The present report describes a patient with deep venous thrombosis who had recurrent pulmonary embolism despite thrombolysis and anticoagulation. [ncbi.nlm.nih.gov]

Presents a consistent chapter organization that delivers all the content you need in a logical, practical manner. Presents a new co-editor, Thomas D. [books.google.de]

• Recurrent Pulmonary Embolism

  Abstract Sixty-nine patients (37.5%) presented recurrent pulmonary embolic phenomena. [ncbi.nlm.nih.gov]

• Fever

  Symptoms of infectious tenosynovitis of the finger, hand, or wrist Symptoms include: Swelling Pain Slight bending of the finger at rest Trouble using the hand or finger Fever (not always present) Treatment for infectious tenosynovitis of the finger, hand [saintlukeskc.org]

  Later, symptoms may indicate fever, distortion of the kidney mass, evidence of secondary tumours elsewhere in the body, abdominal and flank pain, weight loss, nausea, loss of appetite, and vomiting. [britannica.com]

  The COPD patient presented fever and dyspnea, which are common symptoms in acute exacerbation and could be improved by appropriate therapy. [omicsonline.org]

  Symptoms may include any of the following: Difficulty moving the joint Joint swelling in the affected area Pain and tenderness around the joint Pain when moving the joint Redness along the length of the tendon Fever, swelling, and redness may indicate [medlineplus.gov]

  But most children with Wilms' tumor experience one or more of these signs and symptoms: An abdominal mass you can feel Abdominal swelling Abdominal pain Other signs and symptoms may include: Fever Blood in the urine Nausea or vomiting or both Constipation [mayoclinic.org]

• Dyspnea

  A 45-year-old woman with a history of recurrent pulmonary embolism was admitted to the emergency clinic with dyspnea, wheezing and tachypnea. Partial deep vein thrombosis of the popliteal vein was seen on Doppler sonography. [ncbi.nlm.nih.gov]

  Dyspnea, Orthopnea, and Paroxysmal Nocturnal Dyspnea. Butterworth Publishers. Archived from the original on 27 April 2018. Retrieved 15 August 2014. [en.wikipedia.org]

  The COPD patient presented fever and dyspnea, which are common symptoms in acute exacerbation and could be improved by appropriate therapy. [omicsonline.org]

  He had sustained brief episodes of dyspnea and light headedness on several occasions during the previous 7 years. [nature.com]

• Hemoptysis

  There was no history of fever, wheezing, hemoptysis, trauma, or motor weakness. Her medical history was negative for any major disorders. However, she declared occasional exposure to cow dung and hay. [ijhas.in]

  However, there are many key symptoms and signs of acute pulmonary embolism: Symptoms: Dyspnea, particularly abrupt in onset or abruptly worsening Pleuritic chest pain Cough Symptoms of deep venous thrombosis: calf/thigh pain and/or leg swelling Hemoptysis [clinicaladvisor.com]

  +2 (C) Wells CPR Clinical signs of DVT +3 Low Recent surgery or immobilization +1.5 Intermediate 2–6 High > 6 Unlikely 0–4 Likely > 4 Heart rate > 100 bpm +1.5 Previous history of PE or DVT +1.5 Hemoptysis +1 Malignancy +1 Alternative diagnosis less [onlinelibrary.wiley.com]

  A 43-year-old woman with a history of pulmonary embolism (PE) and antiphospholipid antibody syndrome taking rivaroxaban presented to the ED with shortness of breath, hemoptysis, and pleuritic chest pain. Chest CT demonstrated multiple PEs. [epmonthly.com]

  Pulmonary infarction is typically characterized by chest pain (mainly pleuritic) and, occasionally, hemoptysis. The chest wall may be tender. [merckmanuals.com]

• Painful Cough

  However, there are many key symptoms and signs of acute pulmonary embolism: Symptoms: Dyspnea, particularly abrupt in onset or abruptly worsening Pleuritic chest pain Cough Symptoms of deep venous thrombosis: calf/thigh pain and/or leg swelling Hemoptysis [clinicaladvisor.com]

  and tracheal deviation. [2] Pneumonia [ edit ] The symptoms of pneumonia are fever, productive cough, shortness of breath, and pleuritic chest pain. [2] Inspiratory crackles may be heard on exam. [2] A chest x-ray can be useful to differentiate pneumonia [en.wikipedia.org]

  cough, or hemoptysis often suggest a small embolism near the pleura. [tmj.ro]

