Acute pulmonary embolism due to right basilic vein thrombosis

2021 ◽  
Vol 14 (8) ◽  
pp. e244280
Author(s):  
Swetha Chenna ◽  
Venu Chippa

A 40-year-old African-American woman presented to the emergency room (ER) with right upper extremity pain for 3 hours after sleeping overnight on that side. She was diagnosed with basilic vein thrombosis; in the ER, she was tachycardic with minimal ambulation, prompting CT pulmonary angiogram, which confirmed right-sided pulmonary embolism. Bilateral upper and lower extremity venous Dopplers did not show any acute deep venous thrombosis. She received appropriate anticoagulation. Risk factors are a smoker and recently started contraceptive pills.

2017 ◽  
Vol 35 (3) ◽  
pp. 396-400
Author(s):  
Hai-Ting Zhou ◽  
Wen-Ying Yan ◽  
De-Li Zhao ◽  
Hong-Wei Liang ◽  
Guo-Kun Wang ◽  
...  

2018 ◽  
Vol 3 (4) ◽  
pp. 271-276 ◽  
Author(s):  
Kathrin Dohle ◽  
Daniel-Sebastian Dohle ◽  
Hazem El Beyrouti ◽  
Katja Buschmann ◽  
Anna Lena Emrich ◽  
...  

AbstractObjectivesAcute pulmonary embolism can be a life-threatening condition with a high mortality. The treatment choice is a matter of debate. The early and late outcomes of patients treated with surgical pulmonary embolectomy for acute pulmonary embolism in a single center were analyzed.MethodsAll consecutive patients operated on for pulmonary embolism between January 2002 and March 2017 were reviewed. Patient demographics and pre- and postoperative clinical data were retrieved from our patient registry, and risk factors for in-hospital and long-term mortality were identified.ResultsIn total, 175 patients (mean age 59±3 years, 50% male) were operated on for acute pulmonary embolism. In-hospital mortality was 19% (34/175). No differences were found when comparing surgery utilizing a beating heart or cardioplegic arrest. Risk factors for in-hospital mortality were age >70 years [odds ratio (OR) 4.8, confidence interval (CI) 1.7–13.1, p=0.002], body surface area <2 m2 (OR 4.7, CI 1.6–13.7, p=0.004), preoperative resuscitation (OR 14.1, CI 4.9–40.8, p<0.001), and the absence of deep vein thrombosis (OR 9.6, CI 2.5–37.6, p<0.001). Follow-up was 100% complete with a 10-year survival rate of 66.4% in 141/175 patients surviving to discharge. Once discharged from hospital, none of the risk factors identified for in-hospital mortality were relevant for long-term survival except the absence of deep vein thrombosis (OR 3.2, CI 1.2–8.2, p=0.019). The presence of malignancy was a relevant risk factor for long-term mortality (OR 4.3, CI 1.8–10.3, p=0.001).ConclusionSurgical pulmonary embolectomy as a therapy for acute pulmonary embolism demonstrates excellent short- and long-term results in patients with an otherwise life-threatening disease, especially in younger patients with a body surface area >2 m2 and pulmonary embolism caused by deep vein thrombosis. Pulmonary embolectomy should therefore not be reserved as a treatment of last resort for clinically desperate circumstances.


2021 ◽  
Vol 76 (4) ◽  
pp. 310-312
Author(s):  
M.T. Tsakok ◽  
Z. Qamhawi ◽  
S.F. Lumley ◽  
C. Xie ◽  
P. Matthews ◽  
...  

Author(s):  
Mohamad Kanso ◽  
Thomas Cardi ◽  
Halim Marzak ◽  
Alexandre Schatz ◽  
Loïc Faucher ◽  
...  

