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https://www.readbyqxmd.com/read/28432672/para-atrial-non-acute-mediastinal-hematoma-after-left-atrial-maze-procedure-mimicking-tumor-in-a-patient-with-treated-melanoma
#1
G Schaiberger, D Pucar, V Patel, B Bateson, H Williams, W Bates
INTRODUCTION: The Cox Maze III procedure is considered the gold standard open surgical procedure for management of atrial fibrillation. This article outlines a unique case of a para-atrial mediastinal hematoma following a bilateral thoracoscopic left atrial Maze procedure mimicking malignancy. REPORT: A 60-year-old male, with past history of melanoma, underwent bilateral thoracoscopic left atrial mini maze procedure with radiofrequency energy and exclusion of the left atrial appendage...
April 21, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/28431873/a-novel-clinical-index-for-the-assessment-of-rvd-in-acute-pulmonary-embolism-blood-pressure-index
#2
Hale Ates, Ihsan Ates, Harun Kundi, Mehmet Fettah Arikan, Fatma Meric Yilmaz
BACKGROUND: This study aims to investigate the role of the blood pressure index (BPI), which is a new index that we developed, in detection of right ventricular dysfunction (RVD) in acute pulmonary embolism (APE). METHODS: A total of 539 patients, (253 males and 286 females), diagnosed with APE using computer tomography pulmonary angiography were included in the study. The BPI was obtained by dividing systolic blood pressure (SBP) by diastolic blood pressure (DBP)...
April 12, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28431860/predictive-value-of-perfusion-defects-on-dual-energy-cta-in-the-absence-of-thromboembolic-clots
#3
Richard A P Takx, Thomas Henzler, U Joseph Schoepf, Thomas Germann, Stefan O Schoenberg, Aysel Shirinova, Ralf W Bauer, Claudia Frellesen, Long Jiang Zhang, John W Nance, Christian Fink, Paul Apfaltrer
BACKGROUND: To determine the predictive value of volumetrically measured lung perfusion defects (PDvol) and right ventricular dysfunction on dual-energy computed tomography angiography (DE-CTA) for predicting all cause mortality in patients suspected of pulmonary embolism (PE) but without evident thromboembolic clot on CTA. METHODS: 448 patients underwent DE-CTA on a 64-channel DSCT system between January 2007 and December 2012 for suspected PE, of which 115 were without detectable thromboembolic clot on CTA...
April 18, 2017: Journal of Cardiovascular Computed Tomography
https://www.readbyqxmd.com/read/28416939/a-systemic-onset-juvenile-idiopathic-arthritis-patient-with-reduced-anakinra-treatment-admitted-with-an-attack
#4
Dilek Yilmaz, Mediha Akcan, Semiha Terlemez, Ferah Sonmez, Abdullah Baris Akcan
Interleukin-1 plays an important role in the pathogenesis of systemic-onset juvenile idiopathic arthritis (SoJIA), and the use of anti-interleukin-1 therapy has been increasing. We report a case of a 14-year-old male patient with SoJIA. He was in remission with anakinra treatment for almost 2 years. When we extended the therapeutic range and decreased the dose (1 mg/kg twice a week), he developed symptoms mimicking pulmonary embolism and cardiac ischemia. Increased cardiac enzyme levels and echocardiographic findings were interpreted as myopericarditis...
February 2017: Eurasian Journal of Medicine
https://www.readbyqxmd.com/read/28414995/case-report-of-an-intracaval-leiomyomatosis-10-months-after-complete-hysterectomy
#5
Hannah Maria Schäfer, Andrej Isaak, Lorenz Gürke
INTRODUCTION: Intravenous leiomyomatosis (IVL) is a rare smooth muscle tumor, usually found in women with tumors of the reproductive organs, such as uterus myomatosous. Surgically, this case belies the call for sternotomy and two-stage surgery in caval IVL extending to the right atrium: we suggest one-stage median laparotomy as a minimal procedure with maximal benefit. PRESENTATION OF CASE: We present the case of a 60-year-old postmenopausal woman with suspected intravenous leiomyomatosis of the right internal iliac vein...