  However, it can be particularly challenging as the symptoms (dyspnoea, pleuritic chest pain, retrosternal chest pain, cough and haemoptysis) are not specific (NICE 2012a). [cochranelibrary.com]

• Exertional Dyspnea

  Case Report In January 2015, a 76-year-old ex-smoker was referred to our hospital with a 2-months history of increase in cough, purulent expectoration, exertional dyspnea and pyrexia. [omicsonline.org]

  Distinct sensations include effort/work, chest tightness, and air hunger (the feeling of not enough oxygen). [1] Dyspnea is a normal symptom of heavy exertion but becomes pathological if it occurs in unexpected situations [2] or light exertion. [en.wikipedia.org]

  Chronic thromboembolic pulmonary hypertension causes symptoms and signs of right heart failure, including exertional dyspnea, easy fatigue, and peripheral edema that develops over months to years. [merckmanuals.com]

• Pleuritic Pain

  The most common symptoms were dyspnea, usually of onset within seconds, at rest or with exertion (73%), pleuritic pain (44%), calf or thigh pain (44%), calf or thigh swelling (41%), and cough (34%).[6] With only 24% of patients presenting with tachycardia [ncbi.nlm.nih.gov]

  The classic presentation for PE with pleuritic pain, dyspnea and tachycardia is likely caused by a large fragmented embolism causing both large and small PEs. [en.wikipedia.org]

  pain, cough, or hemoptysis often suggest a small embolism near the pleura. [tmj.ro]

• Chest Pain

  Chest pain that radiates to one or both shoulders or arms, chest pain that occurs with physical activity, chest pain associated with nausea or vomiting, chest pain accompanied by diaphoresis or sweating, or chest pain described as "pressure," has a higher [en.wikipedia.org]

  We describe a 30-year-old woman with a history of recurrent pulmonary embolism who was admitted for investigation of pleuritic chest pain in whom transesophageal echocardiography played a critical role in the diagnosis and management. [ncbi.nlm.nih.gov]

  […] of stress can also cause chest pain. [healthmoin.com]

  The most common symptoms of a pulmonary embolus are the acute onset of: Chest pain: The pain is often described as pleuritic, a sharp pain that worsens when taking a deep breath. [medicinenet.com]

• Cyanosis

  Being short of breath, especially during exercise Feeling tired Feeling weak Feeling pain or pounding in the chest (the pounding is called palpitations) Swelling of the legs due to fluid retention ( edema ) Developing cyanosis (blue color to fingers and [my.clevelandclinic.org]

  […] pleuritic chest pain apprehension cough haemotypsis leg pain collapse = massive PE acute cardiovascular collapse Examination pale, mottled skin tachypnoea tachycardia signs of DVT hypotension altered LOC elevated JVP parasternal heave loud P2 central cyanosis [lifeinthefastlane.com]

  […] symptoms that can occur with pulmonary embolism include: Rapid or irregular heartbeat Lightheadedness or dizziness Excessive sweating Fever Leg pain or swelling, or both, usually in the calf caused by a deep vein thrombosis Clammy or discolored skin (cyanosis [mayoclinic.org]

  Cyanosis and venous engorgement of the upper torso were observed. HBIG and ε-aminocaproic acid infusions were discontinued immediately. [anesthesiology.pubs.asahq.org]

  Dyspnea / shortness of breath palpitation cyanosis hyperP2 and lower limb edema are more common in recurrent pulmonary embolism. [bigengculture.com]

• Systolic Murmur

  On auscultation, loud ejection systolic murmur can be best heard at the right second intercostal space and radiates to the carotid artery in the neck. Splitting of second heart sound is heard in severe stenosis. [en.wikipedia.org]

  On physical examination, findings of right ventricular dysfunction include bulging neck veins with prominent v waves, a left parasternal lift, an accentuated pulmonic component of the second heart sound, and a systolic murmur at the left lower sternal [tmj.ro]

• Heart Murmur

  Signs and symptoms of heart failure may also present. On auscultation, loud ejection systolic murmur can be best heard at the right second intercostal space and radiates to the carotid artery in the neck. [en.wikipedia.org]

• Retrosternal Chest Pain

  However, it can be particularly challenging as the symptoms (dyspnoea, pleuritic chest pain, retrosternal chest pain, cough and haemoptysis) are not specific (NICE 2012a). [cochranelibrary.com]

The elements of diagnostic workup will vary depending on whether the patient is hospitalized and whether there is hemodynamic instability. [ncbi.nlm.nih.gov]

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]

