Prediction of Moderate or Severe Pulmonary Hypertension by Main Pulmonary Artery Diameter and Main Pulmonary Artery Diameter/Ascending Aorta Diameter in Pulmonary Embolism

2006 ◽  
Vol 14 (5) ◽  
pp. 213-214 ◽  
Author(s):  
Shirin Sanal ◽  
Wilbert S. Aronow ◽  
Gautham Ravipati ◽  
George P. Maguire ◽  
Robert N. Belkin ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Pulmonary Hypertension ◽  
Pulmonary Artery ◽  
Main Pulmonary Artery ◽  
Ascending Aorta ◽  
Severe Pulmonary Hypertension ◽  
Aorta Diameter ◽  
Pulmonary Artery Diameter

scholarly journals Does Larger Fetal Ascending Aorta Than the Pulmonary Artery Indicate Major Cardiac Anomaly?

2020 ◽  
pp. 1
Author(s):  
Safak Yilmaz Baran ◽  
Alev Arslan ◽  
Gulsen Dogan Durdag ◽  
Hakan Kalayci ◽  
Seda Yuksel Simsek ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Right Ventricle ◽  
Pulmonary Valve ◽  
Main Pulmonary Artery ◽  
Double Outlet Right Ventricle ◽  
Ascending Aorta ◽  
Pulmonary Valve Stenosis ◽  
Chamber View ◽  
Aorta Diameter ◽  
Pulmonary Artery Diameter

<p><strong>OBJECTIVE:</strong> This study investigated the cases in which the fetal ascending aorta is larger than the main pulmonary artery on the three-vessel view and aimed to determine the relationship between the larger ascending aorta and major cardiac anomalies.</p><p><strong>STUDY DESIGN:</strong> Pregnancies between 18-24 gestational weeks who underwent detailed second-trimester screening during 2015-2019 were evaluated. Cases whose fetal ascending aorta diameter was larger than fetal main pulmonary artery diameter on the three-vessel view despite normal four-chamber view were analyzed. Prenatal and postnatal echocardiography studies were performed for each case.</p><p><strong>RESULTS:</strong> Fetal ascending aorta diameter larger than fetal main pulmonary artery diameter on the three-vessel view despite normal four-chamber view was detected in 21 fetuses in a total of 3810 pregnancies (0.55%), and 10 (47.6%) of them had major congenital heart disease. The diagnosis of Tetralogy of Fallot, double outlet right ventricle, ventricular septal defect, pulmonary valve stenosis, and moderate to severe tricuspid regurgitation were confirmed with prenatal/postnatal echocardiography studies. The highest ratio of ascending aorta/main pulmonary artery was 1.4 in a fetus with a double outlet right ventricle and pulmonary valve stenosis.</p><p><strong>CONCLUSION:</strong> The fetal ratio of ascending aorta/main pulmonary artery larger than 1 on the three-vessel view may be a sign of certain cardiac anomalies. Nevertheless, this rate is not an indicator of a serious cardiac defect in all cases. Fetal advanced echocardiography and early postnatal cardiac evaluation should be done to confirm the diagnosis.</p>

scholarly journals Severe Pulmonary Hypertension in Acute Pulmonary Thromboembolism: More Common than Expected?

2020 ◽  
Author(s):  
Mahsa Behnemoon ◽  
Elham Laleh ◽  
Amin Sedokani ◽  
Ayatay Bahrami
Keyword(s):  
Pulmonary Embolism ◽  
Pulmonary Hypertension ◽  
Pulmonary Artery ◽  
Hospital Mortality ◽  
Right Ventricular ◽  
Pulmonary Artery Pressure ◽  
Severe Pulmonary Hypertension ◽  
Artery Pressure ◽  
Acute Pe ◽  
Echocardiographic Findings

Abstract Background: Pulmonary embolism (PE) is a relatively common health problem and the third most common cause of cardiovascular death with a 15-20 percent mortality rate. Severe pulmonary arterial hypertension is not common in acute forms of the disease, and we usually expect only mild to moderate degrees of PAH in these patients. However, we have encountered numerous cases of severe pulmonary hypertension after acute PE in our practice. In this study, we aimed to evaluate the echocardiographic findings of patients admitted with documented PE in a 5 years study of two heart centers of Urmia.Methods: In this retrospective study, the data of 183 patients with a definitive diagnosis of acute pulmonary embolism based on pulmonary CT angiography have entered the study.Results: Of the 183 cases diagnosed with pulmonary embolism with an average age of 61.15 years, 45.4% were male and 54.6% were female. Shortness of breath, chest pain, and hemoptysis were seen in 88%, 49.2%, and 13.1% of patients, respectively. Tachypnea and tachycardia were the most common clinical findings with a frequency of 54.1%. Echocardiographic findings of right ventricular enlargement and right ventricular dysfunction were observed in 66.7% and 67.8% of patients, respectively and 42.1% of patients had severe pulmonary hypertension. We found a significant relationship between pulmonary artery pressure severity and shock state as well as in-hospital mortality. While only 3 patients out of 64 cases (4%) with normal or mildly elevated pulmonary artery pressure died in their hospital stay period, the mortality rate was 28.5% in patients with moderate or severe pulmonary artery hypertension (p-value=0.002).Conclusion: we found a relatively high frequency of severe pulmonary artery hypertension in patients admitted with the definite diagnosis of acute pulmonary embolism and there was a significant correlation between pulmonary artery pressure severity and shock state, as well as in-hospital mortality. So, echocardiographic findings including right ventricular systolic pressure and TR velocity may have additional prognostic value in the decision making of acute PE patients and could be helpful in reducing in-hospital mortality of this complex illness provided being included in prognostic models of acute PE, based on future studies.

