Asymptomatic Pulmonary Embolism after Ablation

Cardiology ◽  
2016 ◽  
Vol 134 (4) ◽  
pp. 426-432 ◽  
Author(s):  
Gamze Babur Guler ◽  
Mehmet Mustafa Can ◽  
Ekrem Guler ◽  
Tugba Akinci ◽  
Ozlem Sogukpinar ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Sudden Cardiac Arrest ◽  
Right Atrial ◽  
Arterial Tree ◽  
3 Dimensional ◽  
Life Threatening ◽  
History Of ◽  
Pulmonary Arterial ◽  
N 93 ◽  
Ischemic Attack

Background: Pulmonary embolism (PE) is a life-threatening event with a broad presentation spectrum ranging from asymptomatic cases to sudden cardiac arrest. It is unclear if right atrial emboli cause PE in patients with atrial fibrillation (AF) or if mild PE itself increases right cardiac pressure provoking AF. Objective: To determine the incidence and predictors of asymptomatic PE in patients undergoing AF ablation. Method and Results: Patients (n = 93) were screened and those with previous or current symptomatic PE or venous thromboembolism, pulmonary hypertension, increased right heart pressures detected on echocardiography, a history of stroke, transient ischemic attack, coagulopathy or cancer and inappropriate contrast for the evaluation of pulmonary arterial tree were excluded. The remaining AF patients (n = 71) underwent guided ablation controlled with 3-dimensional, left atrial and pulmonary venous computed tomography. The asymptomatic PE was defined by using the modified Miller score by 2 independent assessors in 6 patients. Univariate logistic regression showed that age (OR: 1.094, 95% CI 1.007-1.188, p = 0.033), diabetes (OR: 12.000, 95% CI 1.902-75.716, p = 0.008), CHA2DS2-VASc score (OR: 2.800, 95% CI 1.304-6.013, p = 0.008), and pulmonary artery diameter (OR: 1.221, 95% CI 1.033-1.444, p = 0.019) were significantly associated with PE. However, multivariate analysis revealed that the CHA2DS2-VASc score (p = 0.047) remained the exclusive significant predictor for asymptomatic PE. Conclusion: The incidence of random asymptomatic PE in AF patients is high (>8%). The CHA2DS2-VASc score can predict silent PE. Since patients with a high CHA2DS2-VASc score are already anticoagulated, our results do not change clinical practice but are noteworthy in terms of the cause-effect relationship between AF and PE.

scholarly journals Computer Assisted System for Detecting Pulmonary Embolism in Lungs

2021 ◽  
Vol 10 (4) ◽  
pp. 89-94
Author(s):  
Dr. M. Sucharitha ◽  
◽  
Dr. P.H.V. Sesha Talpa Sai ◽  
Ms. M. L. R. Chaitanya Lahari ◽  
Ms. P. Haseena Bee ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Blood Clot ◽  
Computer Assisted ◽  
Arterial Tree ◽  
Life Threatening Illness ◽  
Contrast Enhanced Ct ◽  
Novel Approach ◽  
Contrast Enhanced ◽  
Life Threatening ◽  
Pulmonary Arterial

A pulmonary embolism (PE) occurs when a blood artery in the lungs becomes suddenly blocked, generally owing to a blood clot. PE is a frequent life-threatening illness that should be diagnosed as soon as possible. A novel approach for automatically detecting PE in contrast-enhanced CT images is suggested in this research. To identify PE, computerized tomography (CT) is the main test to capture images. It is quick test, incursive with good quality images, enhanced contrast and multi-sliced images can be obtained. Candidate identification, feature calculation, and classification are all part of the system. The major aims of candidate detection are to include PE with even entire occlusions and to eliminate erroneous diagnosis of tissue and parenchymal disorders. When calculating characteristics, the location and structure of the pulmonary vascular tree, as well as the severity, form, and size of an embolus, are all taken into consideration. The ability of the CAD tool to identify emboli in the sectional and sub sectional pulmonary Arterial Tree (PAT) was examined.

