scholarly journals Tension Pneumothorax complicating COVID19 Pneumonia

2021 ◽  
Author(s):  
Amr Mohamed
Keyword(s):  
Pulmonary Embolism ◽  
Acute Pulmonary Embolism ◽  
Tension Pneumothorax ◽  
High Index ◽  
Acute Decompensation ◽  
High Index Of Suspicion

Acute decompensation in patient with COVID19 is usually a consequence of worsening ARDS , however acute pulmonary embolism and acute pneumothorax are frequently recognized causes of acute decompensation , the later causes are treatable and having high index of suspicion is very important in order not to miss them.

Salvage pulmonary thromboembolectomy for massive pulmonary embolism in a child presented with syncope and subsequent cardiac arrest

2019 ◽  
Vol 29 (8) ◽  
pp. 1094-1096
Author(s):  
Koray Ak ◽  
Yasar Birkan ◽  
Figen Akalın ◽  
Deniz Günay
Keyword(s):  
Pulmonary Embolism ◽  
Cardiac Arrest ◽  
Cardiopulmonary Arrest ◽  
Massive Pulmonary Embolism ◽  
High Index ◽  
Exertional Dyspnoea ◽  
Pulmonary Embolectomy ◽  
High Index Of Suspicion

AbstractPulmonary embolism is frequently under-recognised in children and, therefore, a high index of suspicion should be exerted on patients with exertional dyspnoea, presyncope/syncope and unexplained cardiopulmonary arrest. We discuss a 10-year-old previously healthy girl who presented with syncope and subsequent cardiac arrest related to massive pulmonary embolism and was salvaged successfully by emergent pulmonary embolectomy.

scholarly journals Case of COVID-19 infection and polycythaemia presenting with massive acute pulmonary embolism

2020 ◽  
Vol 13 (9) ◽  
pp. e237390
Author(s):  
Asadullah Nawazani ◽  
Mahmoud Ghanaim ◽  
Sadia Tariq
Keyword(s):  
Pulmonary Embolism ◽  
Oxygen Saturation ◽  
Male Patient ◽  
Acute Pulmonary Embolism ◽  
Polycythaemia Vera ◽  
Thromboembolic Events ◽  
Shortness Of Breath ◽  
Low Oxygen ◽  
High Index Of Suspicion ◽  
Predisposing Conditions

We are reporting a middle-aged male patient with polycythaemia vera comorbidity. The patient was exhibiting symptoms including fever, cough and shortness of breath and was found to have acute pulmonary embolism. He was diagnosed with SARS-CoV-2. This case suggests that a high index of suspicion should be taken into consideration for thromboembolic events, when treating patients with COVID-19 with breathing difficulty and low oxygen saturation levels, especially in those who have underlying predisposing conditions for coagulopathy.

Pulmonary Embolism

1997 ◽  
Vol 17 (01) ◽  
pp. 1-4
Author(s):  
K. M. Moser
Keyword(s):  
Pulmonary Embolism ◽  
Lower Extremity ◽  
Pulmonary Angiography ◽  
High Index ◽  
Diagnostic Approach ◽  
Patient Needs ◽  
Clinical Context ◽  
High Index Of Suspicion ◽  
Extremity Veins

SummaryOur diagnostic approach to the embolic suspect involves a high index of suspicion based on the clinical context. Next, study of the lower extremity veins; if such a study (IPG, Duplex, venogram) discloses proximal DVT, the patient needs treatment and a search for embolism may or may not be required. If it is, perfusion and ventilation scans are performed next. If this test is non-diagnostic, pulmonary angiography is the final step. As noted, other technics are under investigation. It will take time to assess whether their promise is fulfilled since it is well-known that “early reports” are usually the most positive and may not translate into clinical, non-investigative use.

scholarly journals Acute Pulmonary Embolism in the COVID-19 Era: The Experience of a Ghanaian Patient

2021 ◽  
Vol 8 ◽  
pp. 237437352199723
Author(s):  
Kofi Tekyi Asamoah
Keyword(s):  
Pulmonary Embolism ◽  
Acute Pulmonary Embolism ◽  
Healthcare Delivery ◽  
Clinical Manifestations ◽  
Screening Tests ◽  
Polymerase Chain Reaction Test ◽  
Polymerase Chain ◽  
High Index Of Suspicion ◽  
Chain Reaction Test ◽  
Transmissible Infection

The coronavirus pandemic has resulted in profound changes in healthcare delivery, some based on official reforms and others driven by healthcare professionals’ fear of exposure to coronavirus disease (COVID-19). Many patients require screening tests of one form or the other before being attended to in hospitals. The protean clinical manifestations of this highly transmissible infection require that a high index of suspicion be maintained. Pulmonary embolism is a potentially fatal emergency whose presentation is mimicked by COVID-19. Delays in ruling out COVID-19 may result in undue delays in initiating treatment for pulmonary embolism, potentially resulting in significant morbidity and mortality. This article presents a patient whose treatment for acute pulmonary embolism was forestalled by delays in getting the polymerase chain reaction test for COVID-19 done. It reiterates the need for physicians to test promptly in order to allow early focus on differential diagnoses which were routinely being investigated promptly prior to the COVID-19 pandemic.

