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https://www.readbyqxmd.com/read/28228310/comparison-of-pesi-echocardiogram-ctpa-and-nt-probnp-as-risk-stratification-tools-in-patients-with-acute-pulmonary-embolism
#1
A Vamsidhar, D Rajasekhar, V Vanajakshamma, A Y Lakshmi, K Latheef, C Siva Sankara, G Obul Reddy
OBJECTIVE: The aim of this study is to prospectively assess the diagnostic accuracy of pulmonary embolism severity index, echocardiogram, computed tomography pulmonary angiogram (CTPA), and N-terminal pro b-type natriuretic peptide (NT-proBNP) for predicting adverse events in acute pulmonary embolism patients. METHODS: Thirty consecutive acute pulmonary embolism patients were included in this study. Combined adverse events consisted of in-hospital death or use of escalation of care including cardiopulmonary resuscitation, mechanical ventilation, vasopressor therapy, or secondary thrombolysis during hospital stay...
January 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28217685/right-ventricular-metastatic-tumor-from-a-primary-carcinoma-of-uterine-cervix-a-cause-of-pulmonary-embolism
#2
Gwan Hee Han, Do Youn Kwon, Roshani Ulak, Kyung Do Ki, Jong-Min Lee, Seon-Kyung Lee
The presence of intracavitary cardiac metastasis from squamous cell carcinoma of the uterine cervix is extremely rare. The diagnosis is made almost exclusively postmortem. Apart from causing intracardiac obstruction, it can present as pulmonary emboli and the prognosis is extremely poor. It is important to suspect this diagnosis in patient with recurrent pulmonary emboli. Due to the rarity of this condition it is very difficult to standardize care for these patients. However, it is possible that aggressive therapy may lengthen patients' survival and quality of life...
January 2017: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/28217316/subacute-right-heart-failure-revealing-three-simultaneous-causes-of-post-embolic-pulmonary-hypertension-in-metastatic-dissemination-of-breast-cancer
#3
Flavien Vincent, Nicolas Lamblin, Marion Classe, Guillaume Schurtz, Antoine Rauch, Marie Fertin, Pascal De Groote
A 72-year-old woman with history of breast cancer only treated surgically was referred to our department for pulmonary hypertension (PH) suspicion. Echocardiogram revealed elevated right ventricular systolic pressure. Computed tomography (CT) angiogram showed no pulmonary embolism (PE), but lung scan revealed two ventilation-perfusion mismatch areas. Right cardiac catheterization established precapillary PH. Despite treatment with PH specific therapy (sildenafil, ambrisentan, and epoprostenol), her condition worsened rapidly with acute right heart failure (RHF)...
February 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/28179706/massive-pulmonary-embolism-presenting-as-seizures
#4
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/28133551/large-left-ventricular-thrombus-in-a-patient-with-systemic-and-venous-thromboembolism-secondary-to-protein-c-and-s-deficiency
#5
Mohit Pahuja, Bujji Ainapurapu, Aiden Abidov
58-year-old Hispanic female presented with an altered mental status. A CT scan of the head demonstrated multiple scattered infarcts and a large right temporal lobe infarct. We also diagnosed the patient with right popliteal and femoral vein thrombosis, bilateral pulmonary embolism, and a transient right radial artery occlusion. Her 12-lead EKG showed lateral ST elevation. Emergent coronary angiogram revealed normal coronaries. Echocardiogram demonstrated a large mobile mass attached to the anterolateral free wall with overall normal contractility of the left ventricle...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28054894/a-rare-case-of-a-pedicled-mobile-thrombus-in-right-atrium
#6
Xiaodong Li, Liping Chen, Xiumei Duan, Xiaocong Wang
Pedicled mobile thrombus in the right atrium is an extremely rare condition. Here, we described a case of a 42-year-old male hospitalized with complaints of chest pain and hemoptysis. Computed tomographic angiography of the pulmonary artery showed signs of embolism, and thoracic echocardiography indicated a pedicled mobile cloudy echo in the right atrium, which was initially suspected to be a myxoma. However, it was confirmed to be a thrombus by histopathological examination. Postoperatively, the patient was treated with anticoagulant therapy comprising of low molecular heparin and warfarin, and the patient recovered well...