Abstract Background  Since the onset of the COVID-19 pandemic, several cardiovascular manifestations have been described. Among them, venous thromboembolism (VTE) seems to be one of the most frequent, particularly in intensive care unit patients. We report two cases of COVID-19 patients developing acute pulmonary embolism (PE) after discharge from a first hospitalization for pneumonia of moderate severity. Case summary  Two patients with positive RT-PCR test were initially hospitalized for non-severe COVID-19. Both received standard thromboprophylaxis during the index hospitalization and had no strong predisposing risk factors for VTE. Few days after discharge, they were both readmitted for worsening dyspnoea due to PE. One patient was positive for lupus anticoagulant. Discussion  Worsening respiratory status in COVID-19 patients must encourage physicians to search for PE since SARS-CoV-2 infection may act as a precipitant risk factor for VTE. Patients may thus require more aggressive and longer thromboprophylaxis after COVID-19 related hospitalization.


2021 ◽  
Author(s):  
Judah Nijas Arul ◽  
Preetam Krishnamurthy ◽  
Balakrishnan Vinod Kumar ◽  
Thoddi Ramamurthy Muralidharan ◽  
Senguttuvan Nagendra Boopathy ◽  
...  

Abstract BackgroundMcConnell’s sign is a specific echocardiographic finding that was first described in patient with acute pulmonary embolism signifying right ventricular dysfunction. It remains an under-recognized sign in patients with right ventricular infarction.Case PresentationAn 80-year-old woman presented with sudden onset chest pain and breathlessness. The electrocardiogram showed features suggestive of inferior, posterior, and right ventricular infarction with complete heart block and McConnell’s sign was seen on the echocardiography. CT pulmonary angiogram ruled out the present of pulmonary thromboembolism. Coronary angiogram revealed an occluded right coronary artery with collateral supply from the left circulation. Medical management was planned after patient-physician discussion. Patient symptomatically improved with medical management.ConclusionAlthough McConnell’s sign is suggestive of acute pulmonary embolism, it may also be present in patients with right ventricular dysfunction due to infarction. The presence of McConnell’s sign in a patient presenting with acute coronary syndrome should prompt evaluation for right ventricular infarction in the absence of acute pulmonary embolism.


2020 ◽  
Author(s):  
Samuel Z. Goldhaber

Venous thromboembolism, which involves venous thrombosis and pulmonary embolism, is a leading cause of morbidity and mortality in hospitalized patients and is being seen with increasing frequency in outpatients. This chapter discusses the risk factors, etiology, classification, pathophysiology, natural history, prognosis, diagnosis (including venous thrombosis, recurrent venous thrombosis, and pulmonary embolism), prophylaxis, and treatment of venous thromboembolism (including the pharmacology of antithrombotic agents), as well as venous thromboembolism in pregnancy and miscellaneous thromboembolic disorders (including thrombosis of unusual sites).  This review contains 8 figures, 16 tables, and 79 references. Keywords: Venous thromboembolism, pulmonary embolism, deep vein thrombosis, embolectomy, thrombolysis, hypercoagulability, duplex ultrasonography, D-dimer, anticoagulation


2020 ◽  
Author(s):  
Aaron B Waxman ◽  
Aaron W Aday

More than 200,000 individuals are hospitalized with an acute pulmonary embolism in the United States annually. Despite advances in diagnosis and treatment, pulmonary embolism accounts for nearly 1% of all cardiovascular-related deaths each year in the United States alone. Those who survive an acute episode remain at a risk of recurrent events as well as ongoing dyspnea, reduced quality of life, and chronic thromboembolic pulmonary hypertension. Recognized risk factors for pulmonary embolism include advanced age, obesity, smoking, malignancy, immobilization from any cause, pregnancy and the postpartum period, oral contraceptives, and hormone replacement therapy. Numerous heritable and acquired thrombophilias increase the risk of pulmonary embolism. Additionally, inflammation and autoimmune disorders are increasingly recognized as potent risk factors for pulmonary embolism. This review contains 3 figures, 6 tables, 54 references. Key Words: anticoagulation, deep vein thrombosis, epidemiology, genetics, inflammation, malignancy, pulmonary embolism, thrombosis, venous thromboembolism


2020 ◽  
pp. postgradmedj-2020-138677
Author(s):  
Craig Richmond ◽  
Hannah Jolly ◽  
Chris Isles

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.


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