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Pulmonary Artery Thrombosis


Presentation

  • We present a case of a 76-year-old man, known to have cardiac failure on regular treatment who presented with predominant features of right-sided heart failure accompanied with dizziness.[ncbi.nlm.nih.gov]
  • He presented with massive haemoptysis related to pulmonary artery aneurysms. Initial treatment consisted in urgent right inferior lobectomy, corticosteroids and monthly intravenous cyclophosphamide.[ncbi.nlm.nih.gov]
  • Although 85 % of children with TE-PE had an elevated D-dimer at presentation, it was non-discriminatory for the diagnosis.[ncbi.nlm.nih.gov]
  • This report describes the case of a term infant with a pulmonary artery thrombosis presenting as persistent pulmonary hypertension of the newborn.[ncbi.nlm.nih.gov]
  • We herein present a case of a preterm newborn with pulmonary artery thrombosis accompanied by acute-onset respiratory failure and cyanotic congenital heart disease. The thrombosis was successfully treated using tissue plasminogen activator.[ncbi.nlm.nih.gov]
Cyanotic Congenital Heart Disease
  • We herein present a case of a preterm newborn with pulmonary artery thrombosis accompanied by acute-onset respiratory failure and cyanotic congenital heart disease. The thrombosis was successfully treated using tissue plasminogen activator.[ncbi.nlm.nih.gov]
Colic
  • With this presentation, it could easily be diagnosed as a renal colic case in a young patient.[sjkdt.org]
Right Flank Pain
  • Abstract A young 23-year-old male patient presented with a two-day history of right flank pain. He had no history of any significant illnesses in the past. His investgations showed nephrotic range proteinuria with hypoalbuminemia.[sjkdt.org]

Workup

  • […] patient may be disastrous and lead to early postoperative allograft failure. 11 Pulmonary vein thrombosis may also present more insidiously with recurrent pulmonary edema and pulmonary fibrosis. 12 This patient presented with abdominal pain; further workup[mdedge.com]
  • Workup identified a pulmonary artery stump thrombosis. Due to the acute onset of his symptoms, the patient was anticoagulated, and his chest pain resolved.[thrombosisjournal.biomedcentral.com]
  • Blood investigations showed that the patient had type III Protein S deficiency, as the thrombophilia workup revealed low functional Protein S ( 0.249 iu/ ml, Normal 0.52-1.18) and low free Protein S antigenic ( 0.347 iu/ml, N 0.62-1.3).[omicsonline.org]
  • (See Workup .) Immediate full anticoagulation is mandatory for all patients suspected to have DVT or pulmonary embolism. Diagnostic investigations should not delay empirical anticoagulant therapy. (See Treatment .)[emedicine.medscape.com]
  • Electrocardiography and chest radiography should usually be incorporated into the diagnostic workup. The most frequent electrocardiographic abnormality is the inversion of T waves in the anterior leads, especially leads V1 to V4.[tmj.ro]
Ground Glass Appearance
  • Chest radiography showed florid ground glass appearances in both lung fields. Intravenous immunoglobulin (IVIg) 21 gm daily and subsequently intravenous pentaglobulin 300 mg daily were given between day 13 and day 16.[pmj.bmj.com]
Mural Thrombus
  • In this case, the presence of mural thrombus in the central pulmonary arteries on computed tomography made the distinction difficult.[ncbi.nlm.nih.gov]
Chlamydia
  • […] pneumoniae infection: the Azithromycin in Coronary Artery Disease: Elimination of Myocardial Infection with Chlamydia (ACADEMIC) study.[books.google.de]
Hepatocellular Carcinoma
  • During the virus C infection the presence of cirrhosis is the major risk factor for the development of hepatocellular carcinoma. In the absence of cirrhosis the estimated prevalence hepatocellular carcinoma ranged from 6.7% to 50.1%.[ncbi.nlm.nih.gov]

Treatment

  • Although treatment of neonatal thrombosis remains controversial, thrombolytic agents must be considered when the thrombosis is life threatening.[ncbi.nlm.nih.gov]
  • The patient and her family refused surgical treatment.[ncbi.nlm.nih.gov]
  • Corticosteroid therapy was intensified, monthly intravenous cyclophosphamide was continued and an anticoagulant was added to the treatment with a favourable clinical and radiological response.[ncbi.nlm.nih.gov]
  • In patients with TE-PE, pharmacologic thrombolysis was used in 29 %; unfractionated heparin was the most common initial anticoagulant treatment in 64 % and low-molecular-weight heparins the most common follow-up treatment in 83 %.[ncbi.nlm.nih.gov]
  • We present a case of a 76-year-old man, known to have cardiac failure on regular treatment who presented with predominant features of right-sided heart failure accompanied with dizziness.[ncbi.nlm.nih.gov]

