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echocardiography embolism

Anthony J Weekes, Angela K Johnson, Daniel Troha, Gregory Thacker, Jordan Chanler-Berat, Michael Runyon
BACKGROUND: Right ventricular dysfunction (RVD) in pulmonary embolism (PE) has been associated with increased morbidity. Tools for RVD identification are not well defined. The prognostic value of RVD markers to predict serious adverse events (SAE) during hospitalization is unclear. OBJECTIVE: Prospectively compare the incidence of SAE in normotensive emergency department patients with PE based upon RVD by goal-directed echocardiography (GDE), cardiac biomarkers, and right-to-left ventricle ratio by computed tomography (CT)...
October 14, 2016: Journal of Emergency Medicine
Deisy Barrios, Vladimir Rosa-Salazar, Raquel Morillo, Rosa Nieto, Sara Fernández, José Luis Zamorano, Manuel Monreal, Adam Torbicki, Roger D Yusen, David Jiménez
BACKGROUND: For patients diagnosed with acute pulmonary embolism (PE), the prognostic significance of concomitant right heart thrombi (RHT) lacks clarity. METHODS: We performed a meta-analysis of studies that enrolled patients with acute PE to assess the prognostic value of echocardiography-detectable RHT for the primary outcome of short-term all-cause mortality, and the secondary outcome of short-term PE-related mortality. We conducted unrestricted searches of Pubmed and Embase from 1980 through January 31, 2016 and used the terms "right heart thrombi", "pulmonary embolism", and "prognos*"...
October 13, 2016: Chest
Praveen Hariharan, David M Dudzinski, Rachel Rosovsky, Farris Haddad, Peter MacMahon, Blair Parry, Yuchiao Chang, Christopher Kabrhel
Computed tomography pulmonary angiogram (CTPA) provides a volumetric assessment of clot burden in acute pulmonary embolism (PE). However, it is unclear if clot burden is associated with right-sided heart strain (RHS) or adverse clinical events (ACE). We prospectively enrolled Emergency Department patients with PE (in CTPA) from 2008 to 2011. We assigned 1 to 9 points as clot burden score, based on whether emboli were saddle, central, lobar, segmental, and subsegmental. We evaluated a novel score (the "CT-PASS") based on the sum (in millimeters) of the largest filling defects in the right and left pulmonary vasculature...
August 24, 2016: American Journal of Cardiology
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
Elisa Damiani, Alex Dyson, Lucia Zacchetti, Abele Donati, Mervyn Singer
BACKGROUND: Hypoxemia may compromise cell metabolism and organ function. Supplemental oxygen (O2) at high concentrations may prove ineffective, and issues relating to hyperoxia, barotrauma, mechanical ventilation, and extracorporeal oxygenation are well documented. Old reports suggest the potential safety and efficacy of alternative routes for O2 administration, such as intravenous or intestinal. We re-explored these routes in rat models of hypoxemia. METHODS: Hypoxemia was induced in spontaneously breathing, anesthetized rats by breathing a hypoxic gas mix (FiO2 0...
December 2016: Intensive Care Medicine Experimental
U S Dinesh Kumar, Shyam Prasad Shetty, K R Sujay, Murugesh Wali
Left ventricular (LV) mass is a rare condition, of which the most common is thrombus. Echocardiography is a very useful modality of investigation to evaluate the LV mass. We are reporting a case of LV mass presenting with neurological symptom. The diagnosis of this mass was dilemma as the echocardiographic features were favoring tumor as well as thrombi. Mass (a) measuring 3.8 cm × 1.9 cm attached to the left ventricle apex appeared to be pedunculated tumor and mass (b) measuring 2.4 cm × 1.8 cm attached to the chordae of anterior mitral leaflet resembled a thrombus or an embolized tumor entangled in the chordae...
October 2016: Annals of Cardiac Anaesthesia
Yuji Ueno, Kazuo Yamashiro, Ryota Tanaka, Takuma Kuroki, Kenichiro Hira, Naohide Kurita, Takao Urabe, Nobutaka Hattori
BACKGROUND AND PURPOSE: Underlying embolic causes diagnosed by transesophageal echocardiography could be implicated in mechanisms of embolic stroke of undetermined source. We aimed to explore factors, including underlying embolic causes, related to recurrent vascular events in embolic stroke of undetermined source. METHODS: Patients who fulfilled the diagnostic criteria for embolic stroke of undetermined source and whose potential embolic sources were examined by transesophageal echocardiography were included...
October 4, 2016: Stroke; a Journal of Cerebral Circulation
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
Allan Davies, Prasad Gunaruwan, Nicholas Collins, Malcolm Barlow, Nick Jackson, James Leitch
PURPOSE: Pulmonary vein isolation using cryoballoon ablation is an established approach to treating atrial fibrillation. The procedure involves insertion of a 15-Fr sheath into the left atrium across the interatrial septum. This creates an iatrogenic atrial septal defect, which may have important long-term clinical relevance, especially in younger patients. We sought to determine the long-term incidence of these defects and determine the direction of shunt using contrast transesophageal echocardiography...
