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Pulmonal hypertension

Deana Mikhalkova, Eric Novak, Ari Cedars
In the adult congenital heart disease (ACHD) population, pulmonary valve replacement (PVR) is a common intervention, its benefit, however, has been incompletely investigated. This study investigates short- and intermediate-term outcomes after PVR in ACHD. Using State Inpatient Databases from the Healthcare Cost and Utilization Project, we investigated both hospitalization rate and financial burden accrued over the 12-month period after PVR compared with the 12 months before. Among 202 patients who underwent PVR, per patient-year hospitalization rates doubled in the year after PVR compared with the year before (0...
August 22, 2016: American Journal of Cardiology
Ada C Stefanescu Schmidt, Doreen DeFaria Yeh, Sara Tabtabai, Kevin F Kennedy, Robert W Yeh, Ami B Bhatt
The population of adults with tetralogy of Fallot (TOF) is growing, and it is not known how the changes in age distribution, treatment strategies, and prevalence of co-morbidities impact their interaction with the health care system. We sought to analyze the frequency and reasons for hospital admissions over the past decade. We extracted serial cross-sectional data from the United States Nationwide Inpatient Sample on hospitalizations including the diagnostic code for TOF from 2000 to 2011. From 2000 to 2011, there were 20,545 admissions for subjects with TOF, with a steady increase in annual number...
September 15, 2016: American Journal of Cardiology
Tuğçe Tural-Kara, Halil Özdemir, Ergin Çiftçi, Erdal İnce
Congenital lobar emphysema is a rare disease, which is characterized by pulmoner hyperinflation. Depending on the degree of bronchial obstruction, the clinical presentation may be variable. We report a rare case with congenital lobar emphysema in a 38-days-old male infant who presented with severe respiratory distress and hypertension. Air trapping in the left upper lung and significant mediastinal shift to the right were observed on the chest x-ray. Emphysematous changes were detected on the thorax computed tomography and considered as congenital lobar emphysema...
July 2016: Saudi Medical Journal
Q X Zeng, Z H Liu, J G He, X H Ni, X S Cheng, Q Gu, Z H Zhao, Q Luo, C M Xiong
OBJECTIVE: To summarize the clinical features of Takayasu arteritis (TA) patients with pulmonary hypertension due to pulmonary artery involvement. METHODS: Ninety-four TA patients with pulmonary artery involvement treated in Fuwai Hospital from Jun 1988 to Jun 2014 were retrospectively summarized. Patients were divided into two groups according to whether aorta and its main branches affected (APTA, n=48) or not (PTA, n=46). Clinical features and angiographic data were further analyzed...
April 26, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Konstadina Darsaklis, Matthew E Dickson, William Cornwell, Colby R Ayers, Fernando Torres, Kelly M Chin, Susan Matulevicius
Right-sided heart failure is the most common cause of death in pulmonary hypertension (PH). Echocardiographic measurements of right atrial (RA) size are associated with worse outcome in PH, however the association between RA function and death in PH has not been well-described. 160 PH patients (World Health Organization groups 1-5) underwent cardiac magnetic resonance imaging (cMRI) and right heart catheterization (RHC) within 6 weeks of each other at a tertiary care academic medical center in the United States...
July 2016: International Journal of Cardiovascular Imaging
Fabrice Antigny, Aurélie Hautefort, Jolyane Meloche, Milia Belacel-Ouari, Boris Manoury, Catherine Rucker-Martin, Christine Péchoux, François Potus, Valérie Nadeau, Eve Tremblay, Grégoire Ruffenach, Alice Bourgeois, Peter Dorfmüller, Sandra Breuils-Bonnet, Elie Fadel, Benoît Ranchoux, Philippe Jourdon, Barbara Girerd, David Montani, Steeve Provencher, Sébastien Bonnet, Gérald Simonneau, Marc Humbert, Frédéric Perros
BACKGROUND: Mutations in the KCNK3 gene have been identified in some patients suffering from heritable pulmonary arterial hypertension (PAH). KCNK3 encodes an outward rectifier K(+) channel, and each identified mutation leads to a loss of function. However, the pathophysiological role of potassium channel subfamily K member 3 (KCNK3) in PAH is unclear. We hypothesized that loss of function of KCNK3 is a hallmark of idiopathic and heritable PAH and contributes to dysfunction of pulmonary artery smooth muscle cells and pulmonary artery endothelial cells, leading to pulmonary artery remodeling: consequently, restoring KCNK3 function could alleviate experimental pulmonary hypertension (PH)...
