
Sandra Milena Carvajal, Fredy Ariza, David Andrés De Paz, Dario Alberto Castaño
No abstract text is available yet for this article.
January 2017: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/28239036/short-term-subcutaneous-fondaparinux-and-oral-edoxaban-for-acute-venous-thromboembolism
#9
Shinji Hisatake, Takayuki Kabuki, Shunsuke Kiuchi, Takashi Oka, Shintaro Dobashi, Takahiro Fujii, Yoshihiro Iwasaki, Takanori Ikeda
BACKGROUND: No studies have compared treatment efficacy between subcutaneous (SC) fondaparinux and oral edoxaban, which are categorized as factor Xa inhibitors, for venous thromboembolism (VTE) in the acute phase, and only a limited number of imaging-based quantitative studies have evaluated treatment.Methods and Results:In this open-label, randomized study, 50 patients with acute non-massive pulmonary embolism (PE) and/or deep-vein thrombosis (DVT) were assigned to fondaparinux or edoxaban groups...
February 25, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28231684/emergency-peripartum-hysterectomy-a-challenge-or-an-obstetrical-defeat
#10
(no author information available yet)
OBJECTIVES: Peripartum hysterectomy remains an obstetric nightmare. Most obstetricians consider it a defeat. The aim of our study was to assess the prevalence, indications, procedures and complications of emergency peripartum hysterectomy (EPH) in the 2nd Department of Obstetrics & Gynecology, Medical University of Warsaw during a 7 year period (2007-2013). METHODS: A retrospective evaluation of 21,144 deliveries was performed. We analyzed all cases of EPH, including the maternal characteristics, obstetrical history, course of pregnancy and delivery, type of surgery and complications...
October 24, 2016: Neuro Endocrinology Letters
https://www.readbyqxmd.com/read/28214153/arrhythmogenic-right-ventricular-dysplasia-atypical-clinical-presentation
#11
José Marçalo, Luiz Menezes Falcão
A 67-year-old man was admitted to our hospital after episodes of syncope preceded by malaise and diffuse neck and chest discomfort. No family history of cardiac disease was reported. Laboratory workup was within normal limits, including D-dimers, serum troponin I and arterial blood gases. The electrocardiogram showed sinus rhythm with T-wave inversion in leads V1 to V3. Computed tomography angiography to investigate pulmonary embolism showed no abnormal findings. Transthoracic echocardiography (TTE) displayed massive enlargement of the right ventricle with intact interatrial septum and no pulmonary hypertension...
March 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/28209484/successful-provision-of-inter-hospital-extracorporeal-cardiopulmonary-resuscitation-for-acute-post-partum-pulmonary-embolism
#12
C McDonald, J Laurie, S Janssens, C Zazulak, P Kotze, K Shekar
Mortality during pregnancy in a well-resourced setting is rare, but acute pulmonary embolism is one of the leading causes. We present the successful use of extracorporeal cardiopulmonary resuscitation (eCPR) in a 22-year old woman who experienced cardiopulmonary collapse following urgent caesarean section in the setting of a sub-massive pulmonary embolus. Resources and personnel to perform eCPR were not available at the maternity hospital and were recruited from an adjacent pediatric hospital. Initial care used low blood flow extracorporeal membrane oxygenation (ECMO) with pediatric ECMO circuitry, which was optimized when the team from a nearby adult cardiac hospital arrived...
January 9, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28208201/catheter-based-approaches-for-the-treatment-of-acute-pulmonary-embolism
#13
Victor F Tapson, David Jimenez
Except when contraindicated, anticoagulation should be initiated when pulmonary embolism (PE) is strongly suspected and the bleeding risk is perceived to be low, even if the evaluation has not been completed. Low-risk patients with acute PE are simply continued on anticoagulation. Severely ill patients with high-risk (massive) PE require aggressive therapy, and if the bleeding risk is acceptable, systemic thrombolysis should be considered. However, despite clear evidence that parenteral thrombolytic therapy leads to more rapid clot resolution than anticoagulation alone, the risk of major bleeding including intracranial bleeding is significantly higher with thrombolytic therapy...
February 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28208200/massive-pulmonary-embolism-extracorporeal-membrane-oxygenation-and-surgical-pulmonary-embolectomy
#14
Aaron Weinberg, Victor F Tapson, Danny Ramzy
Massive pulmonary embolism (PE) refers to large emboli that cause hemodynamic instability, right ventricular failure, and circulatory collapse. According to the 2016 ACCP Antithrombotic Guidelines, therapy for massive PE should include systemic thrombolytic therapy in conjunction with anticoagulation and supportive care. However, in patients with a contraindication to systemic thrombolytics or in those who fail the above interventions, extracorporeal membrane oxygenation (ECMO) and/or surgical embolectomy may be used to improve oxygenation, achieve hemodynamic stability, and successfully treat massive PE...
