scholarly journals Ulipristal Acetate Efficacy in a Patient with Symptomatic Fibroid and Concomitant Pulmonary Embolism

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
S. von Wunster ◽  
P. D’Oria ◽  
L. Colonna ◽  
G. Patelli
Keyword(s):  
Pulmonary Embolism ◽  
Adverse Events ◽  
Uterine Fibroid ◽  
Uterine Fibroids ◽  
Effective Drug ◽  
Bleeding Control ◽  
Ulipristal Acetate ◽  
Threatening Condition ◽  
Life Threatening ◽  
Fibroid Volume

Ulipristal acetate (UPA) is an effective drug for the treatment of symptomatic uterine fibroids. The drug is highly effective in controlling bleeding control and in the recovery of anemia. Here, we report the case of a woman with severe menorrhagia due to a uterine fibroid and with concomitant pulmonary embolism, a serious life-threatening condition. UPA was shown to be effective in reducing fibroid volume and controlling symptoms, without worsening the underlying embolic disease. No adverse events were observed, and the patient has completely recovered.

scholarly journals T-wave inversion in the precordial leads: сardiac and non-cardiac causes

Kardiologiia ◽  
2020 ◽  
Vol 60 (5) ◽  
pp. 136-145
Author(s):  
I. R. Tsoy ◽  
I. P. Kolos
Keyword(s):  
Pulmonary Embolism ◽  
Differential Diagnosis ◽  
Anterior Wall ◽  
Left Ventricular ◽  
Arrhythmogenic Cardiomyopathy ◽  
Cardiac Memory ◽  
T Wave ◽  
Wave Inversion ◽  
Threatening Condition ◽  
Life Threatening

The T-wave inversion (TWI) is a common electrocardiographic finding. Causes for TWI are numerous and sometimes TWI may appear in life-threatening conditions. The aim of this review was to provide an up-to-date analysis of TWI, including i) definition and prevalence; ii) causes, and iii) differential diagnosis in benign TWI, reversible myocardial ischemia of the left ventricular anterior wall; takotsubo cardiomyopathy; subarachnoid hemorrhage; pulmonary embolism; right ventricular arrhythmogenic cardiomyopathy; and “cardiac memory”. The review presents practical electrophysiological criteria, which allow suspecting in time a life-threatening condition to choose an up-to-date treatment.

scholarly journals Cardiac sarcoidosis: systematic review of literature on corticosteroid and immunosuppressive therapies

2021 ◽  
pp. 2100449
Author(s):  
Julien Stievenart ◽  
Guillaume Le Guenno ◽  
Marc Ruivard ◽  
Virginie Rieu ◽  
Marc André ◽  
...  
Keyword(s):  
Adverse Events ◽  
Cardiac Sarcoidosis ◽  
Positive Impact ◽  
Immunosuppressive Agents ◽  
Left Ventricular ◽  
Randomised Control Trial ◽  
Cochrane Library ◽  
Prisma Statement ◽  
Threatening Condition ◽  
Life Threatening

BackgroundCardiac sarcoidosis (CS) is a life-threatening condition in which clear recommendations are lacking. We aimed to review systematically the literature on cardiac sarcoidosis treated by corticosteroids and/or immunosuppressive agents in order to update the management of CS.MethodsUsing Pubmed, Embase and Cochrane Library databases, we found original articles on corticosteroid and/or standard immunosuppressive therapies for CS which provided at least fair SIGN overall assessment of quality and analyse the relapse rate, major cardiac adverse events (MACEs) and adverse events. We base our methods on Prisma statement and checklist.ResultsWe retrieved 21 studies. Mean quality provided by SIGN assessment was 6.8/14 (range 5–9). Corticosteroids appeared to have a positive impact on left ventricular function, atrioventricular block, and ventricular arrhythmias. For corticosteroids alone, nine (45%) studies (n=351) provided data on relapses, representing an incidence of 34% (n=119). Three studies (14%, n=73) provided data on MACEs (n=33), representing 45% of MACEs in patients treated by corticosteroid alone. Nine studies provided data on adjunctive immunosuppressive therapy in which four studies (n=78) provided data on CS relapse, representing an incidence of 33% (n=26). Limitations consisted in no randomised control trial retrieved and unclear data on MACEs in patients treated by combined immunosuppressive agents and corticosteroids.ConclusionsCorticosteroids should be started early after diagnosis but the exact scheme is still unclear. Studies concerning adjunctive conventional immunosuppressive therapies are lacking and benefits of adjunctive immunosuppressive therapies are unclear. Homogenous data on CS long-term outcomes under corticosteroids, immunosuppressive therapies and other adjunctive therapies are lacking.