The Value of Dual-Source CT in the Diagnosis of Anomalous Origin of Pulmonary Artery

2021 ◽  
Author(s):  
Yusen Feng ◽  
Pengcheng Ma ◽  
Lijuan Wang ◽  
Guifang Sun ◽  
Bin Liu ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Main Pulmonary Artery ◽  
Left Pulmonary Artery ◽  
Ascending Aorta ◽  
Left Main ◽  
Descending Aorta ◽  
Dual Source ◽  
Inner Diameter ◽  
The Right ◽  
Pulmonary Artery Diameter

Abstract Objective: This study is designed to explore the dual-source computed tomography (DSCT) imaging manifestations of the origin of three rare pulmonary artery abnormalities, and to improve the understanding and diagnosis of the disease.Methods: Collected 30 cases of patients diagnosed by DSCT with pulmonary artery abnormal origins, and retrospectively analyzed their imaging data and postoperative pathological data.Results: Among the 30 patients with abnormal pulmonary artery origin, 16 patients were with unilateral pulmonary artery absence (UAPA), 8 patients were with anomalous origin of unilateral pulmonary artery (AOPA), and 6 patients were left pulmonary artery suspension (LPAS). The diagnosis rate of DSCT is significantly higher than that of echocardiography. The results of DSCT imaging showed that the inner diameter of the ascending aorta, the aortic arch and the descending aorta of UAPA patients were significantly larger than those of LPAS patients (P<0.05). Compared with AOPA patients, the left pulmonary artery diameter, the ratio of the left main pulmonary artery diameter to the main pulmonary artery diameter, and ratio of the left main pulmonary artery diameter to the right main pulmonary artery diameter were significantly increased in UAPA patients (P<0.05). There was no significant difference in the ratio of the inner diameter of the ascending aorta to the descending aorta in patients with UAPA, AOPA and LPAS. Compared with UAPA patients, AOPA patients had no significant changes in the inner diameter of the main pulmonary artery, the inner diameter of the right main pulmonary artery, and the ratio of the inner diameter of the right main pulmonary artery to the main pulmonary artery.Conclusion: DSCT can be used to diagnose the origin of pulmonary artery abnormalities and distinguish its types.

scholarly journals Measurement of Main Pulmonary Artery Diameter and its Ratio with Ascending Aorta in Indian Population by Multi Detector Computed Tomography

2020 ◽  
Author(s):  
Jyoti Gangadhar Dulli ◽  
HM Chandrashekar ◽  
J Naveen ◽  
Maskal Revanna Srinivas ◽  
Shreyas G Rao ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Indian Population ◽  
Main Pulmonary Artery ◽  
Ascending Aorta ◽  
Diameter Ratio ◽  
P Value ◽  
Normal Range ◽  
Significant Difference ◽  
The Mean ◽  
Pulmonary Artery Diameter

Introduction: An increase in Pulmonary Artery (PA) pressure is associated with an increase in its diameter. Hence, it is necessary to know the normal range of Main Pulmonary Artery Diameter (MPAD). An attempt has been made to know the same among the Indian population. Aim: To determine the normal range of reference values for diameter of Main Pulmonary Artery (MPA) and its relation with Ascending Aorta (AA) in Indian population. Materials and Methods: A prospective cross-sectional study was conducted between October 2018 and September 2019 ((380 males, 120 females) between the age of 30-65 years). Data from the contrast CT scans of thorax of 500 subjects such as those patients with cough under evaluation, suspected lung nodule, chest wall lesions, primary or secondaries in the lung, etc., who visited the Department of Radio-diagnosis, in the Medical College of South India were analysed. Further, healthy population was also defined as those who were free from chronic cardiopulmonary illness in particular with regard to present study, which would affect the diameter of great vessels including that of PA and aorta. MPA and ascending aortic diameters were measured at the level of pulmonary artery bifurcation, viewed at fixed mediastinal window settings. Statistical Package for Social Sciences (SPSS) version 20, inferential statistics like Unpaired-t test were used to test the significant difference for variables between the two groups (males and females). The level of significance was set at 5%. Results: The MPADs of whole population ranged between 15.6-31.6 mm, with mean diameter of 23.08±2.81 mm. Correlation between age and MPAD was statistically significant (p-value <0.001), while sex-specific MPAD was not significant. The mean AA diameter was 27.15±2.6 mm. The mean AA diameter in males was 27.76±3.2 mm, and 26.67±2.0 mm in females with statistical significance (p-value 0.001) between the groups. The diameter ratio of MPA to AA was 0.85. Conclusion: In present study, the normal ranges of diameter of PA and its ratio with AA were defined among Indians. The diameter ratio of MPA to AA appears to be more important, as it tends to normalise the effects of anthropomorphic factors.

