scholarly journals Pulmonary thromboembolism as presenting feature of COVID-19: Report of four cases

2021 ◽  
Vol 2 (5) ◽  
Author(s):  
Negar Omidi ◽  
◽  
Seyyed Mojtaba Ghorashi ◽  
Masoumeh Lotfi-Tokaldany ◽  
Shaghayegh Ghasemi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ct Angiography ◽  
Clinical Presentation ◽  
Pulmonary Thromboembolism ◽  
Incidental Finding ◽  
Chest Ct ◽  
Presenting Symptoms ◽  
First Impression ◽  
D Dimer ◽  
Pulmonary Ct

Coronavirus disease 2019 (COVID-19) infection is associated with a hypercoagulable state. The similarity in clinical presentation between Pulmonary Thromboembolism (PTE) and COVID-19 render the triage of these patients challenging. We present four cases of COVID-19 who were admitted with first impression of pulmonary thromboembolism in emergency department. The patients were male with age ranged between 46 and 60 years old. None of the patients had criteria of severe COVID-19. Pulmonary Computed Tomography (CT) angiography at admission was consistent with PTE. Incidental finding in pulmonary CT angiography was lung lesions in favor of COVID-19. Pulmonary thromboembolism might be a first presentation feature in COVID-19 patients. Overlaps between presenting symptoms and paraclinical findings such as chest CT and elevations in D-dimer levels in PTE and COVID-19 should be kept in mind.

Value of revised Geneva criteria and d-dimer levels in reducing overuse of pulmonary CT angiography in the diagnosis of pulmonary thromboembolism

2020 ◽  
Vol 27 (3) ◽  
pp. 857
Author(s):  
Hale Turnaoglu ◽  
Sefa Keskin ◽  
Ayse Ozcetin ◽  
Berkay Becer ◽  
Leyla Eybatova ◽  
...  
Keyword(s):  
Ct Angiography ◽  
Pulmonary Thromboembolism ◽  
D Dimer ◽  
Pulmonary Ct

scholarly journals Using Quantitative D-Dimer to Determine the Need for Pulmonary CT Angiography in COVID-19 Patients

2021 ◽  
Author(s):  
Gary Mikhjian ◽  
Ahmad Elghoroury ◽  
Keith Cronovich ◽  
Kevin Brody ◽  
Robert Jarski
Keyword(s):  
Ct Angiography ◽  
D Dimer ◽  
Pulmonary Ct

scholarly journals Elevation of troponin values in differential diagnosis of chest pain in view of pulmonary thromboembolism

2012 ◽  
Vol 69 (10) ◽  
pp. 913-916 ◽  
Author(s):  
Rada Vucic ◽  
Slavko Knezevic ◽  
Zorica Lazic ◽  
Olivera Andrejic ◽  
Dragan Dincic ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Differential Diagnosis ◽  
Heart Disease ◽  
Chest Pain ◽  
Muscle Injury ◽  
Clinical Presentation ◽  
Pulmonary Thromboembolism ◽  
Coronary Syndrome ◽  
Electrocardiographic Abnormalities ◽  
D Dimer

Introduction. Acute coronary syndrome, as unstable form of ischaemic heart disease, beside clinical presentation and electrocardiographic abnormalities, is characterized by increased value of troponin one of cardiospecific enzimes. Although troponin is a high specific and sensitive indicator of acute coronary syndrome, any heart muscle injury may induce its increasing, so there are some other diseases with the increased troponin value. Case report. We presented a female patient with chest pain, admitted because of suspicioun of acute coronary sindrome. Performed coronarography excluded ischemic heart disease. Considering symtomatology, electrocardiographic abnormalities, increased troponin and D-dimer values, as well as echocardiography finding we considered pulmonary embolism as a differential diagnosis, which was confirmed by pulmoangiography. Conclusion. Isolated increased troponin values are not enough for diagnosis of acute coronary syndrome.

scholarly journals Right ectopic intrathoracic kidney: Unusual clinical presentation in a young patient affected by scrotal varicocele

2017 ◽  
Vol 89 (4) ◽  
pp. 323 ◽  
Author(s):  
Lucio Dell'Atti ◽  
Andrea Benedetto Galosi
Keyword(s):  
Computed Tomography ◽  
Renal Function ◽  
Clinical Presentation ◽  
Incidental Finding ◽  
Abdominal Ultrasound ◽  
Kidney Tumors ◽  
First Case ◽  
History Of ◽  
Intrathoracic Kidney ◽  
Good Drainage

Intrathoracic kidney is a partial or complete displacement of the kidney above the hemidiaphragm into the mediastinal compartment of the thorax. It is usually seen as an incidental finding discovered on chest radiograph or abdominal ultrasound. However computed tomography consents the correct detection of intrathoracic masses and defines their shape, size, and extent. We here report a case of ectopic thoracic kidney in a 22-year-old man who had a long history of scrotal discomfort associated with right varicocele. Frequently, this ectopia does not affect renal function and the stretched ureter provides good drainage. In literature, a small number of cases shows that varicocele is a possible mode of presentation of kidney tumors, but this is the first case of varicocele secondary to intrathoracic kidney ectopia.