April 5, 2016: Circulation
Gayatri Mishra, Amrutha Bindu Nagella, S Parthasarathy, Bangaru Vivek
Here, we report a rare case of a 23-year-old term parturient with Eisenmenger syndrome due to Taussig-Bing anomaly presenting with gestational hypertension, oligohydramnios, and intrauterine growth retardation posted for elective cesarean section. Preoperatively, echocardiography of the patient was suggestive of double-outlet right ventricle (DORV) with large sub-pulmonic ventricular septal defect (VSD), right ventricular hypertrophy, bidirectional shunt and severe pulmonary artery hypertension. The surgery was successfully performed under a graded segmental epidural anesthesia with 2% lignocaine...
September 2015: Anesthesia, Essays and Researches
Hideshi Tomita, Tovuudorj Bolormaa, Noriyuki Haneda
We reported transcatheter closure of gigantic persistent ductus arteriosus (PDA) complicated by severe pulmonary hypertension (PH) using a custom-made PDA occluder. A 19-year-old lady weighing 45 kg visited to our Heart Saving Project in Mongolia with a chief complaint of shortness of breath. Contrast CT scan showed ellipsoidal section of PDA whose long axis being 28 mm, and the short axis of 21 mm. A custom-made PDA occluder, whose retention skirt, the aortic side, and the pulmonic side diameter of the body were 54, 36, 34 mm, respectively, was successfully deployed using 14-Fr sheath...
October 28, 2015: Catheterization and Cardiovascular Interventions
Ralf Ewert
While the clinical classification of diseases with pulmonary hypertension (PH) has remained fairly stable in recent years, the treatment options have improved significantly. In addition to the General measures (vaccinations, physical training) new recommendations for supportive therapy (administration of diuretics, iron supplementation and oral anticoagulant) exist currently. Some new substances (mostly in the indication pulmonary arterial hypertension) have been admitted to the targeted drug treatment in recent years...
August 2015: Deutsche Medizinische Wochenschrift
T J Byrne
From a broad perspective there are only three arterial systems that respond to relative hypoxia with vasoconstriction. They are the placental, the pulmonic and the renal vascular beds. The renal system's adaptation to hypoxia is markedly different from the other two circulatory beds and will not be further considered here. Regional vasoconstriction is adaptive in the placenta and lung because it redirects red blood cells from areas of relative hypoxia to more oxygenated areas thereby maximizing oxygen uptake for a given cardiac output...
September 2015: Medical Hypotheses
Jun Yasuhara, Hiroyuki Yamagishi
Pulmonary arterial hypertension (PAH) is a common postoperative complication in patients with congenital heart disease (CHD). Although the recent clinical classification of pulmonary hypertension divided PAH associated with CHD (PAH-CHD) into several subclasses, the anatomical and hemodynamic features of postoperative PAH-CHD vary enormously. Therefore, it is still difficult to obtain clinical evidence supporting the indication of pulmonary vasodilators for PAH-CHD. We often encounter patients with PAH occurring after surgical treatment of tetralogy of Fallot (TOF), especially patients with major aortopulmonary collateral arteries (MAPCAs)...
2015: International Heart Journal
Ekim Seven, Lise L N Husemoen, Hans Ibsen, Nele Friedrich, Matthias Nauck, Kristian Wachtell, Allan Linneberg, Jørgen L Jeppesen
BACKGROUND: The role of the natriuretic peptides (NPs) in hypertension is complex. Thus, a higher blood NP concentration is a robust marker of pressure-induced cardiac damage in patients with hypertension, whereas genetically elevated NP concentrations are associated with a reduced risk of hypertension and overweight individuals presumably at high risk of hypertension have lower NP concentrations. OBJECTIVE: To investigate the associations between serum N-terminal pro-B-type natriuretic peptide (NT-proBNP), used as a surrogate marker for active BNP, and prevalent as well as 5-year incident hypertension in a Danish general population sample...
2015: PloS One
Lydia C Soydan, Heidi B Kellihan, Melissa L Bates, Rebecca L Stepien, Daniel W Consigny, Alessandro Bellofiore, Christopher J Francois, Naomi C Chesler
OBJECTIVES: To compare noninvasive estimates of pulmonary artery pressure (PAP) obtained via echocardiography (ECHO) to invasive measurements of PAP obtained during right heart catheterization (RHC) across a range of PAP. To examine the accuracy of estimating right atrial pressure via ECHO (RAPECHO) compared to RAP measured by RHC (RAPRHC), and determine if adding RAPECHO improves the accuracy of noninvasive PAP estimations. ANIMALS: 14 healthy female beagle dogs...
