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Pulmonary emboli

Zenpei Kano, Sagano Onoyama, Moeri Tsuji, Junichiro Tezuka, Kenji Furuno
No abstract text is available yet for this article.
June 20, 2018: Pediatrics International: Official Journal of the Japan Pediatric Society
Vy T Ho, Kara A Rothenberg, Graeme McFarland, Kenneth Tran, Oliver O Aalami
BACKGROUND: We report the case of a 90-year old woman who presented with septic pulmonary emboli due to suppurative thrombophlebitis at an old peripheral intravenous site. METHODS: After unsuccessful treatment with antibiotics, the patient was taken to the operating room for excision and drainage of the purulent superficial vein. RESULTS: We review the literature and discuss the presentation, risk factors, treatment options, and complications of this often-overlooked disease entity...
January 1, 2018: Vascular and Endovascular Surgery
J Mason DePasse, Wesley Durand, Adam E M Eltorai, Mark A Palumbo, Alan H Daniels
Study design: Retrospective cohort study. Objective: To characterize the timing of complications after posterior cervical fusion. Summary of background data: Understanding the expected timing of postoperative complications facilitates early diagnosis of potential adverse events and is important for optimizing postoperative care. Though studies have examined the incidence of complications after posterior cervical fusion, no study has characterized the timing of these complications...
June 2018: Journal of Orthopaedics
Mukremin Er
Anticoagulants are the standard form of treatment used in deep vein thrombosis (DVT). Thrombolytic therapy is another method to treat thromboembolism by using intravenous administration of streptokinase, urokinase and recombinant tissue plasminogen activator (r-tPA). We have investigated the effect of r-tPA, a systemic thrombolytic used for the treatment of pulmonary emboli, on DVT in the same patients. 130 patients who were diagnosed with both pulmonary embolism and DVT were included in this study. Lower extremity Doppler ultrasonography (DUS) was conducted on all of the patients upon admission and then on the 6th month...
June 6, 2018: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
Christian Andres Inchaustegui, Kevin Yuqi Wang, Oluwadamilola Teniola, Veronica Lenge De Rosen
Large septic pulmonary embolus is a rare finding in right-sided endocarditis. The entity represents a challenging diagnosis due to its variable and nonspecific clinical and radiological presentation and similarities with other conditions. We present a case of a 41 year-old woman who developed a large main pulmonary artery embolus and bilateral cavitary lung nodules in the setting of severe sepsis. Pulmonary artery exploration and clot retrieval ultimately revealed a large septic embolus from Streptococcus mutans native pulmonary valve endocarditis...
February 2018: Journal of Radiology Case Reports
J Lauren Lindsey, Rajay Jain, Vidula Vachharajani
This case report discusses a previously healthy young male who suffered an in hospital cardiac arrest, found to be secondary to massive pulmonary emboli (PE). This patient was not a candidate for PE dosing of tPA, but continued to have worsening cardiogenic shock and acute hypoxic respiratory failure. The decision was made to initiate venoarterial extracorporeal membrane oxygenation (VA ECMO) in combination with catheter assisted thrombolysis. With time, the sequelae of his disease process changed. Although his cardiogenic shock improved, the hypoxemia worsened, and the patient was transitioned from VA to venovenous (VV) ECMO, while managing further complications due to multiple episodes of cardiac arrest and severe coagulopathy with multiple, acute, life-threatening bleeding events...
2018: Respiratory Medicine Case Reports
Tayoot Chengsupanimit, Baskaran Sundaram, Wayne Bond Lau, Scott W Keith, Gregory C Kane
BACKGROUND: Pulmonary infarction is an infrequent complication of pulmonary embolism. Traditionally, it has been regarded as a sign of worse outcome because ischemia can only occur by the simultaneous failure of all oxygenation sources to the area of infarct, but supporting evidence is limited. METHODS: We identified 74 cases of pulmonary infarction over 5 years at a single academic center via review of radiographic reports. Contrast-enhanced chest CT scans were examined to confirm evidence of pulmonary infarction, and patient clinical characteristics and imaging results were studied...
