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https://www.readbyqxmd.com/read/29762422/timely-transthoracic-echocardiogram-in-pulmonary-embolism-is-it-worth-the-trouble
#1
Paul A Bergl, Amit Taneja, Jayshil J Patel
No abstract text is available yet for this article.
June 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29755795/double-bolus-alteplase-therapy-during-cardiopulmonary-resuscitation-for-cardiac-arrest-due-to-massive-pulmonary-embolism-guided-by-focused-bedside-echocardiography
#2
Hafiz B Mahboob, Bruce W Denney
Massive pulmonary embolism (PE) frequently leads to cardiac arrest (CA) which carries an extremely high mortality rate. Although available, randomized trials have not shown survival benefits from thrombolytic use. Thrombolytics however have been used successfully during resuscitation in clinical practice in multiple case reports and in retrospective studies. Recent resuscitation guidelines recommend using alteplase for PE related CA; however they do not offer a standardized treatment regimen. The most consistently applied approach is an intravenous bolus of 50 mg tissue plasminogen activator (t-PA) early during cardiopulmonary resuscitation (CPR)...
2018: Case Reports in Critical Care
https://www.readbyqxmd.com/read/29685020/ability-of-computed-tomography-to-predict-right-heart-strain-on-an-echocardiogram-in-patients-with-acute-pulmonary-embolus
#3
A Shams, J Hung, A Bahl
Patients with submassive pulmonary embolism (PE) resulting in right heart strain (RHS) have an increased risk of mortality compared to those with a preserved right ventricular function. This study aimed to investigate the predictive value of computed tomography pulmonary angiogram (CTPA) findings of right heart strain in patients with computed tomography (CT)-proven PE for the diagnosis of right heart strain by echocardiogram (ECHO). The institutional review board (IRB) approved retrospective chart review of the adult emergency department patients diagnosed with an acute PE between 2012 and 2016...
March 2018: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/29667131/pulmonary-embolism-following-incomplete-surgical-resection-of-a-right-ventricular-myxoma-a-case-report-and-review-of-the-literature
#4
Yazan Assaf, Maher Nasser, Hani Jneid, David Ott
Right ventricular (RV) myxomas are extremely rare, but may have dreadful clinical sequelae including pulmonary embolism (PE). We present a case of a patient who had an RV myxoma that was attached to the tricuspid valve, and therefore could not be resected completely during surgery, and remnants of the tumor were seen on transthoracic echocardiogram during post-operative follow-up. Five months after surgery, the patient had PE, which could be due to tumor emboli or thromboemboli. Since repeat surgical resection was not feasible, the patient was started on warfarin...
April 17, 2018: Cardiology and Therapy
https://www.readbyqxmd.com/read/29628594/an-unusual-case-of-a-parturient-with-uncorrected-pentalogy-of-fallot-presenting-for-elective-cesarean-section-delivery-of-twins
#5
Ying Ci Ho, Sek Koon Boey, Abey Matthew Varughese Mathews, Hooi Geok See, Nian Chih Hwang
We present a 31-year-old primigravida with uncorrected pentalogy of Fallot, pregnant with monochorionic-diamniotic twins, undergoing elective lower segment cesarean section at 36 weeks gestation. Preoperative workup included a transthoracic echocardiogram which revealed a large ventricular septal defect of 1.8 cm with bidirectional shunting, a moderate size atrial septal defect of 1.8 cm with predominant left-to-right shunting, an overriding aorta, moderate right ventricular hypertrophy, and severe pulmonary valve stenosis...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29628339/ischemic-stroke-secondary-to-paradoxical-embolism-through-a-pulmonary-arteriovenous-malformation-case-report-and-review-of-the-literature
#6
Ryan Cappa, Jeanette Du, Joseph F Carrera, Jimmy V Berthaud, Andrew M Southerland
Paradoxical embolism due to isolated pulmonary arteriovenous malformation (AVM) is an uncommon cause of ischemic stroke, with the majority occurring in patients who have not yet been diagnosed with their malformation. We report a 32-year-old man who presented with an abrupt onset of right facial weakness and expressive aphasia. Brain magnetic resonance imaging revealed an acute infarct in the left middle cerebral artery territory and chronic infarcts in the bilateral cerebellar hemispheres. A cardioembolic mechanism was initially considered in the setting of perimyocarditis diagnosed a few months earlier...