March 2015: Journal of Veterinary Cardiology: the Official Journal of the European Society of Veterinary Cardiology
M Halank, R Speich, D Petkova, S Saxer, S Müller-Mottet, E Hasler, M Kolditz, H Wilkens, N Ehlken, M Lichtblau, B Egenlauf, C Kähler, N Lüneburg, D Mertens, U Schulz, A Barner, E Grünig, M Puhan, S Ulrich
No abstract text is available yet for this article.
December 2014: Deutsche Medizinische Wochenschrift
Rebecca Colman, Heather Whittingham, George Tomlinson, John Granton
INTRODUCTION: Patients with pulmonary hypertension (PH) often present with a variety of physical findings reflecting a volume or pressure overloaded right ventricle (RV). However, there is no consensus regarding the diagnostic utility of the physical examination in PH. METHODS: We conducted a systematic review of publications that evaluated the clinical examination and diagnosis of PH using MEDLINE (1946-2013) and EMBASE (1947-2013). We also prospectively evaluated the diagnostic utility of the physical examination findings...
2014: PloS One
Madhuri Kamatham, Adam Wellikoff, Robert Holladay, Gordon Downie
Bronchology/Interventional Procedures Cases ISESSION TYPE: Affiliate Case Report SlidePRESENTED ON: Sunday, October 26, 2014 at 10:45 AM - 12:00 PMINTRODUCTION: Fibrosing mediastinitis is an uncommon benign disorder characterised by proliferation of dense fibrous tissue within the mediastinum. We desrcibe a patient with fibrosing mediastinitis presenting with chronic hemoptysis treated with endobronchial spray cryotherapy (SCT)CASE PRESENTATION: A 31 year old african american female with a history of fibrosing mediastinitis presented to an outside hospital with hemoptysis 1-1...
October 1, 2014: Chest
Jonathan Wiesen, Gustavo Heresi, Wayne Tsuang
Critical Care Case Report Posters IISESSION TYPE: Affiliate Case Report PosterPRESENTED ON: Tuesday, October 28, 2014 at 01:30 PM - 02:30 PMINTRODUCTION: Severe pulmonary hypertension can result in pulmonary artery (PA) dilatation with resultant mechanical complications, such as pulmonary valve insufficiency, PA rupture and, rarely, compression of nearby anatomical structures.CASE PRESENTATION: A 53-year-old male with a known history of severe, inoperable, chronic thromboembolic pulmonary hypertension (CTEPH), presented with hypotension and hypoxic respiratory failure...
October 1, 2014: Chest
M Held, M Linke, B Jany
BACKGROUND AND OBJECTIVE: Since pulmonary hypertension is defined haemodynamically with a mean pulmonary artery pressure (mPAP) of at least 25 mmHg, right heart catheterization is mandatory for diagnosis of PH. However, it remains unclear if echocardiography can always detect a PH and to what extent echocardiographic and invasive parameters correlate. We aimed to determine the frequency of right heart valve insufficiencies, the correlation of mPAP measured invasively and estimated by echocardiography and the correlation of other echocardiographic parameters with invasively measured cardiac output (CO) and pulmonary vascular resistance (PVR) in patients who presented at our center for pulmonary hypertension...
July 2014: Deutsche Medizinische Wochenschrift
Ali Shafiq, Abdullah Bokhari, Imran Nahin, Bobak Rabbani
Massive pulmonary dilation is a rare finding. These aneurysms can result from different aetiologies that can be congenital or acquired. We present a case of a 61-year-old Caucasian woman who presented with dyspnoea and cough and was discovered to have a massive pulmonary aneurysm. After eliminating most other possible causes, pulmonary hypertension and congenital pulmonic valve stenosis were deemed likely aetiological factors for our patient. These aneurysms are very rare and should prompt close attention and surveillance when present...
2014: BMJ Case Reports
F Cinetto, C Agostini
The diagnosis of idiopathic pulmonary fibrosis (IPF) requires exclusion of other known causes of interstitial lung disease (ILD) (e.g., domestic and occupational environmental exposures, systemic connective tissue disease, and drug toxicity), the presence of a 'usual interstitial pneumonia' (UIP) pattern on high resolution computed tomography (HRCT), and specific combinations of HRCT and histopathologic patterns in patients subjected to surgical lung biopsy (SLB). A clear diagnosis and early treatment with currently the only approved anti-fibrotic drug, pirfenidone, represents the standard of care for the treatment of mild-to-moderate IPF...
2013: Sarcoidosis, Vasculitis, and Diffuse Lung Diseases: Official Journal of WASOG
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