Role of 320-slice CT imaging in the diagnostic workup of patients with chronic thromboembolic pulmonary hypertension[J]. Chest, 2013, 143: 1070-1077. DOI:10.1378/chest.12-0407 [39] Auger WR, Fedullo PF, Moser KM, et al. [cem.org.cn]

Recurrent VTE reduction ↓ 26.4% ↓ 26.4% ↓ 26.4% Major bleeding increase ↑ 2.4% ↑ 4.9% ↑ 19.6% Second unprovoked VTE Recurrent VTE reduction ↓ 39.6% ↓ 39.6% ↓ 39.6% Major bleeding increase ↑ 2.4% ↑ 4.9% ↑ 19.6% THROMBOPHILIA TESTING / HYPERCOAGULABLE WORKUP [straighthealthcare.com]

(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]

• Pulmonary Arterial Pressure Increased

  Blood pressure was then noted to decrease precipitously from 110/55 mmHg to 60/33 mmHg soon after HBIG infusion was completed. Pulmonary arterial pressure and central venous pressure were increased at 63/33 mmHg and 40 mmHg, respectively. [anesthesiology.pubs.asahq.org]

• Right Axis Deviation

  Focal oligemia, cardiomegaly and plump pulmonary arteries on chest X-ray films, right axis deviation, clockwise rotation, ST-segment depression and T-wave inversion on electrocardiograms, and dilatations of the pulmonary arterial trunk, the right ventricle [ncbi.nlm.nih.gov]

  An electrocardiogram revealed right bundlebranch block and right axis deviation (the electrocardiogram is available in the Supplementary Appendix). Blood tests revealed an elevated d-dimer level of 2073 ng per milliliter. [inspiro-bg.com]

  EKG showed right axis deviation, a new incomplete right bundle branch block (IRBBB), clockwise rotation, and right heart strain with inverted T waves in V1–V4 ( Figure 2 ). [nature.com]

  […] heart strain), -> right axis deviation -> s wave (I and aVL) > 1.5mm -> Q wave in III and aVF -> p pulmonale -> RBBB CXR: rules out other pathology, focal oligaemia, wedge density (pulmonary infarction) ABG: reduced PaO2 in keeping with size of PE, metabolic [lifeinthefastlane.com]

• Hypocapnia

  Mechanisms of hypoxemia and hypocapnia in pulmonary embolism. Am J Respir Crit Care Med 1995; 152 : 336–347. 10 Frisbie JH, Steele DJR. Postural hypotension and abnormalities of salt and water metabolism in myelopathy patients. [nature.com]

  Arterial or venous blood gas measurement may show an increased alveolar to arterial oxygen (A-a) difference (sometimes called A-a gradient) or hypocapnia; one or both of these tests are moderately sensitive for PE, but neither is specific. [merckmanuals.com]

  Findings of hypoxemia or hypocapnia may increase physician’s level of diagnostic suspicion, but these findings are not specific for pulmonary embolism. [tmj.ro]

• Incomplete Right Bundle Branch Block

  Review of EKGs showed a trend of increasing right axis deviation with recovery and recurrences during the previous 9 years and a current incomplete right bundle branch block with clockwise rotation and inverted T waves in V1-4. [ncbi.nlm.nih.gov]

  EKG showed right axis deviation, a new incomplete right bundle branch block (IRBBB), clockwise rotation, and right heart strain with inverted T waves in V1–V4 ( Figure 2 ). [nature.com]

  New-onset right-bundle branch block or atrial fibrillation is uncommon. [tmj.ro]

• P Pulmonale

  > ETCO2 to gradient hypoxaemia ECG: -> mostly normal -> sinus tachycardia -> SI, QIII, TIII -> non specific ST changes or TWI in anterior leads (right heart strain), -> right axis deviation -> s wave (I and aVL) > 1.5mm -> Q wave in III and aVF -> p [lifeinthefastlane.com]

  Right axis deviation (R > S in V1) and P-pulmonale may be present. T-wave inversion in leads V1 to V4 also occurs. [merckmanuals.com]

Treatment with statins may be an attractive alternative for anticoagulant treatment in the long-term treatment of PE. [ncbi.nlm.nih.gov]

Offers practical, clinically relevant material for the diagnosis and treatment of musculoskeletal conditions. [books.google.de]

CONCLUSION:Statin treatment decreases the risk of recurrent PE, irrespective of VKA treatment. Treatment with statins may be an attractive alternative for anticoagulant treatment in the long-term treatment of PE. [paper.medlive.cn]