June 2018: Respiratory Medicine
Himaja Koneru, Sreeja Biswas Roy, Monirul Islam, Hesham Abdelrazek, Debabrata Bandyopadhyay, Nikhil Madan, Pradnya D Patil, Tanmay S Panchabhai
Pulmonary artery pseudoaneurysm (PAPA), an uncommon complication of pyogenic bacterial and fungal infections and related septic emboli, is associated with high mortality. The pulmonary artery (PA) lacks an adventitial wall; therefore, repeated endovascular seeding of the PA with septic emboli creates saccular dilations that are more likely to rupture than systemic arterial aneurysms. The most common clinical presentation of PAPA is massive hemoptysis and resultant worsening hypoxemia. Computed tomography angiography is the preferred diagnostic modality for PAPA; typical imaging patterns include focal outpouchings of contrast adjacent to a branch of the PA following the same contrast density as the PA in all phases of the study...
2018: Case Reports in Pulmonology
Jessica Andrusaitis, Mohammad Helmy, Christopher E McCoy, Wirachin Hoonpongsimanont, Bharath Chakravarthy, Shahram Lotfipour
Massive and submassive pulmonary emboli (PE) are rare but potentially life-threatening medical conditions that necessitate immediate recognition and appropriate treatment. We report a 52-year-old man who was found to have a submassive central saddle and extensive bilateral PEs after experiencing a syncopal event and who had evidence of right heart strain and pulmonary hypertension. He was subsequently treated with catheter-assisted thrombectomy and pulmonary artery tissue plasminogen activator administration...
February 2018: Clinical practice and cases in emergency medicine
Mette Sørensen Resen, Mai Bang Poulsen, Karsten Overgaard, Rune Skovgaard Rasmussen, Anne Merete Boas Soja, Brian Nilsson, Mariana Obreja Kristensen, Christina Kruuse, Peter Sommer Ulriksen
Objective Transoesophageal echocardiography (TEE) is the gold standard for the detection of cardiac emboli sources in ischaemic stroke patients, but new computed tomography (CT) scanners are able to visualize the heart. This pilot study aimed to compare findings on TEE with combined cardiovascular scan and cerebral CT angiography in cryptogenic ischaemic stroke patients. Methods This pilot study enrolled patients with cryptogenic ischaemic stroke who underwent a combined cardiovascular and cerebral CT angiography scan and a TEE examination, which were interpreted in a blinded manner...
January 1, 2018: Journal of International Medical Research
Coralie Blanche, Rafael Alonso-Gonzalez, Aitor Uribarri, Aleksander Kempny, Lorna Swan, Laura Price, Stephen J Wort, Maurice Beghetti, Konstantinos Dimopoulos
BACKGROUND: Secondary erythrocytosis is common in patients with cyanosis secondary to congenital heart disease (CHD) and/or pulmonary hypertension (PH). This compensatory mechanism aims at increasing oxygen delivery to the tissues, but it requires adequate iron stores. Optimal methods of iron supplementation in this setting remain controversial, with fears of excessive erythropoiesis and hyperviscosity symptoms. We describe our experience using intravenous ferrous carboxymaltose. METHODS AND RESULTS: 142 consecutive cyanotic patients were treated over 5...
May 19, 2018: International Journal of Cardiology
Asadullah Naqvi, Derrick Clarence
Background: The case reinforces the importance of stepping back and looking at every possibility along with multiple co-existing pathologies. It takes into account the thought process of multiple systems and a multidisciplinary team approach. Learning points to take are that decompression illness can present atypically, but one must exclude other causes. Case presentation: We present the case of a 42-year-old male from the West Midlands, UK, who attended the emergency department post-scuba diving with confusion, light-headedness, left arm weakness, and bilateral paraesthesia of the hands...
2018: Journal of Intensive Care
Adam N Protos, Jaimin R Trivedi, William M Whited, Michael P Rogers, Ugochukwu Owolabi, Kendra J Grubb, Kristen Sell-Dottin, Mark S Slaughter
BACKGROUND: Optimal surgical treatment of infective tricuspid endocarditis is debatable, especially in the setting of inherent social and pathologic concerns. This study seeks to compare tricuspid valve repair, replacement, and excision for the treatment of infective endocarditis METHODS: A single center cardiac surgery database was queried between 2012 and 2016 to identify patients >18 years who underwent tricuspid valve surgery for infective endocarditis. Patients were divided into 3 groups based on the type of tricuspid valve surgery: valvectomy, repair, or replacement and evaluated to identify differences between the pre-op factors and outcomes including mortality, length of stay, and complications...