scholarly journals Widespread Parenchymal Abnormalities and Pulmonary Embolism on Contrast-Enhanced CT Predict Disease Severity and Mortality in Hospitalized COVID-19 Patients

2021 ◽  
Vol 8 ◽  
Author(s):  
Francesca Campoccia Jalde ◽  
Mats O. Beckman ◽  
Ann Mari Svensson ◽  
Max Bell ◽  
Magnus Sköld ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Pulmonary Embolism ◽  
Pulmonary Artery ◽  
Troponin T ◽  
Main Pulmonary Artery ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Parenchymal Abnormalities ◽  
Pulmonary Artery Diameter ◽  
D Dimer

Purpose: Severe COVID-19 is associated with inflammation, thromboembolic disease, and high mortality. We studied factors associated with fatal outcomes in consecutive COVID-19 patients examined by computed tomography pulmonary angiogram (CTPA).Methods: This retrospective, single-center cohort analysis included 130 PCR-positive patients hospitalized for COVID-19 [35 women and 95 men, median age 57 years (interquartile range 51–64)] with suspected pulmonary embolism based on clinical suspicion. The presence and extent of embolism and parenchymal abnormalities on CTPA were recorded. The severity of pulmonary parenchymal involvement was stratified by two experienced radiologists into two groups: lesions affecting ≤50% or &gt;50% of the parenchyma. Patient characteristics, radiological aspects, laboratory parameters, and 60-day mortality data were collected.Results: Pulmonary embolism was present in 26% of the patients. Most emboli were small and peripheral. Patients with widespread parenchymal abnormalities, with or without pulmonary embolism, had increased main pulmonary artery diameter (p &lt; 0.05) and higher C-reactive protein (p &lt; 0.01), D-dimer (p &lt; 0.01), and troponin T (p &lt; 0.001) and lower hemoglobin (p &lt; 0.001). A wider main pulmonary artery diameter correlated positively with C-reactive protein (r = 0.28, p = 0.001, and n = 130) and procalcitonin. In a multivariant analysis, D-dimer &gt;7.2 mg/L [odds ratio (±95% confidence interval) 4.1 (1.4–12.0)] and ICU stay were significantly associated with embolism (p &lt; 0.001). The highest 60-day mortality was found in patients with widespread parenchymal abnormalities combined with pulmonary embolism (36%), followed by patients with widespread parenchymal abnormalities without pulmonary embolism (26%). In multivariate analysis, high troponin T, D-dimer, and plasma creatinine and widespread parenchymal abnormalities on CT were associated with 60-day mortality.Conclusions: Pulmonary embolism combined with widespread parenchymal abnormalities contributed to mortality risk in COVID-19. Elevated C-reactive protein, D-dimer, troponin-T, P-creatinine, and enlarged pulmonary artery were associated with a worse outcome and may mirror a more severe systemic disease. A liberal approach to radiological investigation should be recommended at clinical deterioration, when the situation allows it. Computed tomography imaging, even without intravenous contrast to assess the severity of pulmonary infiltrates, are of value to predict outcome in COVID-19. Better radiological techniques with higher resolution could potentially improve the detection of microthromboses. This could influence anticoagulant treatment strategies, preventing clinical detoriation.

scholarly journals TOTAL OCCLUSION OF RIGHT MAIN PULMONARY ARTERY IN A PATIENT WITH SEVERE PULMONARY HYPERTENSION

2021 ◽  
Vol 77 (18) ◽  
pp. 2789
Author(s):  
Cynthia Jackson-Pedroza ◽  
Oscar Garcia-Padron ◽  
Leticia Gallardo Grajeda ◽  
Carlos Dattoli-Garcia ◽  
Fabio Solis-Jimenez ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Pulmonary Artery ◽  
Main Pulmonary Artery ◽  
Severe Pulmonary Hypertension ◽  
Total Occlusion
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