From these results, the authors conclude that a single assessment of persistent perfusion defects at 6 months may guide treatment decisions regarding duration of anticoagulation therapy. [erj.ersjournals.com]

The prognosis of such a disease is bad and the patient died at 1-year follow-up. Recurrent pulmonary embolism with well-conducted oral anticoagulant therapy requires further appropriate investigations, because of high suspicion of neoplastic process. [ncbi.nlm.nih.gov]

[…] without this heterozygosity loss. [5] The prognosis for patients who have a relapse is not as good as it is for those with a newly diagnosed Wilms tumor, with 40-80% of relapse patients expected to survive after salvage therapy. [emedicine.medscape.com]

MRI Increased fluid within tendon sheath: T1: low or intermediate if debris within tendon sheath T2: high T1 C+ (Gd): tendon sheath thickening and peritendinous subcutaneous contrast enhancement Treatment and prognosis Treatments may include non-steroidal [radiopaedia.org]

Etiology Clinical features Subtypes and variants De Quervain tenosynovitis Thickening of the abductor pollicis longus and extensor pollicis brevis due to myxoid degeneration Epidemiology Sex: ♀ > ♂ Age: 30–50 years Often seen in new mothers Etiology Repetitive [amboss.com]

Contrast should be a consideration in cases concerning for infectious etiologies for abscess visualization. [ncbi.nlm.nih.gov]

The synovial membrane is part of a fluid-filled sheath that surrounds a tendon. joint swelling pain in the affected area and pain moving a joint reddening along the length of the affected tendon difficulty moving the joint Etiology Tenosynovitis can be [radiopaedia.org]

Trigger finger: etiology, evaluation, and treatment. Curr Rev Musculoskelet Med. 2008;1(2):92-6. [arthritis-health.com]

Most early reports suggest that hepatic irradiation is the major etiologic factor in hepatic injury. [emedicine.medscape.com]

Etiology Clinical features Subtypes and variants De Quervain tenosynovitis Thickening of the abductor pollicis longus and extensor pollicis brevis due to myxoid degeneration Epidemiology Sex: ♀ > ♂ Age: 30–50 years Often seen in new mothers Etiology Repetitive [amboss.com]

Introduction Infection of the synovial sheath that surrounds the flexor tendon Epidemiology incidence 2.5 to 9.4% of all hand infections risk factors diabetes IV drug use immunocompromised patients Pathophysiology mechanism penetrating trauma to the tendon [orthobullets.com]

Epidemiology Wilms' tumor affects 1 in 10,000 children in North America. [atlasgeneticsoncology.org]

Max Wilms Epidemiology Most common pediatric renal tumor, affecting 1 per 8 - 10,000 children (500 new cases per year in US) 90% diagnosed prior to age 6 years; rarely congenital; occasionally diagnosed in teenagers / adults; age distribution M = F Most [pathologyoutlines.com]

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]

Journal of the National Medical Association, 100, 734-736. [ 8 ] Espinosa, G., Bucciarelli, S., Asherson, R.A. and Cervera, R. (2008) Morbidity and mortality in the catastrophic antiphospholipid syndrome: Pathophysiology, causes of death, and prognostic [scirp.org]

Although this study does not change our current practice, the results of this study are nevertheless important and provide unique new insight into the pathophysiology of CTEPH after PE. [erj.ersjournals.com]

Introduction Infection of the synovial sheath that surrounds the flexor tendon Epidemiology incidence 2.5 to 9.4% of all hand infections risk factors diabetes IV drug use immunocompromised patients Pathophysiology mechanism penetrating trauma to the tendon [orthobullets.com]

This article will review the risk factors, pathophysiology, clinical presentation, evaluation, and treatment of PE. [ncbi.nlm.nih.gov]

[…] defined as acute PE with obstructive shock or SBP submassive PE is acute PE without systemic hypotension (SBP ≥90 mm Hg) but with either RV dysfunction or myocardial necrosis those with none of the above severe features are non-massive or low risk PEs PATHOPHYSIOLOGY [lifeinthefastlane.com]

The results of this study suggest that inferior vena cava filter implantation can be effective for preventing recurrent pulmonary embolism complicating refractory nephrotic syndrome. [ncbi.nlm.nih.gov]

To learn more about how we use cookies, please see our cookies policy Close Intended for healthcare professionals Research Prevention of... [bmj.com]

In order to reduce mortality, prevention of new or recurrent PE is a major therapeutic aim. [clinicaltrials.gov]