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Pulmonary hypertension diagnosis and treatment

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https://www.readbyqxmd.com/read/29451101/severe-tricuspid-regurgitation-and-seizure-on-postpartum-day-10-case-report-of-late-postpartum-eclampsia
#1
Martin Vanden Eede, Matthew Schroyens
OBJECTIVE AND IMPORTANCE: Late postpartum eclampsia is characterized by pre-eclampsia and tonic-clonic seizures presenting more than 48 hours postpartum. It is a rare, frightening and dangerous complication that requires rapid recognition and adequate treatment. CLINICAL PRESENTATION: We present a case of late postpartum eclampsia, initially diagnosed as right-sided heart failure, 10 days postpartum.Two days after the delivery she developed mild swelling of both feet, progressive shortness of breath on exertion and orthopnea...
February 16, 2018: Acta Clinica Belgica
https://www.readbyqxmd.com/read/29416329/sex-specific-cardiopulmonary-exercise-testing-indices-to-estimate-the-severity-of-inoperable-chronic-thromboembolic-pulmonary-hypertension
#2
Tian-Xiang Chen, Bigyan Pudasaini, Jian Guo, Su-Gang Gong, Rong Jiang, Lan Wang, Qin-Hua Zhao, Wen-Hui Wu, Ping Yuan, Jin-Ming Liu
Background: Sex differences in chronic thromboembolic pulmonary hypertension (CTEPH) have been revealed in few studies. Although right heart catheterization (RHC) is the gold standard for clinical diagnosis and assessment of prognosis in pulmonary hypertension (PH), cardiopulmonary exercise testing (CPET) has been a more widely used assessment of functional capacity, disease severity, prognosis, and treatment response in PH. We hypothesized that the "sex-specific" CPET indices could estimate the severity of inoperable CTEPH...
2018: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29413506/pulmonary-arterial-hypertension-in-the-setting-of-scleroderma-is-different-than-in-the-setting-of-lupus-a-review
#3
REVIEW
Isabel S Bazan, Kofi A Mensah, Anastasiia A Rudkovskaia, Percy K Adonteng-Boateng, Erica L Herzog, Lenore Buckley, Wassim H Fares
Pulmonary hypertension (PH) is a clinical syndrome that is subdivided into five groups per the World Health Organization (WHO) classification, based largely on hemodynamic and pathophysiologic criteria. WHO Group 1 PH, termed pulmonary arterial hypertension (PAH), is a clinically progressive disease that can eventually lead to right heart failure and death, and it is hemodynamically characterized by pre-capillary PH and increased pulmonary vascular resistance in the absence of elevated left ventricular filling pressures...
January 2018: Respiratory Medicine
https://www.readbyqxmd.com/read/29369193/fibrosing-mediastinitis-with-pulmonary-hypertension-as-a-complication-of-pulmonary-vein-stenosis-a-case-report-and-review-of-the-literature
#4
Yidan Li, Xiangli Meng, Yidan Wang, Yuanhua Yang, Xiuzhang Lu
INTRODUCTION: Fibrosingmediastinitis (FM) is caused by a proliferation of fibrous tissue in the mediastinum encasing the mediastinal viscera that results in compression of mediastinal bronchovascular structures. Pulmonary hypertension (PH) is a severe complication of FM caused by extrinsic compression of pulmonary blood vessels. CASE PRESENTATION: Here, we present the case of a 47-year-old man who presented with a 10-year history of progressive hemoptysis and a 2-year history of shortness of breath, in whom a diagnosis of FM was made...
January 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29368899/-obesity-hypoventilation-syndrome-and-pulmonary-hypertension-an-association-little-known-in-mexico
#5
Ernesto Díaz-Domínguez, Martín Rosas-Peralta, Luis Efrén Santos-Martínez, Nielzer Armando Rodríguez-Almendros, José Antonio Magaña-Serrano, Gilberto Pérez-Rodríguez
The obesity hypoventilation syndrome (OHS) refers to the combination of obesity, daytime hypercapnia and sleep-disordered breathing. Obesity has risen to epidemic proportions in the last three decades in the United States, Mexico and Europe. The OHS is associated with obstructive sleep apnea syndrome in 30%. Without treatment, mortality is 46% at 50 months. So in this paper we analyze the OHS, obesity and pulmonary hypertension, the pathophysiology, clinical presentation and diagnosis as well as the treatment, which is aimed at the correction of sleep-disordered breathing and hypoxemia; although there is little experience with the use of specific pulmonary vasodilator drugs...