April 5, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29622996/clinical-profile-management-and-outcome-of-pulmonary-embolism-in-shahid-gangalal-national-heart-centre-kathmandu-nepal
#7
Chandra Mani Adhikari, K C Bishal, Sobita Khadka
Background and aims: Pulmonary embolism (PE) is associated with a significant mortality and morbidity. We aim to study clinical profile, management and outcome of PE at Shahid Gangalal National heart Centre, Kathmandu, Nepal. Methods: It was a retrprospective, single centre study, conducted from January 2015 to December 2016. Haemodynamics was used for risk Simplified, PESI score, predisposing factors, symptoms, clinical features at the time of admission, ECG features, echocardiogram, treatment received and the outcome were reviewed...
March 2018: The Egyptian heart journal: (EHJ): official bulletin of the Egyptian Society of Cardiology
https://www.readbyqxmd.com/read/29576872/pfo-closure-in-high-risk-patient-with-paradoxical-arterial-embolism-deep-vein-thrombosis-pulmonary-embolism-and-factor-v-leiden-genetic-mutation
#8
A Parikh, T P Vacek
Occurrence of paradoxical arterial embolism may cause the first symptoms in patients with a coexisting hypercoagulable state and patent foramen ovale (PFO). This can result in significant morbidity and mortality depending on the location of the embolism. The risks and benefits of closure of small PFOs have not been well elucidated in prior studies. We describe a patient with a history of Factor V Leiden heterozygosity who presented with left arm pain secondary to arterial embolism. The patient was a 51-year-old male who initially presented to the emergency department after awaking from sleep with progressive, severe, burning left arm pain...
March 2018: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/29570428/intravascular-cooling-catheter-related-venous-thromboembolism-after-hypothermia-a-case-report-and-review-of-the-literature
#9
Xuan Wang, Brian T Moy, Brett J Hiendlmayr, Felix Krainski, W Lane Duvall, Antonio B Fernandez
Fifty-four year-old man with recent history of myocardial infarction and a percutaneous coronary intervention who suffered a ventricular fibrillation arrest at home. He was resuscitated in the field. His heart rhythm was in atrial fibrillation. The cardiac catheterization showed a patent stent from his previous myocardial infarction and no new occlusions. He subsequently underwent hypothermia protocol using the Alsius CoolGard 3000 Temperature Control System and Icy Catheter. Heparin drip was started for atrial fibrillation 36 hours after catheter insertion and became therapeutic 2 hours before the end of cooling maintenance phase...
March 23, 2018: Therapeutic Hypothermia and Temperature Management
https://www.readbyqxmd.com/read/29563129/serpentine-thrombus-in-the-heart-a-rare-case-of-trapped-thrombus-in-patent-foramen-ovale
#10
Dominika M Zoltowska, Yashwant Agrawal, Jagadeesh K Kalavakunta
A 77-year-old Caucasian woman with recent abdominal surgery was diagnosed with multiple paradoxical systemic emboli in the mesenteric and renal circulation. Diagnosis was made by direct visualisation of a serpentine thrombus traversing both atria through patent foramen ovale (PFO) by transesophageal echocardiogram (TEE). Concomitantly, the patient was found to have deep venous thrombosis and pulmonary embolism. A decision was made to pursue cardiothoracic surgery preceded by inferior vena cava filter placement...
March 21, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29535097/a-case-of-tricuspid-valve-non-bacterial-thrombotic-endocarditis-presenting-as-pulmonary-embolism-in-a-patient-with-antiphospholipid-antibody-syndrome
#11
Dileep Unnikrishnan, Nasreen Shaikh, Ahmad Sharayah, Chandler Patton
A 47-year-old woman with a medical history of Raynaud's phenomenon presented with fever, cough and shortness of breath. She was found to have left lower lobe consolidation and pleural effusion and was treated as a case of pneumonia. During the hospital course, her respiratory status worsened, and she was intubated on the third hospital day. To investigate the high A-a gradient, a Computerized Tomographic Pulmonary Embolism (CTPE) study was done which identified a large left lower pulmonary artery embolism. She was also found to have a new murmur, and an echocardiogram demonstrated a large lesion on tricuspid valve...