scholarly journals EXPRESS: Pulmonary Hypertension Associated With Neurofibromatosis Type 2

2021 ◽  
pp. 204589402110295
Author(s):  
Hirohisa Taniguchi ◽  
Tomoya Takashima ◽  
Ly Tu ◽  
Raphaël Thuillet ◽  
Asuka Furukawa ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Neurofibromatosis Type ◽  
Pulmonary Vascular Remodeling ◽  
Life Threatening ◽  
History Of ◽  
Pulmonary Arterial ◽  
First Time

Although precapillary pulmonary hypertension (PH) is a rare but severe complication of patients with neurofibromatosis type 1 (NF1), its association with NF2 remains unknown. Herein, we report a case of a 44-year-old woman who was initially diagnosed with idiopathic pulmonary arterial hypertension (IPAH) and treated with PAH-specific combination therapy. However, a careful assessment for a relevant family history of the disease and genetic testing reveal that this patient had a mutation in the NF2 gene. Using immunofluorescence and Western blotting, we demonstrated a decrease in endothelial NF2 protein in lungs from IPAH patients compared to control lungs, suggesting a potential role of NF2 in PAH development. To our knowledge, this is the first time that precapillary PH has been described in a patient with NF2. The altered endothelial NF2 expression pattern in PAH lungs should stimulate work to better understand how NF2 is contributing to the pulmonary vascular remodeling associated to these severe life-threatening conditions.

Wolff-Parkinson-White Syndrome

1992 ◽  
Vol 3 (1) ◽  
pp. 180-189 ◽  
Author(s):  
Joanne Hughes Morscher
Keyword(s):  
Sudden Cardiac Arrest ◽  
Cardiac Conduction ◽  
Treatment Modalities ◽  
White Syndrome ◽  
Wpw Syndrome ◽  
Life Threatening ◽  
History Of ◽  
Diagnostic Modalities ◽  
Supraventricular Tachycardias ◽  
Wolff Parkinson White Syndrome

Wolff-Parkinson-White (WPW) syndrome is a cardiac conduction disorder that presents with potentially life-threatening consequences. Wolff-Parkinson-White syndrome-induced dysrhythmias account for 20% of all supraventricular tachycardias that occur in the general population. Clinical presentations range from no symptoms to a sudden cardiac arrest. The risk of sudden death is always present with WPW syndrome, and it is the motivating force in the evaluation and treatment of this syndrome. Current diagnostic modalities are accurate in identifying patients with WPW syndrome, but lack the sensitivity to predict sudden cardiac death. This article reviews the history of WPW syndrome, as well as its general characteristics, diagnostic criteria, treatment modalities, and nursing implications

Possible GoLytely-Associated Cardiac Arrest: A Case Report and Literature Review

2019 ◽  
Vol 33 (3) ◽  
pp. 364-367 ◽  
Author(s):  
Yoonsun Mo ◽  
Shiv Gandhi ◽  
Jose Orsini
Keyword(s):  
Cardiac Arrest ◽  
Abdominal Pain ◽  
Sudden Cardiac Arrest ◽  
Lower Abdominal Pain ◽  
The Past ◽  
Life Threatening ◽  
History Of ◽  
Artery Disease ◽  
Possible Cause

Purpose: To report a case of sudden cardiac arrest possibly associated with the administration of GoLytely® (polyethylene glycol 3350 and electrolytes). Summary: A 60-year-old male with a history of hypertension, hyperlipidemia, type 2 diabetes, and coronary artery disease presented to the emergency department with complaints of constipation and lower abdominal pain over the past week, and the inability to urinate over the past day. The patient had received GoLytely as treatment to alleviate symptoms of constipation and abdominal pain. However, several hours after administration of the bowel prep solution, the patient suffered an episode of cardiac arrest. After ruling out other possible etiologies, GoLytely was suspected as a possible cause of cardiac arrest. The patient had suffered an anoxic brain injury and remained intubated and unconscious until he eventually expired, 20 days after the event. Conclusion: Although GoLytely appears to be a safe agent with fewer side effects, clinicians need to be mindful of potential life-threatening adverse events following GoLytely administration and monitor patients closely during and after administration.