January 2018: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/29359418/effective-shunt-closure-for-pulmonary-hypertension-and-liver-dysfunction-in-congenital-portosystemic-venous-shunt
#6
Kiyoshi Uike, Hazumu Nagata, Yuichiro Hirata, Kenichiro Yamamura, Eiko Terashi, Toshiharu Matsuura, Eiji Morihana, Kazuhiro Ohkubo, Kanako Ishii, Yasunari Sakai, Tomoaki Taguchi, Shouichi Ohga
OBJECTIVE: Congenital portosystemic venous shunt (CPSVS) is a rare vascular malformation with a high risk of mortality from pulmonary arterial hypertension (PAH), but the treatment outcome of CPSVS closure remains elusive. Our aim was to investigate the clinical features and establish the optimal management of CPSVS with or without PAH. METHODS: Twenty-four patients with CPSVS treated in Kyushu University Hospital between 1990 and 2015 were enrolled in this study...
January 23, 2018: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29356440/adherence-and-medication-belief-in-patients-with-pulmonary-arterial-hypertension-or-chronic-thromboembolic-pulmonary-hypertension-a-nationwide-population-based-cohort-survey
#7
Bodil Ivarsson, Roger Hesselstrand, Göran Rådegran, Barbro Kjellström
BACKGROUND: Pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH) are rare diseases with a gradual decline in physical health. Adherence to treatment is crucial in these very symptomatic and life threatening diseases. OBJECTIVE: To describe PAH and CTEPH patients experience of their self-reported medication adherence, beliefs about medicines and information about treatment. METHODS: A quantitative, descriptive, national cohort survey that included adult patients from all PAH-centres in Sweden...
January 22, 2018: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/29332925/pulmonary-artery-pseudoaneurysm-secondary-to-lung-inf-lammation
#8
Shinichirou Ishimoto, Hiroyuki Sakurai, Ryouta Higure, Riken Kawachi, Mie Shimamura
Pulmonary artery aneurysms (PAA) and pseudoaneurysms (PAP) are caused by infections, vasculitis, trauma, pulmonary hypertension, congenital heart disease, and connective tissue disease. Most cases of such aneurysm occur in the trunk or major branches of the pulmonary artery, while the peripheral type is less common. The treatment modalities are medical therapy, surgery, and percutaneous catheter embolization. The mortality rate associated with rupture is approximately 50%. We encountered a case of a 53-year-old man with a pulmonary artery pseudoaneurysm secondary to pneumonia and cavity formation during chemotherapy for acute myeloid leukemia (AML)...
January 15, 2018: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29332633/impact-of-psychological-factors-on-the-health-related-quality-of-life-of-patients-treated-for-pulmonary-arterial-hypertension
#9
Laurence Halimi, Grégory Marin, Nicolas Molinari, Anne-Sophie Gamez, Clément Boissin, Carey M Suehs, Isabelle Vachier, Arnaud Bourdin
OBJECTIVE: Pulmonary arterial hypertension (PAH) is a rare and life-threatening disease well-marked by under diagnosis, delayed diagnosis and atypical treatments. Few data are available on the quality of life (QoL) and psychosocial characteristics of patients with PAH. Our aim is to describe the impact of psychological factors on the health-related quality of life (HRQoL) of treated PAH patients in a cross-sectional study. METHODS: Consecutive patients presenting at our Competency Centre for PAH were recruited...
February 2018: Journal of Psychosomatic Research
https://www.readbyqxmd.com/read/29326818/coping-social-support-and-information-in-patients-with-pulmonary-arterial-hypertension-or-chronic-thromboembolic-pulmonary-hypertension-a-2-year-retrospective-cohort-study
#10
Bodil Ivarsson, Göran Rådegran, Roger Hesselstrand, Barbro Kjellström
Objectives: Pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension are severe diseases with complicated treatment that need care at specialist clinics. The aim was to investigate changes in the patients' perceptions on coping, social support and received information when attending a newly started nurse-coordinated pulmonary arterial hypertension-outpatient clinic. Methods: The present study was a descriptive, questionnaire-based cohort study including 42 adult patients...
