1/66. Sudden unexpected death from pulmonary thromboembolism--examination of antemortem chest X-ray.An autopsy case of a woman who died suddenly from undiagnosed and untreated pulmonary thromboembolism (PTE) on her way home from the hospital is described in this report. She had complained of chest pain and dyspnea on exertion when she visited the hospital and a chest X-ray taken at that time showed remarkable manifestation of right heart failure and PTE, compared with former x-rays taken during previous visits to the hospital. In this report we present the findings of four chest x-rays of this patient, which had been taken both before and after the development of PTE.- - - - - - - - - - ranking = 1keywords = embolism (Clic here for more details about this article) |
2/66. Pulmonary thromboembolism after spinal instrumentation surgery.A 57-year-old woman was hospitalized because of gait disturbance and dysuria. Close examination revealed a cauda equina tumor at the level of L2 and L3. Tumor resection was performed, with posterolateral fusion and spinal instrumentation. On the eleventh day after the surgery, she experienced dyspnea and chest pain during standing and walking exercise. Pulmonary thromboembolism was diagnosed, based on: (1) blood gas analysis findings of hypoxemia and (2) defective images in both of the upper lobes on urgent pulmonary blood flow scintigram. Her clinical status improved with urgent thrombolytic therapy (with tisokinase and urokinase) and anticoagulation therapy (with heparin and warfarin), and her life was saved. When pulmonary thromboembolism occurs, early diagnosis by pulmonary blood flow scintigram and early thrombolytic and anticoagulative therapies are necessary. Special attention should be paid to symptoms of pulmonary thromboembolism in patients after spinal surgery.- - - - - - - - - - ranking = 1.4keywords = embolism (Clic here for more details about this article) |
3/66. Pulmonary thrombosis, homocysteinemia, and reperfusion edema in an adolescent.Deep vein thrombosis, pulmonary embolism, and pulmonary thrombosis in situ are rare in childhood and adolescence [1,2]. Unfortunately, these diagnoses may be unsuspected in a pediatric patient with dyspnea and chest pain. This article illustrates the diagnostic and therapeutic challenges that arose from unrecognized chronic thrombotic disease in an adolescent.- - - - - - - - - - ranking = 0.2440325598476keywords = embolism, thrombosis (Clic here for more details about this article) |
4/66. Acute axillosubclavian vein thrombosis (Paget-Schroetter syndrome) detected by Tc-99m MAA during pulmonary perfusion scintigraphy.The authors describe a 24-year-old man who reported the sudden onset of dyspnea and swelling of his left upper arm. An area of increased activity in the left axillosubclavian region evident on pulmonary perfusion scintigraphy with Tc-99m MAA suggested Paget-Schroetter syndrome (primary deep venous thrombosis of the upper extremity).- - - - - - - - - - ranking = 0.036693799872998keywords = thrombosis (Clic here for more details about this article) |
5/66. amniotic fluid embolism.amniotic fluid embolism is a rare occurrence, with no single pathognomonic clinical or laboratory finding. Diagnosis is based on clinical presentation and supportive laboratory values. We describe the case of a 17-year-old nulliparous woman at 27 weeks' gestation who had uterine bleeding, hematuria, hemoptysis, hypotension, dyspnea, and hypoxemia within 30 minutes of vaginal delivery. Laboratory values revealed diffuse intravascular coagulation. Chest films were consistent with adult respiratory distress syndrome. pulmonary artery catheterization revealed moderately increased pulmonary capillary wedge pressure. Supportive measures, including oxygenation, fluid resuscitation, and plasma, were administered. Central hemodynamic monitoring and inotropic support were necessary. Our patient recovered uneventfully and 6 weeks later was living an unrestricted life-style.- - - - - - - - - - ranking = 1keywords = embolism (Clic here for more details about this article) |
6/66. Right atrial myxoma with extracardiac manifestations.Right atrial myxoma is a rare intracardiac tumor that is often difficult to diagnose. pulmonary embolism from tumor fragments originating from the tumor mass is a potentially fatal complication. early diagnosis of cardiac myxoma is important since surgical treatment leads to resolution with low rates of recurrence and good long-term survival. The presence of a cardiac myxoma can be heralded by nonspecific constitutional symptoms as well as by disturbances in the clotting mechanism.- - - - - - - - - - ranking = 0.2keywords = embolism (Clic here for more details about this article) |
