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https://www.readbyqxmd.com/read/29349525/value-of-ct-pulmonary-angiography-to-predict-short-term-outcome-in-patient-with-pulmonary-embolism
#1
Ahmed M Osman, Emad H Abdeldayem
To evaluate the role of CT pulmonary angiography (CTPA) in the assessment of pulmonary embolism (PE) severity and the related CT cardiac changes, reflecting the clinical status of the patients and predicting the outcome. A prospective study of 184 patients presented with suspicious acute PE. All patients underwent CTPA followed by ECHO. Pulmonary artery obstructive index (PAOI) using Qanadli Score was calculated and cardiac changes recorded. The patients' outcome was followed up for 30 days. Only 150 patients completed the study; 26...
January 18, 2018: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/29298088/echocardiogram-in-the-evaluation-of-hemodynamically-stable-acute-pulmonary-embolism-national-practices-and-clinical-outcomes
#2
David M Cohen, Michael Winter, Peter K Lindenauer, Allan J Walkey
RATIONALE: Societal guideline recommendations vary with regard to the role of routine trans-thoracic echocardiography (TTE) to screen for right ventricular strain in patients with hemodynamically-stable, acute pulmonary embolism (PE). OBJECTIVE: To characterize national patterns in use of early TTE for the evaluation of patients with hemodynamically-stable, acute PE, and determine associations between TTE use and patient outcomes. METHODS: Retrospective cohort study using Premier, Inc...
January 3, 2018: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29279077/platypnea-orthodeoxia-syndrome-after-complicated-cholecystectomy-an-unsuspected-diagnosis
#3
Catarina Queirós, Elsa Francisco, João Almeida
A 65-year-old woman with no significant prior medical history presented, in the postoperative course of a complicated cholecystectomy, several episodes of arterial desaturation. Pulmonary embolism was repeatedly suspected, but there was no evidence of pulmonary thrombus on the chest computed tomography angiographies obtained. As these episodes were mainly induced by postural changes, a platypnea-orthodeoxia syndrome was suspected. A transthoracic echocardiogram was performed and revealed a patent foramen ovale...
November 29, 2017: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/29250236/post-ictal-transient-atrial-fibrillation-as-a-rare-manifestation-of-grand-mal-seizure
#4
Gulshan Man Singh Dangol, David A Hoffman
Atrial fibrillation (AF) most frequently occurs as a consequence of multiple etiologies including valvular disease, coronary artery disease, hyperthyroidism, alcohol ingestion, and pulmonary embolism. However, on rare occasion transient AF may be a result of generalized tonic-clonic seizures (GTCS). A 33-year-old-man presented to the emergency department following GTCS in AF with rapid ventricular response. He had no previous documented history. Diagnostic evaluation including electrolytes, thyroid function, cardiac enzymes, serum and urine drug screen, and two-dimensional echocardiogram were unremarkable...
August 2017: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/29237153/very-small-left-atrial-volume-as-a-marker-for-mortality-in-patients-undergoing-nongated-computed-tomography-pulmonary-angiography
#5
Zach Rozenbaum, Yoav Granot, Paul Turkeltaub, Dotan Cohen, Tomer Ziv-Baran, Yan Topilsky, Shlomo Berliner, Galit Aviram
OBJECTIVES: To evaluate the association between very small left atria (VSLA) on nongated computed tomography pulmonary angiography (CTPA) and mortality in patients without pulmonary embolism (PE). METHODS: Patients who underwent nongated CTPA between 2011 and 2015 in order to rule out PE, and had an echocardiogram within 24 h of the CTPA, were retrospectively identified. The left atrial volume of nongated CTPA was calculated using automatic 4-chamber volumetric analysis software...
December 14, 2017: Cardiology
https://www.readbyqxmd.com/read/29217343/patent-foramen-ovale-in-patients-with-pulmonary-embolism-a-prognostic-factor-on-ct-pulmonary-angiography
#6
Meng Zhang, Stephanie Tan, Vishal Patel, Benjamin A Zalta, Anna Shmukler, Jeffrey M Levsky, Vineet R Jain, Nada M Shaban, Linda B Haramati
BACKGROUND: Patent foramen ovale (PFO) in patients with acute pulmonary embolism (PE) represents a risk factor for mortality, but this has not been evaluated for CT pulmonary angiography (CTPA). The purpose of the present study was to assess the relationship between PFO and mortality in patients with acute PE diagnosed on CTPA. MATERIALS AND METHODS: This retrospective study included 268 adults [173 women, mean age 61 (range 22-98) years] diagnosed with acute PE on non-ECG-gated 64-slice CTPA in 2012 at our medical center...