March 13, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29511695/dynamic-course-of-serratia-marcescens-pulmonic-valve-endocarditis-resulting-in-submassive-pe-and-valve-replacement
#12
Chloe Grace Meyer, Thomas Paul Vacek, Amit Bansal, Ravi Gurujal, Analkumar Parikh
This report illustrates a case of a 42-year-old male with a history of intravenous drug abuse who presented with septic shock. Diagnostic studies, including a transthoracic echocardiogram, chest computed tomography angiography, transesophageal echocardiogram, and blood cultures ultimately revealed Serratia marcescens pulmonic valve infective endocarditis that was treated with intravenous antibiotics. In addition to the rare form of endocarditis and bacterium involved, this case brings into awareness the dynamic nature of the hospital course that requires vigilance in responding to hypotensive episodes for consideration of pulmonary embolism...
January 2018: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/29475918/pulmonary-tumor-embolism-due-to-squamous-cell-carcinoma-of-the-uterine-cervix-a-case-report
#13
Shohei Okazaki, Takanori Abe, Natsuko Takayanagi, Masanori Yasuda, Fumikazu Sakai, Kunihiko Kobayashi, Shingo Kato
BACKGROUND/AIM: We report on a case of pulmonary tumor embolism caused by squamous cell carcinoma of the uterine cervix. PATIENTS AND METHODS: A 60-year-old female diagnosed with stage IVB (cT4N1M1) squamous cell carcinoma of the uterine cervix was admitted to our institution with a chief complaint of progressive dyspnea that developed within a few days after admission. RESULTS: A chest CT scan showed dilated pulmonary arteries, right ventricular enlargement and mosaic ground-glass opacities in both lungs...
March 2018: In Vivo
https://www.readbyqxmd.com/read/29468168/severe-pulmonary-hypertension-due-to-adult-onset-still-s-disease
#14
Ankur Sinha, Ravikaran Patti, Paurush Ambesh, Chukwudi Obiagwu, Namrita Malhan, Kabu Chawla
A 29-year-old female with adult-onset Still's disease (AOSD) presented with progressive shortness of breath both on rest and on exertion, increased abdominal girth, and swelling in both legs. She was on oral prednisone and was recently started on canakinumab (interleukin-1 antagonist) for joint pain and rash of AOSD. Echocardiogram showed severely dilated right ventricle, dilated pulmonary artery, moderately reduced right ventricular systolic function, but with normal left ventricular systolic function. Computed tomography with contrast ruled out pulmonary embolism...
January 2018: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/29436310/ultrasound-assisted-catheter-directed-thrombolysis-for-submassive-pulmonary-embolism
#15
Prasoon P Mohan, John J Manov, Francisco Contreras, Michael E Langston, Mehul H Doshi, Govindarajan Narayanan
PURPOSE: Catheter-directed thrombolysis (CDT) is a relatively new therapy for pulmonary embolism that achieves the superior clot resolution compared to systemic thrombolysis while avoiding the high bleeding risk intrinsically associated with that therapy. In order to examine the efficacy and safety of CDT, we conducted a retrospective cohort study of patients undergoing ultrasound-assisted CDT at our institution. METHODS: The charts of 30 consecutive patients who underwent CDT as a treatment of pulmonary embolism at our institution were reviewed...
