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.

scholarly journals Intervention in Massive Pulmonary Embolus: Catheter Thrombectomy/Thromboaspiration versus Systemic Lysis versus Surgical Thrombectomy

2018 ◽  
Vol 35 (02) ◽  
pp. 108-115 ◽  
Author(s):  
Martin Edwards ◽  
Adam Plotnik ◽  
John Moriarty
Keyword(s):  
Pulmonary Artery ◽  
Pulmonary Embolus ◽  
Current Medical ◽  
Pulmonary Perfusion ◽  
Systemic Thrombolysis ◽  
Threatening Condition ◽  
Life Threatening ◽  
Surgical Embolectomy ◽  
Surgical Thrombectomy ◽  
Acute Pe

AbstractMassive pulmonary embolus (PE), defined as hemodynamic shock from acute PE, is a life-threatening condition. Deaths from massive PE, especially when unsuspected, occur within minutes to hours of onset and as such prompt intervention can be lifesaving. Acute massive PE patients have traditionally been candidates for treatment with intravenous systemic thrombolysis to improve pulmonary artery pressure, arteriovenous oxygenation, and pulmonary perfusion in an effort to reduce mortality. However, patients with contraindications to systemic thrombolysis or those who have failed thrombolysis may benefit from other techniques including endovascular and surgical embolectomy. This article will review the current medical management as well as catheter-directed therapies and surgical embolectomy in the treatment of patients with massive PE.

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 Tracheal development after left pulmonary artery reimplantation: an individual study

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Xiaoyang Hong ◽  
Ruijie Li ◽  
Zhe Zhao ◽  
Jiangheng Guan ◽  
Hui Wang ◽  
...  
Keyword(s):  
Pulmonary Artery ◽  
Pulmonary Arteries ◽  
Left Pulmonary Artery ◽  
Weaning Failure ◽  
Threatening Condition ◽  
Ventilation Weaning ◽  
Life Threatening ◽  
The Mean ◽  
Tracheal Carina

Abstract Pulmonary artery sling (PA sling) often presents as a life-threatening condition requiring urgent surgical correction. We reported 32 cases of PA sling in children who were followed up postoperatively in the past 6 years. All patients with PA slings who were admitted to the hospital from January 2012 to December 2017 and underwent surgery were retrospectively analyzed. The mean age of the 32 patients at repair was 16.97 months (range, 15 days to 128 months). Six patients required ventilator assistance for respiratory failure. All children underwent left pulmonary artery (LPA) reimplantation (n = 32), and 3 patients needed reimplantation slide tracheoplasty (n = 3) due to ventilation weaning failure. Four patients died, 27 patients survived until discharge, and 18 patients were followed up. Pulmonary computed tomography imaging and echocardiography were performed in 18 patients who were followed up. After LPA reimplantation, the tracheal carina area was significantly enlarged compared to that preoperation (p = 0.0002). In this follow-up cohort study, 75% of the patients who underwent LPA reimplantation survived until discharge. The survivors had subsequently well-developed pulmonary arteries and tracheas.

Life-threatening pulmonary emboli and cor pulmonale: treatment with percutaneous pulmonary artery stent placement.

Radiology ◽  
1994 ◽  
Vol 191 (2) ◽  
pp. 473-475 ◽  
Author(s):  
Z J Haskal ◽  
M C Soulen ◽  
E A Huettl ◽  
H I Palevsky ◽  
C Cope
Keyword(s):  
Pulmonary Artery ◽  
Stent Placement ◽  
Cor Pulmonale ◽  
Pulmonary Emboli ◽  
Life Threatening

Laparoscopic Splenectomy for Atraumatic Splenic Rupture

2011 ◽  
Vol 96 (1) ◽  
pp. 87-89 ◽  
Author(s):  
Ugo Grossi ◽  
Antonio Crucitti ◽  
Gerardo D'Amato ◽  
Andrea Mazzari ◽  
Pasquina M. C. Tomaiuolo ◽  
...  
Keyword(s):  
Laparoscopic Splenectomy ◽  
Splenic Rupture ◽  
Clinical Entity ◽  
Rare Clinical Entity ◽  
Life Saving ◽  
Threatening Condition ◽  
Life Threatening ◽  
Atraumatic Splenic Rupture ◽  
Prompt Diagnosis

Abstract Atraumatic splenic rupture (ASR) is a rare clinical entity. Several underlying benign and malignant conditions have been described as a leading cause. We report on a case of ASR in a 41-year-old man treated with laparoscopic splenectomy. Considering ASR as a life-threatening condition, a prompt diagnosis can be life saving.

scholarly journals Ureteroarterial Fistula from Ureteral Stump: A Challenging Case

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
Pietro Pozzilli ◽  
Massimo Lenti ◽  
Stefano Mosca ◽  
Elisabetta Nunzi ◽  
Luigi Mearini
Keyword(s):  
Rare Condition ◽  
Diagnosis And Treatment ◽  
Endovascular Stent ◽  
Difficult Diagnosis ◽  
Ureteroarterial Fistula ◽  
Threatening Condition ◽  
Life Threatening ◽  
Endovascular Stent Placement ◽  
Prompt Diagnosis ◽  
Ureteral Occlusion

