scholarly journals All that clots is not blood: Bone cement implantation syndrome presenting as an intracardiac mass and pulmonary embolism

2022 ◽  
Author(s):  
May Anne Cheong ◽  
Kenneth Michael Chew
Keyword(s):  
Pulmonary Embolism ◽  
Femoral Neck ◽  
Bone Cement ◽  
Revision Operation ◽  
Intracardiac Mass ◽  
Pulmonary Angiogram ◽  
Ct Pulmonary Angiogram ◽  
Perioperative Complication ◽  
Bone Cement Implantation Syndrome ◽  
The Right

Bone cement implantation syndrome (BCIS) is a rare and potentially fatal perioperative complication of cemented orthopaedics surgery. A CT-pulmonary angiogram and echocardiogram images were acquired from an 88-year-old patient who had a perioperative collapse while undergoing a revision operation for a peri-implant fracture of the right femoral neck. Findings were suggestive of an intracardiac clot connected to a saddle pulmonary artery embolus. Patient also developed disseminated intravascular coagulation. Overall findings were suggestive of bone cement implantation syndrome.

scholarly journals Feasibility of Detecting Pulmonary Embolism Using Noncontrast MRI

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
C. S. Mudge ◽  
T. T. Healey ◽  
M. K. Atalay ◽  
J. A. Pezzullo
Keyword(s):  
Pulmonary Embolism ◽  
Cardiac Mri ◽  
Imaging Techniques ◽  
Pulmonary Arteries ◽  
Pulmonary Emboli ◽  
Pulmonary Angiogram ◽  
Mri Protocol ◽  
Ct Pulmonary Angiogram ◽  
Magnetic Resonance Imaging Techniques ◽  
The Right

Purpose. The purpose of this study was to evaluate the feasibility of detecting pulmonary emboli utilizing noncontrast magnetic resonance imaging techniques in patients with known pulmonary embolism. Materials and Methods. Eleven patients were enrolled in a study to evaluate right ventricular function by cardiac MRI in patients diagnosed with acute pulmonary embolism on CT pulmonary angiogram. Cardiac MRI was performed as soon as possible following pulmonary embolism detection. Two independent observers reviewed the precontrast portion of each MRI, scoring right, left, and lobar arteries as positive or negative for PE. The CTs were reviewed and interpreted in the same manner. Results. MRI was obtained on average of 40 hours after the CT. Forty-eight vessels were affected by PE on CT, 69% of which were identified on MRI. All eight pulmonary emboli located in the right or left pulmonary arteries were detected on MRI. Of the 15 pulmonary emboli that were not detected on MRI, 7 were subsegmental, 6 were segmental, and 2 were located in a branch not included in the MRI field of view. Conclusions. Most pulmonary emboli detected on CT were identified on noncontrast MRI, even though our MRI protocol was not optimized for pulmonary artery visualization.

scholarly journals COVID-19 CT pulmonary angiogram examinations and reported pulmonary embolism incidence: comparison between peak first wave and early second wave

2021 ◽  
Vol 76 (4) ◽  
pp. 310-312
Author(s):  
M.T. Tsakok ◽  
Z. Qamhawi ◽  
S.F. Lumley ◽  
C. Xie ◽  
P. Matthews ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Pulmonary Angiogram ◽  
Ct Pulmonary Angiogram ◽  
Second Wave

scholarly journals Pulmonary Thromboembolism in a Child with Sickle Cell Hemoglobin D Disease in the Setting of Acute Chest Syndrome

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Hazel Villanueva ◽  
Sandeepkumar Kuril ◽  
Jennifer Krajewski ◽  
Aziza Sedrak
Keyword(s):  
Pulmonary Artery ◽  
Sickle Cell ◽  
Pulmonary Thromboembolism ◽  
Acute Chest Syndrome ◽  
Standard Management ◽  
Pulmonary Angiogram ◽  
Right Pulmonary Artery ◽  
Ct Pulmonary Angiogram ◽  
Complete Thrombosis ◽  
The Right