scholarly journals Pulmonary thromboembolism in patients after COVID-19 - predictive indicators for correct diagnosis

2021 ◽  
Author(s):  
Dilyana Yakova-Hristova ◽  
Iana Simova ◽  
Plamen Pavlov ◽  
Martin Hristov ◽  
Todor Kundurzhiev ◽  
...  
Keyword(s):  
Predictive Value ◽  
Clinical Presentation ◽  
Pulmonary Thromboembolism ◽  
Correct Diagnosis ◽  
Right Ventricular Dysfunction ◽  
S Wave ◽  
Life Threatening ◽  
Almost All ◽  
Ecg Criteria ◽  
D Dimer

Introduction: Infection caused by SARS-CoV-2 has been shown to lead to significant procoagulant events, in some cases involving life-threatening pulmonary thromboembolism (PE). Additional conditions complicating the diagnosis are the presence of risk factors for PE in almost all patients with COVID-19, as well as the overlap of the clinical presentation between PE and COVID-19. Materials and Methods: Therefore we conducted a single-center study at the Heart and Brain Hospital, Pleven in the period December 2020-February 2021. It included 27 consecutively hospitalized patients with recent pneumonia caused by Covid-19 and clinical presentation referring to PE. The cohort was divided into two groups - with and without a definitive diagnosis of PE, proven by CT pulmoangiography. The aim was to find the indicators that predict the presence of PE in patients with acute or Post-acute COVID-19 conditions. Results: Our results show that part of the ECG criteria - S-wave over 1.5 mm in I lead and aVL (p = 0.007), Q-wave in III and aVF (p = 0.020), as well as the D-dimer as quantitative variable (p = 0.025) proved to be independent predictors of PE. The RV/ LV diameter ratios ≥1.0 as well as right ventricular dysfunction showed sensitivity 62.5%, specificity 100%, positive predictive value 100% and negative such 86.4% to verify the PE diagnosisл We suggest that the cut-off value of D-dimer of 1032 ng/ml has an optimal sensitivity (Se) of 87.5%, specificity (Sp) 57.9%, positive a predictive value (PPV) 46.7% and negative predictive value (NPV) of 91.7% for the diagnosis of PE (p = 0.021). Conclusion: Against the background of acute and Post-acute COVID-19 conditions ECG and EchoCG criteria remain predictive of PE. We suggest that a higher D-dimer cut-off value should be applied in COVID-19 and post-COVID-19 patients in order to confirm/dismiss the diagnosis PE.

scholarly journals Avoiding Unnecessary Pulmonary CT Angiography by Using a Combination of Clinical Criteria and D-Dimer Thresholds

2013 ◽  
Vol 03 (02) ◽  
pp. 78-84 ◽  
Author(s):  
Lana Hirai Gimber ◽  
Jamie Leong ◽  
Lauren Todoki ◽  
Hyo-Chun Yoon
Keyword(s):  
Ct Angiography ◽  
Clinical Criteria ◽  
D Dimer ◽  
Pulmonary Ct

scholarly journals High incidence of pulmonary thromboembolism in hospitalized SARS-CoV-2 infected patients

2021 ◽  
Author(s):  
D El-Qutob ◽  
L Alvarez ◽  
P García-Sidro ◽  
M Robustillo ◽  
I Barreda ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Endothelial Cells ◽  
Virus Infection ◽  
Pulmonary Thromboembolism ◽  
Infected Group ◽  
Suspected Infection ◽  
Pulmonary Angiogram ◽  
High Incidence ◽  
Thrombotic Complications ◽  
D Dimer

AbstractIntroductionSARS-CoV-2 infected patients present thrombotic complications caused by direct endothelial cells injury of the microvessels. Pulmonary thromboembolism (PE) has been reported by Computed Tomography pulmonary angiogram (CTPA) in patients with COVID-19 pneumonia with high D-dimer levels.ObjectivesWe present the characteristics of SARS-CoV-2 infected patients diagnosed of PE by CTPA in our hospital. We also present the comparison of these findings with non-infected patients with PE data.MethodsPatients 18 years of age or older with SARS-CoV2 virus infection, and patients with suspected infection at beginning of admission but with negative PCR, were studied with CTPA for suspicion of VTE, during their hospitalization.ResultsDuring the study period, 52 CTPA were performed in our hospital, sixteen in SARS-CoV-2 infected patients. No significant differences in age (p=0.43) and sex (p=0.31) were found between the two groups, infected and non-infected patients. In the infected group, the patients who had PE had a much lower median age (47.8 years) than those without PE (73.3 years). No differences between infected and non-infected patients were detected in the diagnosis of PE with CTPA, 28.6% versus 27.8% (p=1.00). Overall patient mortality was 1.9%; one patient died (6.3%) in the infected group, and none in the non-infected group (p=0.31).ConclusionA considerable incidence of PE diagnosed by CTPA in SARS-CoV-2 infected patients has been observed, despite thrombo-prophylaxis.

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