Ureteroarterial fistula (UAF) is a relatively rare condition with about 150 cases reported in the literature. Since it is a potentially life-threatening condition, a prompt diagnosis and treatment are crucial. We present here a rare, challenging case of UAF diagnosed after left nephrectomy, thus involving the ureteral stump. The difficult diagnosis and treatment by contemporary use of endovascular stent placement and ureteral occlusion by mean of metallic coils and Onyx injection are discussed.

scholarly journals Acute corticosteroid-induced rhabdomyolysis in a golf player

2016 ◽  
Vol 24 (4) ◽  
Author(s):  
D Janse van Rensburg
Keyword(s):  
Early Diagnosis ◽  
Medical Professionals ◽  
Efficient Management ◽  
Secondary Damage ◽  
Threatening Condition ◽  
Life Threatening

Acute corticosteroid-induced rhabdomyolysis is a rare, but potentially life-threatening, condition that deserves the attention of medical professionals and sport scientists. Early diagnosis is vital in minimising the secondary damage caused by rhabdomyolysis. This case of rhabdomyolysis highlights the severity of symptoms and the importance of decisive treatment. Clinicians should be familiar with the most common symptoms of acute corticosteroid-induced rhabdomyolysis to enable early diagnosis and efficient management of this condition.

scholarly journals Salvage of Suboptimal Enhancement of Pulmonary Artery in Pulmonary CT Angiography Studies: Rapid kVp Switch Dual Energy CT Experience

2020 ◽  
Vol 17 (2) ◽  
Author(s):  
Selen Bayraktaroglu ◽  
Akın Cinkooglu ◽  
Naim Ceylan ◽  
Recep Savas
Keyword(s):  
Pulmonary Embolism ◽  
Image Quality ◽  
Pulmonary Artery ◽  
Imaging Modality ◽  
Main Pulmonary Artery ◽  
Pulmonary Arteries ◽  
Dual Energy ◽  
Dual Energy Ct ◽  
Average Increase ◽  
Noise Ratio

Background: Multidetector computed tomography (MDCT) angiography is considered as the gold standard imaging modality in the evaluation of acute pulmonary embolism. Optimum vascular enhancement is critical for MDCT studies. The suboptimal opacification in pulmonary artery could be salvaged using low-energy virtual monoenergetic images (VMI) at rapid kVp switch dual energy CT. Objectives: To explore the potential improvement in pulmonary artery opacification and to assess the change in image quality parameters in VMI using fast switch kVp dual energy CT. Patients and Methods: The CT images of 877 patients who were referred with a preliminary diagnosis of pulmonary embolism were reviewed. Sixty patients with suboptimal enhancement (< 200 Hounsfeld Unit [HU]) were involved. Standard images (140 kVp) and VMI from 40 to 120 keV were generated. Attenuation, noise, signal to noise ratio (SNR) and contrast to noise ratio (CNR) were measured in the pulmonary artery. Using VMIs, the best image was determined as the image with the main pulmonary artery opacification greater than 200 HU and image quality ≥ 3. Fifty six studies that met these criteria were considered as salvaged. At this best energy level, quantitative parameters were compared with standard images. Results: The mean attenuation of pulmonary arteries was 169.80 HU in standard images in patients with suboptimal enhancement. The attenuations of VMIs at 40, 45, 50, 55, 60, 65, and 70 keV were significantly higher than standard images (P < 0.001). Similar findings were observed with SNR and CNR. In the salvaged patients, the average increase in mean pulmonary artery attenuation was 62% (from 172.61 ± 23.4 to 280.55 ± 40.7), the average increase in SNR was 38% (from 12.1 ± 5.3 to 16.7 ± 7.1) and the average increase in CNR was 48% (9.2 ± 4.3 to 13.7 ± 6) (P < 0.001). Conclusions: Low keV VMI reconstructions significantly increase pulmonary artery attenuation, CNR and SNR compared to standard image reconstructions. Suboptimal CT studies could be salvaged using low keV VMIs.

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.

High-Altitude Pulmonary Edema with Absent Right Pulmonary Artery

PEDIATRICS ◽  
1985 ◽  
Vol 75 (2) ◽  
pp. 314-317
Author(s):  
Billy Rios ◽  
David J. Driscoll ◽  
Dan G. McNamara
Keyword(s):  
Pulmonary Artery ◽  
Pulmonary Edema ◽  
High Altitude ◽  
Congenital Absence ◽  
High Altitude Pulmonary Edema ◽  
Threatening Condition ◽  
Right Pulmonary Artery ◽  
Life Threatening ◽  
Low Altitude ◽  
The Right

High-altitude pulmonary edema potentially is fatal. Adults with unilateral absence of a right pulmonary artery are particularly susceptible to high-altitude pulmonary edema. The occurrence of high-altitude pulmonary edema was documented in a child with congenital absence of the right pulmonary artery. Improvement occurred only upon descent to low altitude. Physicians should be aware of this life-threatening condition in children ascending to high altitude, particularly in individuals with unilateral absence of a pulmonary artery.

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