March 31, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28410589/lung-involvement-in-childhood-onset-granulomatosis-with-polyangiitis
#6
REVIEW
Giovanni Filocamo, Sofia Torreggiani, Carlo Agostoni, Susanna Esposito
Granulomatosis with polyangiitis is an ANCA-associated systemic vasculitis with a low incidence in the pediatric population. Lung involvement is a common manifestation in children affected by granulomatosis with polyangiitis, both at disease's onset and during flares. Its severity is variable, ranging from asymptomatic pulmonary lesions to dramatic life-threatening clinical presentations such as diffuse alveolar haemorrhage. Several radiologic findings have been described, but the most frequent abnormalities detected are nodular lesions and fixed infiltrates...
April 14, 2017: Pediatric Rheumatology Online Journal
https://www.readbyqxmd.com/read/28408704/changing-use-patterns-for-99m-tc-maa-from-2000-to-2015
#7
James A Ponto
Since the early 2000's, evaluation of pulmonary embolism (PE) has shifted from (99m)Tc macroaggregated albumin (MAA) perfusion lung scans to CT angiography (CTA). (99m)Tc MAA continues to be used in patients with contraindications to CTA and for other uses. A reduced number of MAA particles is used in patients with pulmonary hypertension (PH) or other risk factors. This study assessed the changing use patterns for (99m)Tc MAA by comparing snap-shots of procedures in 2000 and in 2015 in one institution. Methods: Records for all patients receiving (99m)Tc MAA in the year 2000 and in 2015 were reviewed, making note of the imaging procedure, any contraindication to CTA, and if a reduced number of MAA particles was used...
April 13, 2017: Journal of Nuclear Medicine Technology
https://www.readbyqxmd.com/read/28405830/low-yield-of-ventilation-and-perfusion-imaging-for-the-evaluation-of-pulmonary-embolism-after-indeterminate-ct-pulmonary-angiography
#8
Brian R Curtis, Mougnyan Cox, Michael Poplawski, Andrej Lyshchik
PURPOSE: Ventilation and perfusion (VQ) imaging is common following suboptimal CT pulmonary angiogram (CTPA) for pulmonary embolism (PE) evaluation; however, the results of this diagnostic pathway are unclear. The purpose of our study is to determine the incidence of PE diagnosed on VQ scans performed in patients with suboptimal CTPAs. METHODS: One hundred twenty-two suboptimal CTPAs with subsequent VQ scans within 1 week were retrospectively identified. VQ reports utilizing modified ​prospective investigation of pulmonary embolism diagnosis (PIOPED) and prospective investigative study of acute pulmonary embolism diagnosis (PISAPED) criteria were evaluated for presence of PE; intermediate probability, high probability, and PE present were considered PE positive...
April 12, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28400247/quality-of-life-dyspnea-and-functional-exercise-capacity-following-a-first-episode-of-pulmonary-embolism-results-of-the-elope-cohort-study
#9
Susan R Kahn, Arash Akaberi, John T Granton, David R Anderson, Philip S Wells, Marc A Rodger, Susan Solymoss, Michael J Kovacs, Lawrence Rudski, Avi Shimony, Carole Dennie, Chris Rush, Paul Hernandez, Shawn D Aaron, Andrew M Hirsch
BACKGROUND: We aimed to evaluate health-related quality of life (QOL), dyspnea and functional exercise capacity during the year following the diagnosis of a first episode of pulmonary embolism. METHODS: Prospective multicenter cohort study of 100 patients with acute pulmonary embolism recruited at 5 Canadian hospitals from 2010-2013. We measured the outcomes QOL (by SF-36 and PEmb-QOL measures), dyspnea (by the University of California San Diego Shortness of Breath Questionnaire (SOBQ)) and six-minute walk distance at Baseline, 1, 3, 6, and 12 months after acute pulmonary embolism...