December 2, 2017: Journal of Cardiovascular Computed Tomography
https://www.readbyqxmd.com/read/29187254/acute-disseminated-melioidosis-giving-rise-to-pneumonia-and-renal-abscesses-complicated-with-thrombotic-thrombocytopenic-purpura-in-a-post-partum-woman-a-case-report
#7
Piyumi Sachindra Alwis Wijewickrama, Rohini Weerakoon
BACKGROUND: Melioidosis is an established endemic infection in Sri Lanka, caused by Burkholderia pseudomallei, a gram negative bacterium distributed in saprophytes in soil and surface water. Main mode of transmission is via percutaneous inoculation. Pneumonia is the most common presentation in acute disease. CASE PRESENTATION: We report a 33 year old previously healthy Sinhalese female with an occupational exposure to surface water in paddy fields, who was on postpartum day 6 following an uncomplicated pregnancy and delivery via an elective caesarian section...
November 29, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/29155385/local-low-dose-urokinase-thrombolysis-for-the-management-of-hemodynamically-stable-pulmonary-embolism-with-right-ventricular-dysfunction
#8
Sara Alcántara Carmona, Marina Pérez Redondo, Luis Nombela Franco, Rocío González Costero, Bárbara Balandín Moreno, Miguel Valdivia de la Fuente, Santiago Méndez Alonso, Agustín García Suárez, Ana Royuela
AIMS: To evaluate the effectiveness of local low-dose urokinase thrombolysis (LLDUT) in hemodynamically stable pulmonary embolism with right ventricular dysfunction (RVD). METHODS AND RESULTS: Prospective study. LLDUT with a 200,000 IU bolus followed by a 100,000 IU/h infusion. Treatment duration was determined through radiological control performed 48-72h into treatment. Follow-up echocardiogram was performed within seven days after LLDUT completion. Evolution of thrombus burden, pulmonary artery pressures (PAP) and RVD were studied, and hemorrhagic complications and mortality were recorded...
November 21, 2017: EuroIntervention
https://www.readbyqxmd.com/read/29044787/intracardiac-ablation-for-atrioventricular-nodal-reentry-tachycardia-using-a-6%C3%A2-mm-distal-electrode-cryoablation-catheter-prospective-multicenter-north-american-study-icy-avnrt-study
#9
Peter Wells, Marc Dubuc, George J Klein, Dan Dan, Jean-Francois Roux, Evan Lockwood, Marcio Sturmer, David Dunbar, Paul Novak, Arun Rao, Brett J Peterson, Fred Kueffer, Kenneth A Ellenbogen
INTRODUCTION: Radiofrequency (RF) ablation is effective for slow pathway ablation, but carries a risk of inadvertent AV block requiring permanent pacing. By comparison, cryoablation with a 4 mm distal electrode catheter has not been reported to cause permanent AV block but has been shown to be less effective than RF ablation. We sought to define the safety and efficacy of a 6 mm distal electrode cryoablation catheter for slow pathway ablation in patients with atrioventricular nodal reentry tachycardia (AVNRT)...
October 17, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29018013/stroke-resulting-from-an-isolated-pulmonary-arteriovenous-malformation
#10
Jakob Saidman, Hossam Abdou, Sridhar Sampath Kumar
Isolated pulmonary arteriovenous malformations (PAVM) are rare, but can be responsible for paradoxical embolic events. It is important to recognise these situations early and intervene quickly to attain the best outcome. We describe the case of a 45-year-old woman with a long-standing history of migraines with aura who presented to the emergency department with left-sided weakness and slurred speech. Work-up was unclear and she was diagnosed with cryptogenic stroke. Follow-up transoesophageal echocardiogram was suggestive of an atrial septal defect, though no clear defect was evident...