May 16, 2018: Annals of Thoracic Surgery
Menno V Huisman, Stefano Barco, Suzanne C Cannegieter, Gregoire Le Gal, Stavros V Konstantinides, Pieter H Reitsma, Marc Rodger, Anton Vonk Noordegraaf, Frederikus A Klok
Pulmonary embolism (PE) is caused by emboli, which have originated from venous thrombi, travelling to and occluding the arteries of the lung. PE is the most dangerous form of venous thromboembolism, and undiagnosed or untreated PE can be fatal. Acute PE is associated with right ventricular dysfunction, which can lead to arrhythmia, haemodynamic collapse and shock. Furthermore, individuals who survive PE can develop post-PE syndrome, which is characterized by chronic thrombotic remains in the pulmonary arteries, persistent right ventricular dysfunction, decreased quality of life and/or chronic functional limitations...
May 17, 2018: Nature Reviews. Disease Primers
Laura Varela Barca, Jose López-Menéndez, Ana Redondo Palacios, Jorge Rodríguez-Roda Stuart
The case is reported of a 55 year-old woman, with a previously known congenital septal defect, who was admitted to the emergency department with a diagnosis of meningoencephalitis, septic shock, and rapid clinical deterioration. Echocardiography revealed a vegetation occupying the right-side heart. Endocarditis affectation of the septal defect, aortic and tricuspid valves was noted and blood cultures were positive for Staphylococcus aureus. Urgent surgical treatment was performed whereby the ventricular septal defect was closed, a meticulous debridement of the affected area was conducted, and the aortic and tricuspid valves were replaced...
September 2017: Journal of Heart Valve Disease
Ankita Baidya, Vanishri Ganakumar, Ranveer S Jadon, Piyush Ranjan, Smita Manchanda, Rita Sood
Septic pulmonary emboli can occur as a complication of many diseases, most common being right sided infective endocarditis. Septic emboli through a peripheral venous cannula are rarely reported in literature though central venous catheter is commonly implicated. We describe a case of widespread cellulitis and septic pulmonary emboli as a complication of peripheral venous cannulation.
2018: Drug Discoveries & Therapeutics
Donna May Kimmaliardjuk, Carole Dennie, Sean Dickie, Eric C Belanger, Fraser Rubens
A 29-year-old male with chronic pulmonary emboli presented to hospital with progressive pleuritic chest pain. He was in acute right ventricular failure, and thus underwent intra-pulmonary arterial tissue plasminogen (tPA). He developed massive hemoptysis requiring emergent thromboendarterectomy. A clot was visualized in the main left pulmonary artery which had formed a bronchovascular fistula into the left upper lobe bronchus. Pathology of the clot revealed fibrinopurulent exudate and Gram-positive cocci. The left pulmonary artery was repaired with a pericardial patch, and the left upper lobe was oversewn with subsequent left upper lobectomy...
May 5, 2018: Annals of Thoracic Surgery
Frances Rickard, Catherine Hyams, Andrew T Low
A 70-year-old man presented with breathlessness, cough and fever while receiving pembrolizumab for melanoma. A CT pulmonary angiogram demonstrated small bilateral upper lobe segmental pulmonary emboli with patchy ground-glass opacities and basal perilobular consolidation, in keeping with organising pneumonia. He was treated for community-acquired pneumonia and pulmonary emboli but rapidly deteriorated, with increasing hypoxia and dyspnoea. He was admitted to the intensive care unit for support with continuous positive airway pressure and high flow nasal oxygen...
May 7, 2018: BMJ Case Reports
Jose Manuel Fernando Ignacio, Katrina Hannah Dizon Ignacio
Pulmonary cement embolism (PCE) can follow cement augmentation procedures for spine fractures due to osteoporosis, traumatic injuries, and painful metastatic lesions. PCE is underreported and it is likely that many cases remain undiagnosed. Risk factors for PCE have been identified, which can help alert clinicians to patients likely to develop the condition, and there are recommended techniques to reduce its incidence. Most patients with PCE are asymptomatic or only develop transient symptoms, although a few may exhibit florid cardiorespiratory manifestations which can ultimately be fatal...
April 2018: Asian Spine Journal
Daniel Garcia Párraga, Michael Moore, Andreas Fahlman
Hydrostatic lung compression in diving marine mammals, with collapsing alveoli blocking gas exchange at depth, has been the main theoretical basis for limiting N2 uptake and avoiding gas emboli (GE) as they ascend. However, studies of beached and bycaught cetaceans and sea turtles imply that air-breathing marine vertebrates may, under unusual circumstances, develop GE that result in decompression sickness (DCS) symptoms. Theoretical modelling of tissue and blood gas dynamics of breath-hold divers suggests that changes in perfusion and blood flow distribution may also play a significant role...
April 25, 2018: Proceedings. Biological Sciences
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