April 8, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28396728/computed-tomography-pulmonary-angiography-using-a-20-reduction-in-contrast-medium-dose-delivered-in-a-multiphasic-injection
#10
Mitchell Chen, Gaith Mattar, Jamal A Abdulkarim
AIM: To evaluate the feasibility of reducing the dose of iodinated contrast agent in computed tomography pulmonary angiography (CTPA). METHODS: One hundred and twenty-seven patients clinically suspected of having pulmonary embolism underwent spiral CTPA, out of whom fifty-seven received 75 mL and the remaining seventy a lower dose of 60 mL of contrast agent. Both doses were administered in a multiphasic injection. A minimum opacification threshold of 250 Hounsfield units (HU) in the main pulmonary artery is used for assessing the technical adequacy of the scans...
March 28, 2017: World Journal of Radiology
https://www.readbyqxmd.com/read/28393706/ultrasound-assisted-catheter-directed-thrombolysis-in-high-risk-and-intermediate-high-risk-pulmonary-embolism-a-meta-analysis
#11
Cihangir Kaymaz, Özgür Yaşar Akbal, Ibrahim Halil Tanboğa, Aykun Hakgör, Fatih Yilmaz, Selçuk Öztürk, Nertila Poçi, Sevim Türkday, Nihal Özdemir, Stavros Konstantinides
Catheter-directed Ultrasound-Assisted Thrombolysis (USAT) is a novel technology providing a high efficacy with a reduced bleeding risk in patients with pulmonary embolism (PE). We performed a meta-analysis based on presented or published PE series in which USAT was utilized. We searched the MEDLINE, EMBASE and the Cochrane Library for trials published up to December 2015. The primary outcomes were mean pulmonary artery pressure (PAMP), right to left ventricle diameter ratio (RV/LV ratio) and computed tomography (CT) obstruction score...
April 4, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28391603/embedded-clinical-decision-support-in-electronic-health-record-decreases-use-of-high-cost-imaging-in-the-emergency-department-embed-study
#12
Kelly Bookman, David West, Adit Ginde, Jennifer Wiler, Robert McIntyre, Andrew Hammes, Nichole Carlson, David Steinbruner, Matthew Solley, Richard Zane
OBJECTIVE: Evaluate the impact of evidence-based clinical decision support tools integrated directly into provider workflow in the electronic health record on utilization of CT brain, c-spine and pulmonary embolism (PE). METHODS: Validated, well accepted scoring tools for head injury, c-spine injury and pulmonary embolism were embedded into the electronic health record in a manner minimally disruptive to provider workflow. This was a longitudinal, before/after study in 5 emergency departments in a healthcare system with a common electronic health record...
April 9, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28389294/comparison-of-aspire-mechanical-thrombectomy-versus-angiojet-thrombectomy-system-in-a-porcine-iliac-vein-thrombosis-model
#13
Roy J Weinberg, Tamuru Okada, Aaron Chen, Walter Kim, Changyi Chen, Peter H Lin
PURPOSE: To compare the efficacy and safety profile of the AngioJet thrombectomy device and ASPIRE thrombectomy system in a porcine venous thrombosis model. MATERIALS AND METHODS: Twelve adult pigs underwent bilateral iliac venous thrombosis created by using a stent-graft thrombosis model, and subsequently underwent either AngioJet (n = 6) or ASPIRE mechanical thrombectomy (n = 6) one week later. Intravascular ultrasound (IVUS) was used to assess thrombectomy efficacy, and computed tomography was used to evaluate pulmonary embolism (PE)...
April 4, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28370558/an-unexpected-tumor-causing-right-ventricular-obstruction
#14
Jorge Padilla-Ibarra, Hugo Rodríguez Zanella, Roberto Cano Zarate, Erick Alexánderson-Rosas
A 58-year-old male with a history of a soft tissue sarcoma in remission presented with a 2 weeks history of progressive dyspnea. Transthoracic echocardiography showed right ventricular dilation; right ventricular systolic pressure (RVSP) of 110 mm Hg, and a lobulated mass in the right ventricular outflow tract (RVOT) causing obstruction. Microbubble contrast was administered showing perfusion within the mass, which suggested malignancy. A CT pulmonary angiogram (CTPA) confirmed the presence of the mass in the RVOT without evidence of pulmonary embolism...