October 10, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29017434/transesophageal-echocardiogram-guided-stent-placement-in-superior-vena-cava-syndrome-secondary-to-granulomatous-lung-disease-a-case-series-and-literature-review
#11
REVIEW
Kaiwen Sun, Rishi Batra, Nicholas W Markin, Melissa Suh, Iraklis I Pipinos, Ellen K Roberts, Jason N Mactaggart, B Timothy Baxter
Obstruction of the superior vena cava (SVC) is an uncommon, but potentially life-threatening condition due to likely development of edema in the head and neck and potential respiratory compromise. Less than half of those affected by SVC syndrome survive more than a year. Obstruction can be from neoplasms or secondary to benign disease. Treatment for most cases of symptomatic SVC syndrome involves placement of a stent to relieve the stenosis. Serious complications such as stent migration, pulmonary embolism, and cardiac tamponade can occur in 5% to 10% of cases, and inadequate imaging of the SVC-atrial junction by fluoroscopy contributes to these problems...
November 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28988309/durable-benefit-of-particle-occlusion-of-systemic-to-pulmonary-collaterals-in-select-patients-after-superior-cavopulmonary-connection
#12
Michael L O'Byrne, David N Schidlow
Systemic to pulmonary arterial collaterals (SPC) are commonly found in patients undergoing staged operative palliation for single ventricle heart disease. Occlusion of SPC as part of pre-Fontan catheterization has been shown to improve hemodynamics acutely. Anecdotally, the effect of this intervention appears to be transient, and to our knowledge there is no data supporting its durability in these patients. Between 1/1/2016 and 5/1/2017, 24 children underwent Glenn operations at our institution. Of these, 3 patients had signs and symptoms deteriorating clinical status suggestive of volume overload in the period between their Glenn operation and Fontan completion, prompting heart catheterization...
October 7, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28983441/high-value-care-in-the-evaluation-of-stroke
#13
Prakrity Urja, Eric H Nippoldt, Virginia Barak, Carrie Valenta
Value-based care emphasizes achieving the greatest overall health benefit for every dollar spent. We present an interesting case of stroke, which made us consider how frequently health care providers are utilizing value-based care. A 73-year-old Caucasian, who was initially admitted for a hypertensive emergency, was transferred to our facility for worsening slurring of speech and left-sided weakness. The patient had an extensive chronic cerebrovascular disease, including multiple embolic type strokes, mainly in the distribution of the right temporal-occipital cerebral artery and transient ischemic attacks (TIAs)...
August 1, 2017: Curēus
https://www.readbyqxmd.com/read/28953498/diagnostic-accuracy-of-point-of-care-ultrasound-performed-by-pulmonary-critical-care-physicians-for-right-ventricle-assessment-in-patients-with-acute-pulmonary-embolism
#14
Jason Filopei, Samuel O Acquah, Eric E Bondarsky, David J Steiger, Navitha Ramesh, Madeline Ehrlich, Paru Patrawalla
OBJECTIVES: Risk stratification for acute pulmonary embolism using imaging presence of right ventricular dysfunction is essential for triage; however, comprehensive transthoracic echocardiography has limited availability. We assessed the accuracy and timeliness of Pulmonary Critical Care Medicine Fellow's performance of goal-directed echocardiograms and intensivists' interpretations for evaluating right ventricular dysfunction in acute pulmonary embolism. DESIGN: Prospective observational study and retrospective chart review...
December 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28948507/oral-factor-xa-inhibitors-for-the-treatment-of-left-ventricular-thrombus-a-case-series
#15
Keaton S Smetana, Jessie Dunne, Kevin Parrott, George A Davis, Amy C Schmelzer Collier, Mary Covell, Susan Smyth
Left ventricular thrombus (LVT) formation usually necessitates short term anticoagulation for thrombus resolution and to prevent embolic events. Historically, vitamin K antagonist therapy has been the treatment of choice. However, with the advent of direct acting anticoagulants, their role in the management of LVT is not clear. Patients were included if they had received rivaroxaban or apixaban for more than 1 day for LVT documented on imaging. The primary objective was resolution of LVT at 3 months based on assessment by an independent cardiologist review of initial and subsequent imaging results...