7/66. A case of diarrhea and orthopnea in a 57-year-old female.A 57-year-old female patient with known cardiac disease developed a 4 to 6 week history of diarrhea, followed by onset of orthopnea and subsequent right-sided cardiac failure. On hospital admission she was found to have pure tricuspid regurgitation, without evidence of cardiac ischemia, pulmonary embolism, bacterial endocarditis or pericardial disease. A 24-hour urine collection for 5-HIAA was elevated, and a subsequent octreotide scan documented abnormal uptake in the pelvic cul-de-sac. Bilateral ovarian masses were found at laparotomy, which on pathological examination were found to be a benign left ovarian cystic teratoma, and a right carcinoid tumor of the ovary. This patient presented with systemic complaints of diarrhea, and orthopnea and right sided heart failure that on evaluation were ultimately found to be due to a unilateral primary carcinoid tumor of the ovary, which accounts for less than 0.1% of all ovarian carcinomas, and only 5% of all carcinoids. Treatment of this malignant carcinoid syndrome presentation consisted of debulking of the tumor and continuation of her diuretics and digoxin. diarrhea and orthopnea ceased within 2 weeks after her oophorectomy. On evaluation 6 weeks and 6 months postoperatively, her cardiac function was stable, though unchanged. 5-HIAA levels were within normal limits, demonstrating the curative function of surgery in patients with unilateral ovarian carcinoid without evidence of metastases, as well as preserved cardiac function in otherwise stable patients.- - - - - - - - - - ranking = 0.2keywords = embolism (Clic here for more details about this article) |
8/66. Pulmonary tumor embolism as a presenting feature of cavoatrial hepatocellular carcinoma.Pulmonary tumor embolism as a presenting feature of hepatocellular carcinoma is rare. It has been reported only once previously. In that case, other signs and symptoms of liver disease were present. We report the case of a patient with cavoatrial hepatocellular carcinoma presenting with isolated pulmonary tumor embolism, without any clinical or laboratory evidence of liver disease. Hepatocellular carcinoma should be included in the differential diagnosis as a rare cause of pulmonary tumor embolism.- - - - - - - - - - ranking = 1.4keywords = embolism (Clic here for more details about this article) |
9/66. Acute dyspnea in a woman with swelling of the left leg treated with low molecular weight heparine.A case of rectus sheath hematoma diagnosed initially as probable pulmonary embolism in a patient on anticoagulation with low molecular weight heparins for swelling of the left leg is presented. Prompt consideration of this hematoma in the emergency department is important to avoid unnecessary and potentially dangerous treatment.- - - - - - - - - - ranking = 0.2keywords = embolism (Clic here for more details about this article) |
10/66. meige syndrome secondary to basal ganglia injury: a potential cause of acute respiratory distress.BACKGROUND: meige syndrome is a movement disorder that includes blepharospasm and oromandibular dystonias. Its etiology may be idiopathic (primary) or it may arise secondary to focal brain injury. Acute respiratory distress as a feature of such dystonias occurs infrequently. A review of the literature on meige syndrome and the relationship between dystonias and respiratory compromise is presented. methods: A 60-year-old woman suffered a cerebral anoxic event secondary to manual strangulation. She developed progressive blepharospasm combined with oromandibular and cervical dystonias. neuroimaging demonstrated bilateral damage localized to the globus pallidus. Years later, she presented to the emergency department in intermittent respiratory distress associated with facial and cervical muscle spasms. RESULTS: Increasing frequency and severity of the disorder was noted over years. The acute onset of respiratory involvement required intubation and eventual tracheotomy. A partial therapeutic benefit of tetrabenazine was demonstrated. CONCLUSION: This case highlights two interesting aspects of Meige's syndrome: (1) Focal bilateral basal ganglia lesions appear to be responsible for this patient's movement disorder which is consistent with relative overactivity of the direct pathway from striatum to globus pallidus internal and substantia nigra pars reticularis; (2) Respiratory involvement in a primarily craniofacial dystonia to the point of acute airway compromise.- - - - - - - - - - ranking = 5.9621910000986E-5keywords = cerebral, brain (Clic here for more details about this article) |
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