Introduction. Sickle cell hemoglobin D disease (HbSD) is a rare variant of sickle cell disease (SCD). Incidence of pulmonary thromboembolism (PE) and deep venous thrombosis (DVT) in children with HbSD is unknown. PE and DVT are known complications of SCD in adults but have not been reported in the literature in children with HbSD.Case Report. We are reporting a case of a 12-year-old boy with HbSD with acute chest syndrome (ACS) complicated by complete thrombosis of the branch of the right pulmonary artery and multiple small pulmonary artery emboli seen on computed tomography (CT) pulmonary angiogram and thrombosis of the right brachial vein seen on Doppler ultrasound. Our patient responded to treatment with anticoagulant therapy.Conclusion. There are no cases reported in children with HbSD disease presenting as ACS with pulmonary thromboembolism. We suggest that PE should be suspected in patients presenting with ACS who do not show improvement with standard management. CT pulmonary angiogram should be utilized for early diagnosis and appropriate management as there is no current protocol for management of PE/DVT in pediatric patients with SCD.

Primary pulmonary angiosarcoma

2021 ◽  
Vol 14 (11) ◽  
pp. e244578
Author(s):  
Muhammad Kashif Rana ◽  
Owais Rahman ◽  
Aiden O’Brien
Keyword(s):  
Pulmonary Arteries ◽  
Rare Type ◽  
Pulmonary Artery Sarcoma ◽  
Pulmonary Angiogram ◽  
Primary Pulmonary Artery Sarcoma ◽  
History Of ◽  
Ct Pulmonary Angiogram ◽  
The Right ◽  
Specific Symptoms ◽  
Large Primary

Primary pulmonary angiosarcoma is a rare type of malignant vascular tumour with poor prognosis. Diagnosis is often late due to non-specific symptoms and low clinical suspicion for angiosarcoma. A 72-year-old man presented to hospital with a 6-month history of mild progressive dyspnoea, with associated cough, episodes of presyncope and weight loss. CT pulmonary angiogram (CTPA) was reported as a large saddle pulmonary embolism extending into both the right and left pulmonary arteries. Further Multidisciplinary team meeting (MDM) discussion, and review of CTPA and subsequent investigations revealed a large primary pulmonary artery sarcoma which was later confirmed histology. The patient was referred to the cardiothoracic surgeons and underwent left radical pneumonectomy.

Syncope in pulmonary embolism: a retrospective cohort study

2020 ◽  
pp. postgradmedj-2020-138677
Author(s):  
Craig Richmond ◽  
Hannah Jolly ◽  
Chris Isles
Keyword(s):  
Pulmonary Embolism ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
District General Hospital ◽  
Clinical Feature ◽  
Pulmonary Angiogram ◽  
Ct Pulmonary Angiogram ◽  
Age Range ◽  
Symptoms And Signs

ObjectiveTo determine the prevalence of syncope or collapse in pulmonary embolism (PE).MethodsA retrospective cohort study was conducted. We examined the frequency with which syncope or collapse (presyncope) occurred alone or with other symptoms and signs in an unselected series of 224 patients presenting to a district general hospital with PE between September 2012 and March 2016. Confirmation of PE was by CT pulmonary angiogram in each case.ResultsOur cohort of 224 patients comprised 97 men and 127 women, average age 66 years with age range of 21–94 years. Syncope or collapse was one of several symptoms and signs that led to a diagnosis of PE in 22 patients (9.8%) but was never the sole presenting feature. In descending order, these other clinical features were hypoxaemia (17 patients), dyspnoea (12), chest pain (9), tachycardia (7) and tachypnoea (7). ECG abnormalities reported to occur more commonly in PE were found in 13/17 patients for whom ECGs were available. Patients with PE presenting with syncope or collapse were judged to have a large clot load in 15/22 (68%) cases.ConclusionSyncope was a frequent presenting symptom in our study of 224 consecutive patients with PE but was never the sole clinical feature. It would be difficult to justify routine testing for PE in patients presenting only with syncope or collapse.