2, 2016: Heart Surgery Forum
https://www.readbyqxmd.com/read/27932051/functional-and-exercise-limitations-after-a-first-episode-of-pulmonary-embolism-results-of-the-elope-prospective-cohort-study
#7
Susan R Kahn, Andrew M Hirsch, Arash Akaberi, Paul Hernandez, David R Anderson, Philip S Wells, Marc Rodger, Susan Solymoss, Michael J Kovacs, Lawrence Rudski, Avi Shimony, Carole Dennie, Christopher Rush, William H Geerts, Shawn D Aaron, John T Granton
BACKGROUND: We aimed to determine the frequency and predictors of exercise limitation after pulmonary embolism (PE), and to assess its association with health-related quality of life (HRQOL) and dyspnea. METHODS: 100 patients with acute PE were recruited at five Canadian hospitals from 2010-2013. Cardiopulmonary exercise testing (CPET) was performed at 1 and 12 months. Quality of life, dyspnea, six-minute walk distance (6MWD), residual clot burden (perfusion (Q) scan; CT pulmonary angiography (CTPA)), cardiac function (echocardiogram) and pulmonary function tests (PFT) were measured during follow-up...
December 5, 2016: Chest
https://www.readbyqxmd.com/read/27920693/capecitabine-induced-coronary-vasospasm
#8
Danish Henry, Francine Rudzik, Allison Butts, Aju Mathew
Capecitabine, an oral prodrug of 5-fluorouracil (5-FU), is approved for early-stage and advanced colorectal cancer and metastatic breast cancer. Cardiotoxicity of 5-FU is well described in the literature. However, cardiac adverse effects of capecitabine are poorly described. We report a case of coronary vasospasm induced by capecitabine. A 41-year-old female with metastatic breast cancer presented with chest pain 3 days after starting capecitabine. The chest pain was relieved by rest and exacerbated by exertion...
September 2016: Case Reports in Oncology
https://www.readbyqxmd.com/read/27912200/is-cha2ds2-vasc-appropriate-for-hyperthyroid-patients-with-atrial-fibrillation-implications-of-adding-a-transesophageal-echocardiography-evaluation
#9
Marcus Vinicius Leitão de Souza, Patricia de Fátima Dos Santos Teixeira, Mario Vaisman, Sergio Salles Xavier
BACKGROUND: Anticoagulation remains a controversial issue among hyperthyroid patients with atrial fibrillation (AF). We aimed to evaluate the prevalence of the thrombogenic milieu (TM), detected using transesophageal echocardiography (TEE), among patients with AF related to hyperthyroidism, and to correlate these findings with the clinical embolic risk classification (CHA2DS2-VASc). METHODS: CHA2DS2-VASc score, thyroid hormonal status, time since hyperthyroidism diagnosis, transthoracic echocardiography (TTE) and TEE were assessed in 47 consecutive patients aged between 18 and 65years with AF related to hyperthyroidism...
February 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27873765/extensive-biatrial-thrombus-straddling-the-patent-foramen-ovale-and-traversing-into-the-left-and-right-ventricle
#10
Adil Sattar, Theingi Tiffany Win, Alex Schevchuck, Abinash Achrekar
We report an extremely rare case of an extensive biatrial thrombus straddling a patent foramen ovale (PFO) extending into the bilateral ventricles in a patient presenting with an acute embolic stroke. Our patient further developed a massive saddle pulmonary embolus (PE) with haemodynamic instability during the course of his hospitalisation. The risks of pharmacological thrombolysis or surgical thrombectomy for PE in a haemodynamically unstable patient with recent embolic stroke posed a significant therapeutic dilemma...