Prognosis

  • The prognosis of patients with nephrotic syndrome who develop RVT is unclear. There are no large studies that have addressed this issue. Laville et al [18] followed-up 27 patients with documented RVT to evaluate their long-term prognosis.[sjkdt.org]
  • Kerr Clinical course and late prognosis of treated subacute massive, acute minor, and chronic pulmonary thromboembolism Br Heart J, 39 (1977), pp. 1135-1142 [2.] K.M. Moser, W.R. Auger, P.F.[archbronconeumol.org]
  • The presence of a right heart thrombus in PE is relevant for the prognosis, as it predicts a higher mortality rate ( 44%) [ 5 ]. Sometimes, the differential diagnosis of an FRHT may be difficult.[omicsonline.org]
  • Based on his poor functional status and his overall clinical condition, his prognosis was poor. He received hospice care and died 3 months later. DISCUSSION Pulmonary vein thrombosis is a rare condition.[mdedge.com]
  • Complications and prognosis If left untreated, the prognosis for PE is poor. Even when treated, some patients develop chronic thromboembolic pulmonary hypertension, which is caused by obstruction of the pulmonary arteries due to PE.[patient.info]

Etiology

  • It has been described following lobectomy, lung transplant, and in association with metastatic carcinoma. 1-4 Some cases have been described as idiopathic. 5-7 Its exact incidence is unknown, and treatment depends on etiology.[mdedge.com]
  • (See Etiology .) Pathophysiology There are both respiratory and hemodynamic consequences associated with pulmonary embolism.[emedicine.medscape.com]

Epidemiology

  • The epidemiology of venous thromboembolism in the community. Arterioscler Thromb Vasc Biol. 2008 Mar. 28(3):370-2. [Medline]. [Full Text]. Sandler DA, Martin JF.[emedicine.medscape.com]
  • The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies. Int J Surg, 12 (2014), pp. 1495-1499 [13] R. Otero Candelera, E. Grau Segura, D. Jiménez Castro, F.[archbronconeumol.org]
  • Epidemiology The incidence of venous thromboembolism (VTE) varies from 1-1.5 per 1,000 person-years [ 2 ].[patient.info]
  • Pulmonary embolism, part I: Epidemiology, risk factors and risk stratification, pathophysiology, clinical presentation, diagnosis and non-thrombotic pulmonary embolism. Exp Clin Cardiol 2013;18:129-38. PubMed PMC 3.[vpjournal.net]
  • Epidemiology The estimated prevalence of CTEPH after acute pulmonary embolism is 0.1–4% after 2 years [ 2, 13 – 16 ]. The median age at diagnosis is 63 years, and both genders are equally affected [ 17 ].[intechopen.com]
Sex distribution
Age distribution

Pathophysiology

  • The pathophysiology of these events remains poorly defined.[annalspc.com]
  • […] been recognized as one of the complications of nephrotic syndrome since 1840. [1] Although it was initially thought to be the cause rather than the effect of nephrotic syndrome, today, it is clear that the hypercoagulable state is the result of several pathophysiological[sjkdt.org]
  • This brief article covers PE stratification, pathophysiology, and endovascular therapy for massive and submassive PE. Pulmonary embolism is stratified by short-term mortality.[vasculardiseasemanagement.com]
  • Pathophysiology There are both respiratory and hemodynamic consequences associated with pulmonary embolism.[emedicine.medscape.com]
  • Pulmonary embolism, part I: Epidemiology, risk factors and risk stratification, pathophysiology, clinical presentation, diagnosis and non-thrombotic pulmonary embolism. Exp Clin Cardiol 2013;18:129-38. PubMed PMC 3.[vpjournal.net]

Prevention

  • These cases illustrate a rising clinical problem in this special population-that is, how to treat and prevent large pulmonary artery thrombosis in the setting of haemoptysis. The authors discuss their approach to these cases and the known literature.[ncbi.nlm.nih.gov]
  • N Engl J Med ‎ Seite 339 - Anderson JL, Muhlestein JB, Carlquist J, Allen A, Trehan S, Nielson C, Hall S, Brady J, Egger M, Hörne B, Lim T (1999) Randomized secondary prevention trial of azithromycin in patients with coronary artery disease and serological[books.google.de]
  • Although anticoagulation seems logical for both prevention and treatment of thrombosis, it may be a double-edged sword that increases the risk of fatal bleeding.[circ.ahajournals.org]
  • The good news is that DVT is preventable and treatable if discovered early.[cdc.gov]
  • Medications Medicines can help prevent repeated episodes of pulmonary embolism by preventing new blood clots from forming or preventing existing clots from getting larger.[northshore.org]

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