scholarly journals Atraumatic hemopericardium in a patient receiving warfarin therapy for a pulmonary embolus

CJEM ◽  
2005 ◽  
Vol 7 (03) ◽  
pp. 168-170
Author(s):  
Peter G. Katis
Keyword(s):  
Emergency Department ◽  
Pulmonary Embolism ◽  
Cardiac Tamponade ◽  
Pulmonary Embolus ◽  
Warfarin Therapy ◽  
Pericardial Tamponade ◽  
Thromboembolic Disease ◽  
Threatening Condition ◽  
Life Threatening ◽  
Echocardiographic Evidence

ABSTRACT Acute pericardial tamponade is a potentially life-threatening condition that requires immediate treatment. This report describes a patient who presented to the emergency department with an acute hemopericardium and echocardiographic evidence of cardiac tamponade following the initiation of warfarin therapy for a recently diagnosed pulmonary embolism. The association between cardiac tamponade, oral anticoagulation and pulmonary thromboembolic disease is briefly discussed.

Suspected Pulmonary Embolism in the First 2,000 Incidents Reports of Perioperative and Anesthetic Adverse Events in Thailand (PAAd Thai) Study

2020 ◽  
Vol 103 (9) ◽  
pp. 869-877
Keyword(s):  
Pulmonary Embolism ◽  
Adverse Events ◽  
Clinical Presentation ◽  
Patient Characteristics ◽  
Thromboembolic Complication ◽  
Adverse Outcomes ◽  
Risk Patients ◽  
Life Threatening ◽  
Incident Reports ◽  
Orthopedic Patients

Background: Perioperative pulmonary embolism (PE) is a rare but life-threatening complication. The diagnosis remains challenging due to non-specific clinical presentations, which may vary from asymptomatic to cardiovascular collapse. Objective: To describe the clinical presentation, diagnosis, and outcomes of the patients after suspected PE as well as to investigate the cause among Thai surgical population. Materials and Methods: The authors conducted an observational study by retrospective analysis of the data from the Perioperative and Anesthetic Adverse Events in Thailand (PAAd Thai) study. All surgical patients under anesthesia in 22 participating hospitals between January 1 and December 31, 2015, were included. The incident reports of suspected PE were reviewed independently by three anesthesiologists. Data regarding patient characteristics, clinical manifestation, and other details were obtained from the standardized incident report forms. Descriptive statistics was used. Results: Of the 2,000 incident reports, 16 patients were diagnosed with suspected PE. Cardiac arrest occurred in 11 cases (68.7%) and the overall mortality rate was 37.5% (6 of 16 patients). Most incidents were reported in orthopedic patients (10 cases, 62.5%) and caused by thrombosis (13 cases, 81.2%). Most of the incidents occurred intraoperatively (10 cases, 62.5%). The confirmatory imaging studies were investigated in eight cases (50%). To minimize the adverse outcomes, having more experience along with the help from experienced assistants and improved multidisciplinary support, were predominantly recommended. In addition, the most frequent suggested corrective strategies were implementation of appropriate clinical practice guideline and quality assurance activity. Conclusion: Perioperative PE causes significant morbidity and mortality. The diagnosis remains difficult but early detection of suspicious clinical presentation and optimization of the treatment are crucial. Identification of high-risk patients, intraoperative vigilance, and effective interdepartmental communication should be considered to improve patient outcomes. Keywords: Perioperative, adverse event, anesthesia, pulmonary embolism, thromboembolic, complication

scholarly journals Diagnosis, Treatment and Follow Up of Acute Pulmonary Embolism: Consensus Practice from the PERT Consortium