scholarly journals Focus Assessed Transthoracic Echocardiography (FATE) to facilitate the diagnosis of low risk Pulmonary Embolism in Emergency Department

2013 ◽  
Vol 12 (4) ◽  
pp. 459-461 ◽  
Author(s):  
RS Sazwan ◽  
YU Devi ◽  
FM Hashairi ◽  
WAR Wan Faizia
Keyword(s):  
Emergency Department ◽  
Pulmonary Embolism ◽  
Transthoracic Echocardiography ◽  
Gold Standard ◽  
Clinical Presentation ◽  
Medical Science ◽  
Low Risk ◽  
Pulmonary Angiogram ◽  
Ct Pulmonary Angiogram ◽  
Standard Investigation

A diagnosis of Pulmonary Embolism (PE) is difficult that may be missed because of non specific clinical presentation. However, early diagnosis is fundamental, since immediate treatment is highly effective. Thus, with the availability of ultrasound machine in Emergency Department (ED) can help Emergency Physician to diagnose PE by using Focus Assessed Transthoracic Echocardiography (FATE) to facilitate the diagnosis of PE in low risk patient before proceed with the gold standard investigation which is CT Pulmonary Angiogram (CTPA). We believed this case was likely to be repeated on some readers' clinical practice and this procedure is an appropriate option to consider in such cases. DOI: http://dx.doi.org/10.3329/bjms.v12i4.16101 Bangladesh Journal of Medical Science Vol. 12 No. 04 October ’13 Page 459-461

scholarly journals 780 Appearing and disappearing right-heart thrombus: a case reporto in COVID-19 patient

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Giacomo Campi ◽  
Martina Finocchi ◽  
Nicolas Palagano ◽  
Emanuela Calcagno ◽  
Alessandra Pesci ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Right Ventricle ◽  
Thrombus Formation ◽  
Nasopharyngeal Swab ◽  
Cardiac Ultrasound ◽  
Free Wall ◽  
Pulmonary Angiogram ◽  
Right Ventricle Free Wall ◽  
Ct Pulmonary Angiogram ◽  
The Right

Abstract Aims Venous thromboembolism represents frequent complication of patients with severe COVID-19 disease. Several reports about atypical thrombosis are described, rarely it has been described a right venticular thrombus during the course of infection. We report a case of right endoventricular thrombosis in a patient with SARS-Cov-2 pneumonia. Methods and results A 58-year-old man was admitted to our ward for severe respiratory failure in interstitial pneumonia. The nasopharyngeal swab for COVID-19 resulted positive. Steroids and prophylaxis with LMWH were started, associated to CPAP to maintain good gas exchange. During hospitalization a venous ECD was performed with evidence of left popliteal thrombosis despite the therapy. d-Dimer was 4463  ng/ml. A new onset AF was documented at the telemetry, without troponin elevation. A cardiac ultrasound was performed showing a right endoventricular lesion of 1.8  cm adhering to the free wall of the right ventricle. A CT-pulmonary angiogram (CTPA) resulted negative for pulmonary embolism and confirmed suspected right ventricular thrombus. Treatment with fondaparinux 7.5 mg was started. After 10 days, cardiac ultrasound shown complete resolution of thrombosis, and CT confirmed the disappearing of the mass. Dabigatran 150  mg twice/day was started. Patient clinically improved and he was discharged after 20 days of hospitalization. Conclusions SARS-CoV-2 infection may cause inflammation with cytokine storm and hypercoagulability leading to venous thromboembolism. Atypical thrombus formation was reported, including right-ventricle free wall. Early caridac ultrasound was critical to make diagnosis and starting prompt treatment, therefore routine cardiac ultrasound is mandatory in severe COVID-19 patients.

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