scholarly journals Acute Massive Pulmonary Embolism with Direct Visualization of a Free-floating Right Heart Thrombus Successfully Treated with Fibrinolysis: A Case Report

2020 ◽  
Vol 121 (1) ◽  
pp. 42-48
Author(s):  
Elisavet Kaitalidou ◽  
Dimitrios Karapiperis ◽  
Vasileios Makrakis ◽  
Maria Kipourou ◽  
Dimitrios Petroglou
Keyword(s):  
Pulmonary Embolism ◽  
Hemodynamic Instability ◽  
Massive Pulmonary Embolism ◽  
Right Atrial ◽  
Direct Visualization ◽  
Atrial Thrombus ◽  
Right Heart ◽  
Motor Weakness ◽  
History Of ◽  
The Right

A male patient with a history of immobilization due to motor weakness, was transferred to our emergency department after syncope during physiotherapy, with recorded hypotension. Transthoracic echocardiography showed severe dilatation of the right ventricle (RV), with apex hypercontractility and almost akinetic RV free wall. The above findings, in addition to the unexpected visualization of a large, free-floating, right atrial thrombus, a rare finding associated with high mortality, readily confirmed the clinical suspicion of acute pulmonary embolism (PE) causing circulatory collapse. Intravenous fibrinolysis and vasopressor therapy were successfully administered, and hemodynamic instability was soon alleviated.

scholarly journals Simultaneous Hydatid Cysts of Both the Right Atrium and Right Ventricle

2007 ◽  
Vol 50 (3) ◽  
pp. 217-219
Author(s):  
Caner Arslan ◽  
Emir Cantürk ◽  
Egemen Duygu ◽  
Ahmet Kürsat Bozkurt
Keyword(s):  
Right Ventricular ◽  
Right Atrial ◽  
Hydatid Cysts ◽  
Hepatic Hydatid Cyst ◽  
History Of ◽  
Ischemic Attack ◽  
The Right ◽  
Work Up ◽  
Hepatic Hydatid ◽  
Fatal Complications

Hydatid disease in both chambers of the heart is very rare. Mobile right atrial and right ventricular hydatid cysts were diagnosed incidentally in the etiologic work up for a transient ischemic attack in a 77-year-old man with a history of a hepatic hydatid cyst operation. Transthoracic echocardiography was very successful in the diagnosis of both hydatid cysts. Transesophagial echocardiography and computed tomography confirmed the diagnosis. Both right atrial and right ventricular hydatid cysts were removed under cardiopulmonary bypass to prevent morbidities and potentially fatal complications.

scholarly journals Predictive value of chest HRCT for survival in idiopathic pulmonary arterial hypertension

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Aneta Kacprzak ◽  
Barbara Burakowska ◽  
Marcin Kurzyna ◽  
Anna Fijałkowska ◽  
Michał Florczyk ◽  
...  
Keyword(s):  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Prognostic Value ◽  
Idiopathic Pulmonary Arterial Hypertension ◽  
Right Atrial ◽  
Normal Lung ◽  
Mixed Venous Blood ◽  
Positive History ◽  
History Of ◽  
Pulmonary Arterial