November 21, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27812780/pulmonary-arteriovenous-malformations-embolized-using-a-micro-vascular-plug-system-technical-note-on-a-preliminary-experience
#11
Emanuele Boatta, Christine Jahn, Matthieu Canuet, Julien Garnon, Nitin Ramamurthy, Roberto Luigi Cazzato, Afshin Gangi
AIM: To report our preliminary experience using a Micro Vascular Plug (MVP) deployed through a 2.8Fr micro-catheter for the treatment of pulmonary arteriovenous malformations (PAVMs) in a cohort of patients affected by Hereditary Haemorrhagic Telangiectasia (HHT). MATERIALS AND METHODS: Four consecutive female patients (mean age 38.0 years; range 25-55 years) with PAVMs diagnosed on echocardiogram/bubble test and contrast-enhanced CT (CECT) underwent MVP embolization...
February 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/27793505/emergency-physician-performed-tricuspid-annular-plane-systolic-excursion-in-the-evaluation-of-suspected-pulmonary-embolism
#12
James Daley, John Grotberg, Joseph Pare, Amanda Medoro, Rachel Liu, Michael Kennedy Hall, Andrew Taylor, Christopher L Moore
OBJECTIVES: The primary objectives were to describe the diagnostic characteristics tricuspid annular plane systolic excursion (TAPSE) for pulmonary embolism (PE) and to optimize the measurement cutoff of TAPSE for the diagnosis of PE. Secondary objectives included assessment of interrater reliability and the quantitative visual estimation of TAPSE. METHODS: This is a prospective observational cohort study involving a convenience sample of patients at an urban academic emergency department...
January 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27793158/clinical-and-echocardiographic-predictors-of-mortality-in-acute-pulmonary-embolism
#13
Talal Dahhan, Irfan Siddiqui, Victor F Tapson, Eric J Velazquez, Stephanie Sun, Clemontina A Davenport, Zainab Samad, Sudarshan Rajagopal
PURPOSE: The aim of this study was to evaluate the utility of adding quantitative assessments of cardiac function from echocardiography to clinical factors in predicting the outcome of patients with acute pulmonary embolism (PE). METHODS: Patients with a diagnosis of acute PE, based on a positive ventilation perfusion scan or computed tomography (CT) chest angiogram, were identified using the Duke University Hospital Database. Of these, 69 had echocardiograms within 24-48 h of the diagnosis that were suitable for offline analysis...
October 28, 2016: Cardiovascular Ultrasound
https://www.readbyqxmd.com/read/27739276/successful-thrombolysis-of-a-large-pulmonary-artery-thrombosis
#14
Ajay U Mahajan, Deepak S Laddhad, Deepak Bohara, Sangeeta D Laddhad, Yogita T Dinde, Sachin S Bhabad
A 32 yrs old man presented with shortness of breath and syncopal episode with preceding history of DVT 15days above. Patient has tachycardia hypoxia and hypotension, on evaluation ECG Showed S1 Q3 T3 Pattern, bedside Echo Showed visible thrombus of 3cm in pulmonary artery, successfully thrombolysed with tenecteplase and streptokinase. This case study is presented to stress importance of urgent bedside echo in all sudden onset dysponea and hypoxia to rule out pulmonary Embolism which can be successfully thrombolysed without delay...
June 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27734186/estimation-of-right-ventricular-dysfunction-by-computed-tomography-pulmonary-angiography-a-valuable-adjunct-for-evaluating-the-severity-of-acute-pulmonary-embolism
#15
Dong Jia, Xiao-Ming Zhou, Gang Hou
To evaluate the feasibility and the efficacy of computed tomography pulmonary angiography (CTPA) in differentiating acute pulmonary embolism (PE) patients with or without right ventricular dysfunction and to evaluate the severity of right ventricular dysfunction in acute PE patients with CPTA. We retrospectively collected and measured the following parameters: right ventricular diameter by short axis in the axial plane (RVDaxial), left ventricular diameter by short axis in the axial plane (LVDaxial), right ventricular diameter by level on the reconstructed four-chamber views (RVD4-CH), left ventricular diameter by level on the reconstructed four-chamber views (LVD4-CH), main pulmonary artery diameter (MPAD), ascending aorta diameter (AOD), coronary sinus diameter (CSD), superior vena cava diameter (SVCD), inferior vena cava (IVC) reflux and interventricular septum deviation by CTPA, and we calculated the RVDaxial/LVDaxial, RVD4-CH/LVD4-CH and MPAD/AOD ratios in acute PE patients...