Tissue plasminogen activator as a novel diagnostic aid in acute pulmonary embolism

VASA ◽  
2014 ◽  
Vol 43 (6) ◽  
pp. 450-458 ◽  
Author(s):  
Julio Flores ◽  
Ángel García-Avello ◽  
Esther Alonso ◽  
Antonio Ruíz ◽  
Olga Navarrete ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Negative Predictive Value ◽  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Predictive Value ◽  
Acute Pulmonary Embolism ◽  
Enzyme Linked Immunosorbent Assay ◽  
Diagnostic Utility ◽  
Tissue Plasminogen ◽  
D Dimer

Background: We evaluated the diagnostic efficacy of tissue plasminogen activator (tPA), using an enzyme-linked immunosorbent assay (ELISA) and compared it with an ELISA D-dimer (VIDAS D-dimer) in acute pulmonary embolism (PE). Patients and methods: We studied 127 consecutive outpatients with clinically suspected PE. The diagnosis of PE was based on a clinical probability pretest for PE and a strict protocol of imaging studies. A plasma sample to measure the levels of tPA and D-dimer was obtained at enrollment. Diagnostic accuracy for tPA and D-dimer was determined by the area under the receiver operating characteristic (ROC) curve. Sensitivity, specificity, predictive values, and the diagnostic utility of tPA with a cutoff of 8.5 ng/mL and D-dimer with a cutoff of 500 ng/mL, were calculated for PE diagnosis. Results: PE was confirmed in 41 patients (32 %). Areas under ROC curves were 0.86 for D-dimer and 0.71 for tPA. The sensitivity/negative predictive value for D-dimer using a cutoff of 500 ng/mL, and tPA using a cutoff of 8.5 ng/mL, were 95 % (95 % CI, 88–100 %)/95 % (95 % CI, 88–100 %) and 95 % (95 % CI, 88–100 %)/94 %), respectively. The diagnostic utility to exclude PE was 28.3 % (95 % CI, 21–37 %) for D-dimer and 24.4 % (95 % CI, 17–33 %) for tPA. Conclusions: The tPA with a cutoff of 8.5 ng/mL has a high sensitivity and negative predictive value for exclusion of PE, similar to those observed for the VIDAS D-dimer with a cutoff of 500 ng/mL, although the diagnostic utility was slightly higher for the D-dimer.

Pulmonary emboli due to venous aneurysm of extremities

VASA ◽  
2011 ◽  
Vol 40 (4) ◽  
pp. 327-332 ◽  
Author(s):  
Gabrielli ◽  
Rosati ◽  
Vitale ◽  
Millarelli ◽  
Siani ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Surgical Resection ◽  
Potential Risk ◽  
Acute Pulmonary Embolism ◽  
Prophylactic Surgery ◽  
Venous Aneurysm ◽  
Pulmonary Emboli ◽  
Thromboembolic Events ◽  
Thromboembolic Complications ◽  
Risk Patients

Venous aneurysms are uncommon but they can have devastating consequences, including pulmonary embolism, other thromboembolic events and death. We report six cases of venous aneurysm of the extremities, in which the first sign of presence was acute pulmonary embolism. Surgical resection is recommended whenever possible. Our experience suggests that prophylactic surgery is cautiously recommended for low-risk patients with venous aneurysms of the abdomen and strongly recommended for extremity deep and superficial venous aneurysms for their potential risk of developing thromboembolic complications despite adequate anticoagulation. Other venous aneurysms should be excised only if they are symptomatic or enlarging.

Diagnostic accuracy of magnetic resonance angiography for acute pulmonary embolism - a systematic review and meta-analysis

VASA ◽  
2016 ◽  
Vol 45 (2) ◽  
pp. 149-154 ◽  
Author(s):  
Jie Li ◽  
Lei Feng ◽  
Jiangbo Li ◽  
Jian Tang
Keyword(s):  
Pulmonary Embolism ◽  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Diagnostic Accuracy ◽  
Acute Pulmonary Embolism ◽  
Meta Analysis ◽  
Likelihood Ratios ◽  
Summary Receiver Operating Characteristic ◽  
Acute Pe ◽  
Limited Sensitivity

Abstract. Background: The aim of this meta-analysis was to evaluate the diagnostic accuracy of magnetic resonance angiography (MRA) for acute pulmonary embolism (PE). Methods: A systematic literature search was conducted that included studies from January 2000 to August 2015 using the electronic databases PubMed, Embase and Springer link. The summary receiver operating characteristic (SROC) curve, sensitivity, specificity, positive likelihood ratios (PLR), negative likelihood ratios (NLR), and diagnostic odds ratio (DOR) as well as the 95 % confidence intervals (CIs) were calculated to evaluate the diagnostic accuracy of MRA for acute PE. Meta-disc software version 1.4 was used to analyze the data. Results: Five studies were included in this meta-analysis. The pooled sensitivity (86 %, 95 % CI: 81 % to 90 %) and specificity (99 %, 95 % CI: 98 % to 100 %) demonstrated that MRA diagnosis had limited sensitivity and high specificity in the detection of acute PE. The pooled estimate of PLR (41.64, 95 % CI: 17.97 to 96.48) and NLR (0.17, 95 % CI: 0.11 to 0.27) provided evidence for the low missed diagnosis and misdiagnosis rates of MRA for acute PE. The high diagnostic accuracy of MRA for acute PE was demonstrated by the overall DOR (456.51, 95 % CI: 178.38 - 1168.31) and SROC curves (AUC = 0.9902 ± 0.0061). Conclusions: MRA can be used for the diagnosis of acute PE. However, due to limited sensitivity, MRA cannot be used as a stand-alone test to exclude acute PE.

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