September 28, 2016: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
David M Dudzinski, Praveen Hariharan, Blair A Parry, Yuchiao Chang, Christopher Kabrhel
BACKGROUND: Right ventricular strain (RVS) identifies patients at risk of hemodynamic deterioration from pulmonary embolism (PE). Our hypothesis was that chest computed tomography (CT) can provide information about RVS analogous to transthoracic echocardiography (TTE) and that RVS on CT is associated with adverse outcomes after PE. METHODS: Consecutive emergency department (ED) patients with acute PE were prospectively enrolled and clinical, biomarker, and imaging data were recorded...
September 24, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Huanhuan Wang, Yin Zhang, Yanbo Xie, Hongyue Wang, Jinqing Yuan
INTRODUCTION: Coronary artery aneurysm (CAA) is defined as coronary dilatation which exceeds the diameter of the normal adjacent artery segments or the diameter of the patient's largest coronary artery by 1.5 times. The incidence of giant CAA is difficult to be determined, since only few reports have been described in the literature. METHODS AND RESULTS: A 65-year-old man was referred to our hospital because of a "mass" in the right heart detected on echocardiography at a regular medical health examination, while he experienced no any symptoms...
September 2016: Medicine (Baltimore)
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
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...
September 19, 2016: Journal of Vascular and Interventional Radiology: JVIR
Antonio H Frangieh, Jasmina Alibegovic, Christian Templin, Oliver Gaemperli, Slayman Obeid, Robert Manka, Erik W Holy, Willibald Maier, Thomas F Lüscher, Ronald K Binder
BACKGROUND: Left atrial appendage occlusion (LAAO) is mostly performed by transesophageal echocardiography (TEE) guidance. Intracardiac echocardiography (ICE) may be an alternative imaging modality for LAAO that precludes the need for general anesthesia or sedation. METHODS AND RESULTS: All consecutive single center, single operator LAAO candidates were analyzed. Baseline clinical and procedural characteristics and in-hospital outcomes were compared between patients in whom a Watchman was implanted with ICE vs...
September 21, 2016: Catheterization and Cardiovascular Interventions
Zairi Ihsen, Mssaad Hela, Mzoughi Khadija, Jnifene Zouhayer
Cardiac myxoma are the most common benign primary cardiac tumors that can lead to many complications as described in literature. Here we report the case of a boy aged 11 that was referred for etiological diagnosis of ischemic stroke. Transthoracic echocardiography reveals a myxoma in the left atrium. Patient was referred to surgery. The diagnosis was confirmed and the mass was completely resected.
2016: Pan African Medical Journal
Aimee E Moores, Michael S Cahill, Todd C Villines
Aortic mycotic aneurysms are a rare but life-threatening potential complication of infective endocarditis. Rapid deterioration of the vascular wall in highly focal areas makes these pseudoaneurysms particularly prone to rupture, resulting in uncontrolled aortic hemorrhage. While computed tomography angiography (CTA) is the imaging modality of choice for the evaluation of mycotic aneurysms, it is not routinely performed in patients with known or suspected infective endocarditis (IE). However, current valvular heart disease guidelines support the use of cardiac CTA in cases of IE and suspected perivalvular extension when there is inadequate or ambiguous visualization on echocardiography...
2016: Case Reports in Medicine
Poul Henning Madsen, Søren Hess
Basic knowledge of pulmonary embolism is relevant to most practicing physicians. Many medical specialties care for patients with increased risk of pulmonary embolism, why recognition of relevant symptoms, a thorough medical history, assessment of the clinical condition of the patient and possibly referral to a relevant facility should be a part of the skills of all clinicians. Sudden onset dyspnea, chest pain, syncope and hemoptysis are essential symptoms of pulmonary embolism, and in most of these patients basic investigations like arterial blood gas analysis, electrocardiogram, chest x-ray and biochemical analyses are appropriate...
September 13, 2016: Advances in Experimental Medicine and Biology
Alexandre Bedet, Keyvan Razazi, Faten May, Armand Mekontso Dessap
No abstract text is available yet for this article.
September 12, 2016: Intensive Care Medicine
Hamid Amoozgar, Sara Salehi, Pouya Farhadi, Mohammad Reza Edraki, Mohammad Borzoee, Gholamhossein Ajami, Sirous Cheriki, Hamid Mohammadi
BACKGROUND: Transcatheter patent ductus arteriosus (PDA) closure is an established procedure. OBJECTIVES: The aim of the study was to assess midterm follow up of the Nit-Occlud coil and the amplatzer ductal occluder (ADO) closure of PDA. PATIENTS AND METHODS: In this cohort study, we collected the longitudinal data of patients who underwent percutaneous closure using coil or ADO from November 2005 to November 2013. A total of 404 patients with PDA closure by devices were included during the study period...
June 2016: Iranian Journal of Pediatrics
Gabriele Di Giammarco, Daniele Marinelli, Massimiliano Foschi, Michele Di Mauro
Tricuspid valve (TV) endocarditis is a common complication in intravenous drug addicts. In case of TV replacement, the main issue is the high risk of new endocarditis on TV prosthesis. On November 2014, a 44 year-old male patient with a history of intravenous drug addiction was referred for TV endocarditis owing to Staphylococcus aureus and severe regurgitation complicated by pulmonary embolism and heart failure. Preoperative echocardiography showed a large vegetation of the anterior leaflet (1.95 × 0.92 cm) covering a huge hole in the leaflet itself...
July 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
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