Abstract Background Little attention has been paid to chest high resolution computed tomography (HRCT) findings in idiopathic pulmonary arterial hypertension (IPAH) patients so far, while a couple of small studies suggested that presence of centrilobular ground-glass opacifications (GGO) on lung scans could have a significant negative prognostic value. Therefore, the aims of the present study were: to assess frequency and clinical significance of GGO in IPAH, and to verify if it carries an add-on prognostic value in reference to multidimensional risk assessment tool recommended by the 2015 European pulmonary hypertension guidelines. Methods Chest HRCT scans of 110 IPAH patients were retrospectively analysed. Patients were divided into three groups: with panlobular (p)GGO, centrilobular (c)GGO, and normal lung pattern. Association of different GGO patterns with demographic, functional, haemodynamic, and biochemical parameters was tested. Survival analysis was also performed. Results GGO were found in 46% of the IPAH patients: pGGO in 24% and cGGO in 22%. Independent predictors of pGGO were: positive history of haemoptysis, higher number of low-risk factors, and lower cardiac output. Independent predictors of cGGO were: positive history of haemoptysis, younger age, higher right atrial pressure, and higher mixed venous blood oxygen saturation. CGGO had a negative prognostic value for outcome in a 2-year perspective. This effect was not seen in the longer term, probably due to short survival of cGGO patients. Conclusions Lung HRCT carries a significant independent prognostic information in IPAH, and in patients with cGGO present on the scans an early referral to lung transplantation centres should be considered.

scholarly journals Pulmonary Arterial Enlargement is Associated With Acute Chest Pain in Patients Without Obstructive Coronary Artery Disease

2018 ◽  
Vol 12 ◽  
pp. 117954841875802
Author(s):  
Narasa Madam ◽  
Wassim Mosleh ◽  
Natdanai Punnanithinont ◽  
Andres Carmona-Rubio ◽  
Zaid H Said ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Chest Pain ◽  
Coronary Artery ◽  
Right Ventricular ◽  
Right Atrial ◽  
Pain Group ◽  
Obstructive Sleep ◽  
History Of ◽  
Pulmonary Arterial ◽  
Artery Disease

Background: Pulmonary hypertension (PH) is an underdiagnosed cause for chest pain in patients without significant coronary artery disease (CAD). Studies showed that enlarged pulmonary arterial (PA) and right ventricular chamber sizes correlate with the severity of PH. Therefore, we studied the association between chest pain, right ventricular dimensions (RVDs), and PA size on coronary coronary tomographic angiography (CCTA). Methods: The CCTA of 87 patients presenting with chest pain without evidence of obstructive CAD was examined. The PA diameter (PAD), right atrial dimension (RAD), and RVD were measured. A comparative control cohort included 31 patients who presented without cardiopulmonary complaints and underwent thoracic CT. The risk for obstructive sleep apnea (OSA) was assessed using STOP-BANG questionnaires. Results: Patients with chest pain without obstructive CAD showed markedly dilated right atrial and ventricular chambers compared with standard parameters (right atrium: 48 ± 6.4 mm; right ventricle long axis: 61 ± 9.5 mm). When comparing chest pain vs non-chest pain group, respectively, the mean PAD measured 25.92 ± 0.43 mm vs 22.89 ± 0.38 mm ( P < .001), RAD2 measured 40.1423 ± 0.7108 mm vs 34.8800 ± 1.0245 mm ( P = .0048), and RVD2 measured 31.7729 ± 0.7299 mm vs 27.6379 ± 1.6178 mm ( P = .034). Chest pain was associated with higher PAD (odds ratio [OR]: 11.11, P < .05) after adjusting for age, sex, body mass index, history of hypertension, hyperlipidemia, congestive heart failure, chronic obstructive pulmonary disease, OSA, and smoking. The chest pain group had a mean STOP-BANG score of 3.9 ± 1.8 in all patients, and 3.62 ± 0.20 in patients without known history of OSA, representing an elevated risk index for the disease. Conclusions: In patients presenting with chest pain without obstructive CAD on CCTA, there is a strong association between the presence of chest pain and enlarged PAD. They also represent a high-risk group for OSA.

Labeling the pulmonary arterial tree in CT images for automatic quantification of pulmonary embolism

2007 ◽  
Author(s):  
Ralph J. M. Peters ◽  
Henk A. Marquering ◽  
Halil Doğan ◽  
Emile A. Hendriks ◽  
Albert de Roos ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Ct Images ◽  
Arterial Tree ◽  
Automatic Quantification ◽  
Pulmonary Arterial
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