2018: SAGE Open Medicine
https://www.readbyqxmd.com/read/29321426/percutaneous-coronary-intervention-for-a-patient-with-left-main-coronary-compression-syndrome
#11
Ryutaro Ikegami, Kazuyuki Ozaki, Takuaya Ozawa, Satoru Hirono, Masahiro Ito, Tohru Minamino
Left main coronary compression syndrome rarely occurs in patients with severe pulmonary hypertension. A 65-year-old woman with severe pulmonary hypertension due to an atrial septal defect suffered from angina on effort. Cardiac computed-tomography and coronary angiography revealed considerable stenosis of the left main coronary artery (LMA) caused by compression between the dilated main pulmonary artery trunk and the sinus of valsalva. Stenting of the LMA under intravascular ultrasound imaging was effective for the treatment of angina...
January 11, 2018: Internal Medicine
https://www.readbyqxmd.com/read/29316567/modern-invasive-hemodynamic-assessment-of-pulmonary-hypertension
#12
Alberto Pagnamenta, Frédéric Lador, Andrea Azzola, Maurice Beghetti
Since 1998 pulmonary hypertension has been clinically classified into five well-defined, distinct categories. A definitive diagnosis of pulmonary hypertension requires the invasive confirmation of an elevated mean pulmonary artery pressure of 25 mm Hg or above during a right heart catheterization. From a hemodynamic point of view, pulmonary hypertension is classified into precapillary and postcapillary pulmonary hypertension on the basis of a pulmonary artery wedge pressure threshold value of 15 mm Hg. Pulmonary vascular resistance is better characterized by multi-point pressure/flow measurements than by single-point determination...
January 9, 2018: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/29311408/hepatic-hydrothorax
#13
Yong Lv, Guohong Han, Daiming Fan
Hepatic hydrothorax (HH) is a pleural effusion that develops in a patient with cirrhosis and portal hypertension in the absence of cardiopulmonary disease. Although the development of HH remains incompletely understood, the most acceptable explanation is that the pleural effusion is a result of a direct passage of ascitic fluid into the pleural cavity through a defect in the diaphragm due to the raised abdominal pressure and the negative pressure within the pleural space. Patients with HH can be asymptomatic or present with pulmonary symptoms such as shortness of breath, cough, hypoxemia, or respiratory failure associated with large pleural effusions...
December 27, 2017: Annals of Hepatology
https://www.readbyqxmd.com/read/29306522/visceral-thromboses-in-pancreas-adenocarcinoma-systematic-review
#14
REVIEW
Angel Mier Hicks, Antonio DeRosa, Michael Raj, Richard Do, Kenneth H Yu, Maeve A Lowery, Anna Varghese, Eileen M O'Reilly
Within gastrointestinal malignancies, primary hepatocellular carcinoma and pancreatic ductal adenocarcinoma (PDAC) are frequently associated with visceral thromboses (VT). Thrombus formation in the portal (PVT), mesenteric (MVT), or splenic vein (SVT) system leads to portal hypertension and intestinal ischemia. VT in PDAC may convey a risk of increased distal thrombosis and poses therapeutic uncertainty regarding the role of anticoagulation. An increasing number of reports describe VT associated with PDAC. It is possible that early diagnosis of these events may help reduce morbidity and speculatively improve oncologic outcomes...
December 12, 2017: Clinical Colorectal Cancer
https://www.readbyqxmd.com/read/29261337/current-and-emerging-imaging-techniques-in-the-diagnosis-and-assessment-of-pulmonary-hypertension
#15
Christopher S Johns, Jim M Wild, Smitha Rajaram, Andy J Swift, David G Kiely
Pulmonary hypertension (PH) is a challenging condition to diagnose and treat. Over the last two decades, there have been significant advances in therapeutic approaches and imaging technologies. Current guidelines emphasize the importance of cardiac catheterization; however, the increasing availability of non-invasive imaging has the potential to improve diagnostic rates, whilst providing additional information on patient phenotypes. Areas covered: This review discusses the role of imaging in the diagnosis, prognostic assessment and follow-up of patients with PH...