October 12, 2016: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/27695491/tricuspid-annulus-plane-systolic-excursion-tapse-has-superior-predictive-value-compared-to-right-ventricular-to-left-ventricular-ratio-in-normotensive-patients-with-acute-pulmonary-embolism
#16
Marzanna Paczyńska, Piotr Sobieraj, Łukasz Burzyński, Maciej Kostrubiec, Małgorzata Wiśniewska, Piotr Bienias, Katarzyna Kurnicka, Barbara Lichodziejewska, Piotr Pruszczyk, Michał Ciurzyński
INTRODUCTION: Right ventricular dysfunction (RVD) is an indicator of poor prognosis in normotensive patients with acute pulmonary embolism (APE). The aim of this study was to compare right ventricular (RV)/left ventricular (LV) ratio measured by echocardiography and multidetector computed tomography (MDCT) with tricuspid annulus plane systolic excursion (TAPSE) as a prognostic factor of APE-related 30-day mortality. MATERIAL AND METHODS: We examined 76 patients with confirmed APE, hemodynamically stable at admission...
October 1, 2016: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/27688000/nonbacterial-thrombotic-endocarditis-involving-both-the-tricuspid-and-aortic-valves
#17
Bhaskar Bhardwaj, Ata Bajwa, Amit Sharma, Arooge Towheed, Bakul V Sanghani, A Iain McGhie
A 71-year-old male presented after sudden onset of confusion and expressive aphasia. MRI head revealed multiple ischemic lesions consistent with cardio-embolic pathophysiology. A computed tomography angiography of lung showed peripheral pulmonary emboli. He underwent a transesophageal echocardiogram as a part of the stroke workup and was found to have vegetations on both aortic and tricuspid valves. The blood cultures did not show any growth, and the patient remained afebrile during the course of hospitalization...
December 2016: Echocardiography
https://www.readbyqxmd.com/read/27660585/thromboembolism-in-transit-and-patent-foramen-ovale-should-screening-echocardiogram-be-routine-for-thromboembolic-disease
#18
Dawn S Hui, Fernando Fleischman, P Michael McFadden
BACKGROUND: Thromboembolism-in-transit straddling a patent foramen ovale (PFO) is a rare condition that requires urgent surgical intervention to prevent arterial emboli. CASE REPORT: We present the case of a 42-year-old female who presented with a symptomatic pulmonary embolism. Echocardiography identified a PFO, with a bridging thrombus-in-transit and evidence of right ventricular strain. Urgent surgery was performed because of the risk of systemic embolism. A large thrombus was identified during biatrial exploration...
2016: Ochsner Journal
https://www.readbyqxmd.com/read/27659895/significance-of-echocardiographically-detected-central-venous-catheter-tip-associated-thrombi
#19
Jeffrey Forris Beecham Chick, Shilpa N Reddy, Ruchika D Bhatt, Benjamin J Shin, James N Kirkpatrick, Scott O Trerotola
PURPOSE: To explore significance, management, and outcomes of central venous catheter (CVC) tip-associated thrombi incidentally detected on echocardiography. MATERIALS AND METHODS: Echocardiogram data from all patients with CVCs from October 2009 to June 2011 were reviewed (N = 170). Patients with CVC tip-associated thrombi were selected (n = 49). Echocardiograms were reviewed for ejection fraction, presence of patent foramen ovale (PFO), presence of other intracardiac shunts, and mean thrombus size...
December 2016: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/27609716/traversing-boundaries-thrombus-in-transit-with-paradoxical-embolism
#20
Varun Miriyala, Muhammad Umer Awan, Kirmanj Faraj, Bipinpreet Nagra
A 72-year-old male is diagnosed with paradoxical embolus after he presented with concurrent deep vein thrombosis, stroke, and multiple arterial emboli in the presence of a patent foramen ovale (PFO). Paradoxical embolus requires the passage of a thrombus from the venous into the arterial circulation through a right-to-left shunt leading to systemic embolism. But, despite the high incidence of PFO (27.3% across all age groups by autopsy), paradoxical embolism (PDE) is uncommon, representing <2% of all arterial emboli...
2016: Journal of Community Hospital Internal Medicine Perspectives
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