November 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28944082/ultra-short-echo-time-magnetic-resonance-imaging-for-detection-of-pulmonary-arteriovenous-malformation-recanalization-after-coil-embolization-a-case-report-and-a-phantom-study
#16
Kohei Hamamoto, Emiko Chiba, Katsuhiko Matsuura, Tomohisa Okochi, Keisuke Tanno, Osamu Tanaka
A pulmonary arteriovenous malformation (PAVM) is a direct connection between the pulmonary arteries and veins for which metallic coil transcatheter embolization is the standard of care. Detecting recanalization after PAVM treatment is crucial, but direct visualization with computed tomography or magnetic resonance imaging (MRI) is generally difficult. Here, we report a case of a recanalized PAVM that was directly detected with ultra-short echo time MRI. The detection of these signals in the coils was confirmed in a phantom study...
September 2017: Acta Radiologica Open
https://www.readbyqxmd.com/read/28904659/-pulmonary-embolism-at-the-university-hospital-campus-of-lome-togo-a-retrospective-study-about-51-cases
#17
Soulemane Pessinaba, Yaovi Dodzi Molba Atti, Soodougoua Baragou, Machihude Pio, Yaovi Afassinou, Mohamed Kpélafia, Edem Goeh-Akué, Findibé Damorou
INTRODUCTION: This study provides an analysis of the evolutionary, clinical and epidemiological aspects of pulmonary embolism at the University Hospital Campus of Lome. METHODS: We conducted a retrospective, analytic and descriptive study over a period of 39 months (November 1 , 2011- January 31, 2015). All the medical records of patients hospitalized for PE in the Department of Cardiology at the University Hospital Campus were analyzed. RESULTS: The prevalence of PE was 3...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28878585/selective-upper-body-perfusion-technique-for-removal-of-renal-cell-carcinoma-extending-into-the-inferior-vena-cava-and-right-atrium
#18
Selim Aydin, Bora Cengiz, Banu Vural Gokay, Anar Mammadov, Remzi Emiroglu, Saadettin Eskicorapci, Ersin Erek
Invasion of a renal cell carcinoma thrombus into the inferior vena cava and right atrium is infrequent. Reaching and completely excising a tumor from the inferior vena cava is particularly challenging because the liver covers the surgical field. We report the case of a 61-year-old man who underwent surgery for a renal cell carcinoma of the right kidney that extended into the inferior vena cava and right atrium. During dissection of the liver to expose the inferior vena cava, transesophageal echocardiograms revealed right atrial mass migration into the tricuspid valve...
August 2017: Texas Heart Institute Journal
https://www.readbyqxmd.com/read/28855497/a-49-year-old-man-with-subacute-respiratory-failure-and-interstitial-lung-opacities
#19
Anastasiia A Rudkovskaia, Ying-Chun Lo, Virginia Brady, Jose Costa, Wassim H Fares
BACKGROUND Pulmonary arterial hypertension (PAH) results from proliferative vasculopathy involving all layers of the blood vessel. Similar findings may be present in pulmonary hypertension (PH) associated with microscopic tumor embolism, which are thought to be related to the phenomenon of pulmonary tumor thrombotic microangiopathy (PTTM). PTTM is associated with the activation of the coagulation system at the surface of the tumor emboli, resulting in stenosis or occlusion of the vessel. CASE REPORT A 49-year-old man with stage IV gastro-esophageal junction adenocarcinoma presented with complaints of cough and shortness of breath...
August 31, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28854949/pulmonary-tumor-embolism-secondary-to-soft-tissue-and-bone-sarcomas-a-case-report-and-literature-review
#20
Nicholas Latchana, Vincent C Daniel, Robert W Gould, Raphael E Pollock
BACKGROUND: Tumor embolisms (TE) are an underappreciated source of pulmonary embolisms in sarcoma. Most evidence in the literature is limited to case reports and none have described the presence of TE secondary to myxofibrosarcoma. We report the first case of myxofibrosarcoma TE and perform a review of the literature for TE secondary to bone and soft tissue sarcomas (STS). CASE PRESENTATION: A 36-year-old female presented with debilitating pain of the right upper extremity secondary to a recurrent soft tissue sarcoma...
August 30, 2017: World Journal of Surgical Oncology
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