March 30, 2017: Echocardiography
https://www.readbyqxmd.com/read/28350720/pulmonary-embolism-mimicking-infectious-pleuritis
#15
Kenichi Tetsuhara, Satoshi Tsuji, Satoko Uematsu, Koichi Kamei
The diagnosis of pulmonary thromboembolism (PE) is often delayed because it is usually misdiagnosed as pneumonia or deep vein thrombosis. We report an unusual case of PE misdiagnosed as viral pleuritis on the first arrival at the emergency department (ED) in our hospital. A 14-year-old girl with no previous significant medical history was referred to the ED with pleuritic and chest pain with low-grade fever 4 days before admission.Echography showed a small amount of left pleural effusion. A 12-lead electrocardiogram was normal...
March 27, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28348945/infective-endocarditis-in-a-patient-with-celiac-disease-after-central-venous-catheter-insertion
#16
Murtaza Sundhu, Suryanarayan Mohapatra, Salome Arobelidze, Parveen Gundelly, Anil Kumar Changarath Vijayan
There is an increasing incidence of infective endocarditis secondary to central venous catheters, which is termed as 'healthcare-associated infective endocarditis'. There is an increased risk of getting infective endocarditis in conditions with malnutrition and also if the tip of the central venous catheter is deep in the right atrium close to the tricuspid valve. We present a case of 31-year-old female who had all these risk factors. She was admitted to the hospital for the work up of the weight loss and was diagnosed with celiac disease...
February 13, 2017: Curēus
https://www.readbyqxmd.com/read/28348360/an-uncommon-case-of-lower-limb-deep-vein-thrombosis-with-multiple-etiological-causes
#17
Jing Miao, Geetha Naik, Sivakumar Muddana, Xiaohuan Li, Supriya Bhimasani, Ronald Alvin Mitchell, Dariush Alaie, Richard L Petrillo
BACKGROUND Deep vein thrombosis (DVT) is a type of venous thromboembolism with diverse clinical and environmental risk factors. Very few cases of DVT with multiple high risk factors have been reported. Here, we report an uncommon DVT case with multiple etiological causes, including appendicitis/appendectomy, morbid obesity, immobilization, positive phosphatidylserine IgG, and heterozygous factor V Leiden mutation. CASE REPORT A 43-year-old female was brought to the emergency room because of 2-week history of pain and swelling and ultrasound revealing evidence of DVT in the right leg...
March 28, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28346962/response-to-comment-on-state-of-the-art-imaging-in-pulmonary-embolism-ventilation-perfusion-single-photon-emission-computed-tomography-versus-computed-tomography-angiography-controversies-results-and-recommendations-from-a-systematic-review
#18
https://www.readbyqxmd.com/read/28331932/pulmonary-embolism-and-in-situ-pulmonary-artery-thrombosis-in-paediatrics-a-systematic-review
#19
Madhvi Rajpurkar, Tina Biss, Ernest Amankwah, Denise Martinez, Suzan Williams, C Heleen Van Ommen, Neil A Goldenberg
Data on paediatric pulmonary embolism (PE) are scarce. We sought to systematically review the current literature on childhood PE and conducted a search on paediatric PE via PubMed (1946-2013) and Embase (1980-2013). There was significant heterogeneity in reported data. Two patterns were noted: classic thromboembolic PE (TE-PE) and in situ pulmonary artery thrombosis (ISPAT). Mean age of presentation for TE-PE was 14.86 years, and 51 % of cases were males. The commonest method for diagnosis of TE-PE was contrast CT with angiography (74 % of patients)...
March 23, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28330686/imaging-of-acute-and-chronic-thromboembolic-disease-state-of-the-art
#20
REVIEW
A Ruggiero, N J Screaton
Acute pulmonary embolism (PE) is a life-threatening condition that requires prompt diagnosis and treatment. Recent advances in imaging allow acute and rapid recognition even by the non-specialist radiologist. Most acute emboli resolve on anticoagulation without sequelae; however, some emboli fail to fully resolve becoming endothelialised with the development of chronic thromboembolic disease (CTED). Increased pulmonary vascular resistance arising from CTED may lead to chronic thromboembolic pulmonary hypertension (CTEPH) a debilitating disease affecting up to 5% of survivors of acute PE...
May 2017: Clinical Radiology
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