2019 ◽  
Vol 25 ◽  
pp. 107602961985303 ◽  
Author(s):  
Belinda Rivera-Lebron ◽  
Michael McDaniel ◽  
Kamran Ahrar ◽  
Abdulah Alrifai ◽  
David M. Dudzinski ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Acute Pulmonary Embolism ◽  
International Association ◽  
Response Team ◽  
Threatening Condition ◽  
Life Threatening ◽  
Acute Pe ◽  
Careful Assessment ◽  
Pulmonary Embolism Response Team

Pulmonary embolism (PE) is a life-threatening condition and a leading cause of morbidity and mortality. There have been many advances in the field of PE in the last few years, requiring a careful assessment of their impact on patient care. However, variations in recommendations by different clinical guidelines, as well as lack of robust clinical trials, make clinical decisions challenging. The Pulmonary Embolism Response Team Consortium is an international association created to advance the diagnosis, treatment, and outcomes of patients with PE. In this consensus practice document, we provide a comprehensive review of the diagnosis, treatment, and follow-up of acute PE, including both clinical data and consensus opinion to provide guidance for clinicians caring for these patients.

scholarly journals The unfortunate miss: a saddle pulmonary embolism

2017 ◽  
Vol 5 (1) ◽  
pp. 136
Author(s):  
William Li ◽  
Marek Gruca ◽  
Bhaskara Madhira
Keyword(s):  
Pulmonary Embolism ◽  
Pulmonary Artery ◽  
Ct Angiography ◽  
Imaging Modality ◽  
Pulmonary Emboli ◽  
Efficient Management ◽  
Threatening Condition ◽  
Life Threatening ◽  
Surgical Thrombectomy ◽  
Prompt Diagnosis

Pulmonary embolism is a potentially life-threatening condition that requires prompt diagnosis and efficient management such as in the form of thrombolysis or surgical thrombectomy. Saddle pulmonary emboli occurring at the bifurcation of the pulmonary artery are especially dangerous as they put afflicted individuals at risk for sudden hemodynamic collapse. While CT Angiography at present is the current imaging modality of choice, times exist when they are contraindicated and V/Q scintigraphy is used as the choice alternative. We present a rare catastrophic case of a saddle pulmonary embolism in an individual with a low-probabilityinterpretation on V/Q scintigraphy despite a clear depiction of the thrombus on echocardiography.

Pulmonary embolism as a potential side effect of olanzapine and the possible beneficiary side effect of duloxetine: A case study

2011 ◽  
Vol 26 (S2) ◽  
pp. 1222-1222
Author(s):  
O. Andrioti ◽  
N. Nikolaidis ◽  
S. Ntonias
Keyword(s):  
Pulmonary Embolism ◽  
Side Effect ◽  
Potential Effect ◽  
Protective Role ◽  
Psychiatric Medication ◽  
Male Smoker ◽  
The Past ◽  
Threatening Condition ◽  
Life Threatening

IntroductionPulmonary embolism is a very serious, life threatening condition. It has been associated with the use of antipsychotic drugs, both typical and atypical, thus consisting a rare but potentially lethal side effect of this drug category. SSRIs/SNRIs on the other hand, are associated with bleeding, increased INR results and platelet dysfunction.Objective and methodA clinical case was followed and reviewed to illustrate the possible connection between the withdrawal of duloxetine and the ongoing use of olanzapine with pulmonary embolism.ResultsA 36-year- old male, smoker of 30 cigarettes/day had been under treatment with olanzapine 30 mg/day and aripiprazole 30 mg/day for the past year. Duloxetine 90 mg/day had also been added for the past nine months and withdrawn after the improvement of depressive symptoms. Approximately one month after its withdrawal the man suffered pulmonary embolism and was hospitalised. During hospitalisation tests found no other factors predisposing to emboli creation. He was discharged with acenocumarol (Sintrom). His psychiatric medication was therefore adjusted to omit olanzapine and SSRIs /SNRIs because of their potential effect on coagulation.ConclusionsCan it be that olanzapine played a role in promoting pulmonary embolism in this patient ?Can it be that duloxetine was playing a protective role and its withdrawal facilitated the onset of pulmonary embolism? There is no certain way to tell but, to our knowledge, there has not been a similar case before and the time sequence of the events might not be coincidental.