February 2018: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/29250690/difficulty-in-positive-diagnosis-of-ascites-and-in-differential-diagnosis-of-a-pulmonary-tumor
#16
Mircea Cătălin ForŢofoiu, Dragoş Marian Popescu, Vlad Pădureanu, Aurelian Constantin Dobrinescu, Adrian Gabriel Dobrinescu, Adrian Mită, Maria Camelia Foarfă, Violeta Serenada Bălă, Anca Emanuela Muşetescu, Nina Ionovici, Maria ForŢofoiu
Ascites is the most frequent complication of cirrhosis and occurs only when the portal hypertension has already installed but ascites is caused by neoplasms, heart failure, tuberculosis, pancreatic illnesses, as well as other kind of affections. We describe the case of a 67-year-old patient, a retired person, without significant personal or familial history, nonsmoker, infrequent alcohol and coffee consumer with following chief complaints at onset: loss of appetite, weight loss, serious physical asthenia, delayed intestinal transit, diffuse abdominal pain and increase of abdominal circumference...
2017: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
https://www.readbyqxmd.com/read/29243189/congenital-portosystemic-venous-shunt
#17
REVIEW
M Papamichail, M Pizanias, N Heaton
Congenital portosystemic venous shunts are rare developmental anomalies resulting in diversion of portal flow to the systemic circulation and have been divided into extra- and intrahepatic shunts. They occur during liver and systemic venous vascular embryogenesis and are associated with other congenital abnormalities. They carry a higher risk of benign and malignant liver tumors and, if left untreated, can result in significant medical complications including systemic encephalopathy and pulmonary hypertension...
December 14, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29240058/-venous-thromboembolic-complications-in-patients-with-cardiovascular-implantable-electronic-devices
#18
R E Kalinin, I A Suchkov, I I Shitov, N D Mzhavanadze, V O Povarov
The problem of venous thromboembolic complications (VTECs) in patients with cardiovascular implantable electronic devices (CIEDs) is extremely important today because of an annually increasing number of surgical interventions for life-threatening arrhythmias and chronic heart failure. There are hitherto no clearly defined reliable risk factors for VTECs due to heterogeneity of the available literature data. Some sources point to elevated thrombus formation in patients with a large number of electrodes, in repeat operative interventions, in the presence of a temporary pacemaker, in implantation on the left side, silicon cover of an electrode, others refute these facts...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/29237073/frequencies-of-borderline-pulmonary-hypertension-before-and-after-the-detect-algorithm-results-from-a-prospective-systemic-sclerosis-cohort
#19
Anna-Maria Hoffmann-Vold, Håvard Fretheim, Øyvind Midtvedt, Karin Kilian, Marianne Angelshaug, Asad Chaudhary, Ragnar Gunnarsson, Cathrine Brunborg, Torhild Garen, Arne K Andreassen, Einar Gude, Øyvind Molberg
Objective: The DETECT algorithm was developed for screening patients with SSc at high risk of pulmonary arterial hypertension (PAH). We evaluated the impact of this algorithm in a SSc population. Methods: Patients from the unselected, prospective Oslo University Hospital SSc study were divided into the Early and DETECT cohorts, respectively, depending on whether an incident right heart catheterization (RHC) was performed before (2009-13) or after (2014-17) the DETECT algorithm was instituted...
December 11, 2017: Rheumatology
https://www.readbyqxmd.com/read/29217599/ers-statement-on-obstructive-sleep-disordered-breathing-in-1-to-23-month-old-children
#20
Athanasios G Kaditis, Maria Luz Alonso Alvarez, An Boudewyns, Francois Abel, Emmanouel I Alexopoulos, Refika Ersu, Koen Joosten, Helena Larramona, Silvia Miano, Indra Narang, Hui-Leng Tan, Ha Trang, Marina Tsaoussoglou, Nele Vandenbussche, Maria Pia Villa, Dick Van Waardenburg, Silke Weber, Stijn Verhulst
The present statement was produced by a European Respiratory Society Task Force to summarise the evidence and current practice on the diagnosis and management of obstructive sleep disordered breathing (SDB) in children aged 1-23 months. A systematic literature search was completed and 159 articles were summarised to answer clinically relevant questions. SDB is suspected when symptoms or abnormalities related to upper airway obstruction are identified. Morbidity (pulmonary hypertension, growth delay, behavioural problems) and coexisting conditions (feeding difficulties, recurrent otitis media) may be present...
December 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
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