Life-threatening acute and chronic thromboembolic pulmonary hypertension and subclavian vein thrombosis

SummaryChronic thromboembolic pulmonary hypertension (CTEPH) is a disease resulting from the thromboembolic obstruction of the segmental and/or large size pulmonary arteries, subsequently leading to pulmonary arterial hypertension. Incomplete resolution of acute pulmonary emboli and thrombus organization are believed to be important for the development of the disease. Primary pulmonary hypertension (PPH) is a further disease that at present is poorly understood but shows a clinical picture similar to CTEPH. Since lipoprotein(a) [Lp(a)], a genetically determined risk factor for atherosclerosis and thrombosis, has been found increased in plasma of patients with deep vein thrombosis and pulmonary embolism, we measured plasma Lp(a) levels in 40 patients with CTEPH and 50 patients with PPH and compared them to 50 matched controls. The median for Lp(a) plasma levels was significantly higher in CTEPH patients (26.6 mg/dl) than in PPH patients (9.6 mg/dl) and controls (7.2 mg/dl). Increased plasma Lp(a) could, therefore, play a significant role in the mechanisms of ongoing thrombosis and thrombus organization in CTEPH, while its possible role in PPH can be limited to a small number of patients.

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Management of Massive and Submassive Pulmonary Embolism, Iliofemoral Deep Vein Thrombosis, and Chronic Thromboembolic Pulmonary Hypertension

Circulation ◽

10.1161/cir.0b013e318214914f ◽

2011 ◽

Vol 123 (16) ◽

pp. 1788-1830 ◽

Cited By ~ 1198

Author(s):

Michael R. Jaff ◽

M. Sean McMurtry ◽

Stephen L. Archer ◽

Mary Cushman ◽

Neil Goldenberg ◽

...

Keyword(s):

Pulmonary Embolism ◽

Pulmonary Hypertension ◽

Deep Vein Thrombosis ◽

Chronic Thromboembolic Pulmonary Hypertension ◽

Vein Thrombosis ◽

Submassive Pulmonary Embolism ◽

Thromboembolic Pulmonary Hypertension ◽

Deep Vein

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Novel Insight into How Nurses Working at PH Specialist Clinics in Sweden Perceive Their Work

Healthcare ◽

10.3390/healthcare8020180 ◽

2020 ◽

Vol 8 (2) ◽

pp. 180

Author(s):

Bodil Ivarsson ◽

Barbro Kjellström

Keyword(s):

Pulmonary Hypertension ◽

Personal Development ◽

Qualitative Content Analysis ◽

Chronic Thromboembolic Pulmonary Hypertension ◽

Life Threatening Illness ◽

Good Patient Care ◽

Information And Communication ◽

Thromboembolic Pulmonary Hypertension ◽

Life Threatening ◽

Specialist Knowledge

Outpatient pulmonary hypertension (PH) specialist centers have an important role in the optimal management of pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH). The aim of the present study was to gain an understanding of the work facing nurses at the outpatient PH specialist centers in Sweden. All nurses (n = 14) working at the outpatient PH specialist centers in Sweden were included. Qualitative content analysis was employed to analyze the interviews, wherein an overarching theme emerged: “Build and maintain a relationship with the patient”. Three categories described the nurses’ experiences: “Ambiguous satisfaction regarding information and communication”, “Acting as a coordinator” and “Professional and personal development”. To provide good patient care, the nurses described the key components as the ability to give information on all aspects of the disease and their availability by phone for patients, their relatives, and other healthcare resources. This requires evidence-based, specialist knowledge about the disease, its care, and treatments as well as experience. In conclusion, working as a nurse at the outpatient PH specialist centers highlight the advantages, expectations, and difficulties in working with patients with a rare and life-threatening illness. The overall knowledge and skills were high, but the nurses expressed a need for in-depth and continued training.

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