scholarly journals Managing venous thromboembolic events in daily practise: ‘‘time is never enough’’

2016 ◽  
Vol 71 (2) ◽  
Author(s):  
D. Anyfantakis ◽  
E.K. Symvoulakis ◽  
I. Mitrouska
Keyword(s):  
Pulmonary Embolism ◽  
Clinical Practice ◽  
Clinical Case ◽  
Daily Clinical Practice ◽  
Thromboembolic Events ◽  
Venous Thromboembolic Events ◽  
Venous Thromboembolic ◽  
Threatening Condition ◽  
Life Threatening

Pulmonary embolism is an insidious life-threatening condition. Its diagnosis represents a challenging topic in daily clinical practice since the recognition and the appropriate management of the condition can lead to the decrease of potentially fatal consequences. We present a clinical case which highlights the necessity for an increased level of ‘surveillance’ from the involved physicians since features of thromboembolic events may be elusive or vague.

scholarly journals Endovascular treatment of acute pulmonary embolism

2018 ◽  
Vol 5 (4) ◽  
pp. 5-11
Author(s):  
M. A. Chernyavskiy ◽  
Y. A. Kudaev ◽  
A. V. Chernov ◽  
N. N. Zherdev ◽  
D. V. Chernova
Keyword(s):  
Pulmonary Embolism ◽  
Endovascular Treatment ◽  
Pulmonary Arteries ◽  
Massive Pulmonary Embolism ◽  
Interventional Treatment ◽  
Fatal Hemorrhage ◽  
Threatening Condition ◽  
Life Threatening ◽  
Shock System ◽  
Very High

Thromboembolism of pulmonary artery is life-threatening condition due to acute right ventricle failure and cardiogenic shock. System thrombolysis is the main way of reperfusion in massive pulmonary embolism with a very high risk of fatal hemorrhage complications. There is a popular revascularization method in two last decades such as endovascular treatment. It allows to recover the blood flow into occluded pulmonary arteries up to three weeks after confirmed embolism episode and to decrease major bleeding risks. Now trials corroborate the high efficacy and safety of interventional treatment the usage of which would allow to improve prognosis in massive pulmonary embolism.

scholarly journals Case Report: Diffuse T wave inversions as initial electrocardiographic evidence in acute pulmonary embolism

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 738 ◽  
Author(s):  
Ogechukwu Egini ◽  
Alix Dufresne ◽  
Mazin Khalid ◽  
Chinedu Egini ◽  
Eric Jaffe
Keyword(s):  
Pulmonary Embolism ◽  
Acute Pulmonary Embolism ◽  
Clinical Signs ◽  
Troponin Elevation ◽  
Coronary Syndrome ◽  
T Wave ◽  
Threatening Condition ◽  
Life Threatening ◽  
Work Up ◽  
Typical Chest Pain

Acute pulmonary embolism (PE) is a life-threatening condition and is typically diagnosed by a combination of symptoms, clinical signs and imaging. Electrocardiogram may be helpful in diagnosis, and the most widely described pattern of occurrence is the so-called S1Q3T3 pattern. Here, we describe the case of an African-American male who presented with typical chest pain, diffuse T wave inversions with serial troponin elevation. There was initial concern for Wellen's syndrome but was finally diagnosed as acute PE. This case underscores the necessity of vigilance and a lower threshold for PE work up even in patients presenting as acute coronary syndrome.

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