February 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28208199/systemic-thrombolytic-therapy-for-acute-pulmonary-embolism-who-is-a-candidate
#15
Stavros V Konstantinides, Stefano Barco
Pulmonary embolism (PE) is a major cause of both acute and long-term morbidity for a large number of patients worldwide, and massive PE is frequently fatal. Right ventricular (RV) dysfunction is a key determinant of prognosis in the acute phase of PE. Patients with clinically overt RV failure, that is, with cardiogenic shock or persistent hypotension at presentation (acute high-risk PE), are clearly in need of immediate reperfusion treatment with systemic thrombolysis or, alternatively, surgical or catheter-directed techniques...
February 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28208195/echocardiography-in-the-risk-assessment-of-acute-pulmonary-embolism
#16
Talal Dahhan, Fawaz Alenezi, Zainab Samad, Sudarshan Rajagopal
Acute pulmonary embolism (PE) is a major cause of morbidity and mortality and is classified as massive (high risk), submassive (intermediate risk), or nonmassive (low risk) based on the hemodynamic status and clinical characteristics of the patient. At this time, the management of patients with submassive PE remains controversial and approaches for improving risk assessment are critical. In this review, we discuss several echocardiographic methods to assess right heart function that may aid in the risk assessment of patients with acute PE...
February 2017: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28206731/thrombus-resolution-and-right-ventricular-functional-recovery-using-ultrasound-accelerated-thrombolysis-in-acute-massive-and-submassive-pulmonary-embolism
#17
Evren Ozcinar, Mehmet Cakici, Nur Dikmen Yaman, Cagdas Baran, Anar Aliyev, Bahadir Inan, Serkan Durdu, Ahmet R Akar, Mustafa Sirlak
BACKGROUND: This study aims to evaluate the efficacy and safety of ultrasound-accelerated catheter- directed thrombolysis (UACDT) in the treatment of massive and submassive pulmonary embolism (PE). METHODS: We conducted a prospective, observational cohort study of consequtive patients with massive or submassive PE treated with low-dose UACDT using EKOS EkoSonic® system at single center from May 2014 until April 2015. Overall, thirty-eight patients (median age, 64...
February 15, 2017: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/28179706/massive-pulmonary-embolism-presenting-as-seizures
#18
Shahrukh Hashmani, Fateh Ali Tipoo Sultan, Murtaza Kazmi, Ammarah Yasmeen
Pulmonary embolism can present in various ways, though seizure activity has been rarely reported. We report a 38 years old male who had met a road traffic accident, underwent surgery, presented a month later with seizures, chest pain, shortness of breath and low blood pressure. Massive pulmonary embolism was diagnosed on CTPA, with classical features on ECG and echocardiogram and the patient was successfully managed with thrombolysis. Massive pulmonary embolism (MPE) should be kept in mind in patients who present with seizures, chest pain and haemodynamic instability...
December 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28168038/echocardiography-for-patients-undergoing-extracorporeal-cardiopulmonary-resuscitation-a-primer-for-intensive-care-physicians
#19
REVIEW
Zhongheng Zhang
Echocardiography is an invaluable tool in the management of patients with extracorporeal cardiopulmonary resuscitation (ECPR) and subsequent extracorporeal membrane oxygenation (ECMO) support and weaning. At the very beginning, echocardiography can identify the etiology of cardiac arrest, such as massive pulmonary embolism and cardiac tamponade. Eliminating these culprits saves life and may avoid the initiation of extracorporeal cardiopulmonary resuscitation. If the underlying causes are not identified or intrinsic to the heart (e...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28166077/a-rare-case-of-bilateral-aspergillomas-in-a-patient-of-ankylosing-spondylitis
#20
A Das, S Pandit, S K Das, S Basuthakur, S Das
Pulmonary involvement by Aspergillus sp. mainly includes allergic bronchopulmonary aspergillosis, aspergilloma, and invasive aspergillosis. Aspergilloma (Fungal ball) is the most common form of aspergillous pulmonary involvement, which occurs in preexisting pulmonary cavities, especially secondary to pulmonary tuberculosis. Ankylosing spondylitis is a rare cause of upper lobe fibro-cavitary lesions in pulmonary parenchyma. It may also lead to development of fungal balls in pulmonary cavities. Most common presentation is mild to massive hemoptysis; dyspnoea, chronic cough, expectoration may be other presentation; even the patient may remain asymptomatic...
April 2016: Kathmandu University Medical Journal (KUMJ)
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