April 2018: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29422852/recurrent-stroke-in-a-young-woman-with-a-single-pulmonary-arteriovenous-fistula-an-unusual-association
#16
Sandra Sousa, Nuno Vasco Costa, Cátia Carmona, Élia Coimbra, Fernando Pita
Introduction: Cryptogenic stroke is present in about 40% of ischemic stroke patients. Extracardiac shunt related to pulmonary arteriovenous fistula (PAVF) could be a rare potential risk factor for embolic stroke. Most PAVFs are multiple, congenital, and associated with hereditary conditions. On the other hand, isolated PAVFs are rare conditions and an uncommon cause of cryptogenic stoke. Case Report: We describe a case of a young woman without history of respiratory diseases or vascular risk factors, who presented with acute onset of transitory aphasia and right hemiplegia...
September 2017: Case Reports in Neurology
https://www.readbyqxmd.com/read/29416468/nonfatal-cardiac-perforation-after-central-venous-catheter-insertion
#17
Vedran Premuzic, Lea Katalinic, Marijan Pasalic, Hrvoje Jurin
Cardiac tamponade caused by perforation of the cardiac wall is a rare complication related to central venous catheter (CVC) placement. A 71-year-old female with a previous history of moderate aortic stenosis and kidney transplantation was admitted to hospital due to global heart failure and worsening of allograft function. Intensified hemodialysis was commenced through a CVC placed in the right subclavian vein. Chest radiography revealed catheter tip in the right atrium and no signs of pneumothorax. Thorough diagnostics outruled immediate life-threatening conditions, such as myocardial infarction and pulmonary embolism...
January 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29404367/paradoxical-emboli-following-a-pulmonary-embolus-in-the-presence-of-a-patent-foramen-ovale
#18
Khalid Najib, Mark Heckle, Sameh Goubran, Rhadika Mehta, Rohan Goswami, Rami N Khouzam
A paradoxical embolism is defined as a systemic arterial embolus due to passage of a venous thrombus through a right to left shunt. We describe a case of acute cerebral vascular accident (CVA), right subclavian arterial embolus, and pulmonary emboli in the setting of a large patent foramen ovale (PFO). A 74-year-old woman with multiple comorbidities presented to the emergency department with acute onset of shortness of breath, weakness, and right arm pain. She was found to have bilateral pulmonary emboli, left CVA, and a right subclavian arterial embolus on computed tomography (CT)...
January 2018: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29375106/tricuspid-regurgitation-peak-gradient-trpg-tricuspid-annulus-plane-systolic-excursion-tapse-a-novel-parameter-for-stepwise-echocardiographic-risk-stratification-in-normotensive-patients-with-acute-pulmonary-embolism
#19
Michał Ciurzyński, Katarzyna Kurnicka, Barbara Lichodziejewska, Marta Kozłowska, Magdalena Pływaczewska, Piotr Sobieraj, Olga Dzikowska-Diduch, Sylwia Goliszek, Piotr Bienias, Maciej Kostrubiec, Piotr Pruszczyk
BACKGROUND: Patients with intermediate-risk acute pulmonary embolism (APE) are a heterogeneous group with an early mortality rate of 2-15%. The tricuspid annulus plane systolic excursion (TAPSE) and tricuspid regurgitation peak gradient (TRPG) can be used for risk stratification, so we analyzed the prognostic value of a new echo parameter (TRPG/TAPSE) for prediction of APE-related 30-day death or need for rescue thrombolysis in initially normotensive APE patients.Methods and Results:The study group consists of 400 non-high-risk APE patients (191 men, age: 63...
March 23, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/29362281/-takotsubo-cardiomyopathy-and-neurogenic-pulmonary-edema-following-fibrinolytic-therapy-for-embolic-stroke-a-case-report
#20
Takehiro Kitagawa, Junkoh Yamamoto, Makoto Kureshima, Hitoshi Maeda, Shigeru Nishizawa
A 79-year-old man presented with left hemiparesis and disturbance of consciousness. Brain magnetic resonance(MR)imaging revealed an infarction in the right insular cortex. MR angiography showed a defect in the inferior trunk of the right middle cerebral artery. The patient was treated with alteplase about 2.5 h after onset. Immediately after the intravenous alteplase administration, the hemiparesis improved. However, his respiratory condition unexpectedly worsened 10 h after onset. Chest radiography demonstrated an infiltrative shadow in both lung fields...
January 2018: No Shinkei Geka. Neurological Surgery
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