1/36. lung transplantation in a Jehovah's Witness.patients of the Jehovah's Witness faith generally do not accept transfusions of blood or blood products but some will accept cadaveric organs for transplantation. We report a left single lung transplantation in a 48-year-old Hispanic female with idiopathic pulmonary fibrosis and secondary pulmonary hypertension. We believe this is the first reported case of lung transplantation in a Jehovah's Witness.- - - - - - - - - - ranking = 1keywords = pulmonary hypertension, hypertension (Clic here for more details about this article) |
2/36. Finger pad tophi.hyperuricemia and gout are known to occur in patients receiving diuretic therapy. More recently recognized, however, is the occurrence of tophaceous gout in patients treated with cyclosporine. We report a 57-year-old man with normal renal function who was started on cyclosporine immediately after undergoing bilateral lung transplantation. Six months later, he developed progressive renal insufficiency and hypertension. In the following four months (10 months after starting his immunosuppressant medication), he presented with a symmetrical distribution of tophi on his finger pads. Seven previous cases of finger pad tophi have been reported and are reviewed.- - - - - - - - - - ranking = 0.077308384253931keywords = hypertension (Clic here for more details about this article) |
3/36. Thoracic epidural anesthesia for modified radical mastectomy in a patient with cryptogenic fibrosing alveolitis: a case report.A case of advanced cryptogenic fibrosing alveolitis (CFA) with multiple bullae and extensive pulmonary fibrosis, scheduled for modified radical mastectomy for carcinoma of breast, is presented. This patient had ischemic heart disease, corticosteroid-induced hypertension, diabetes mellitus, and a difficult airway. Thoracic epidural segmental anesthesia was successfully given to this patient. Preoperative problems, perioperative management, and alternative anesthetic techniques are discussed.- - - - - - - - - - ranking = 0.077308384253931keywords = hypertension (Clic here for more details about this article) |
4/36. Use of nitric oxide for decompensated right ventricular failure and circulatory shock after cardiac arrest.We describe a case of peri-operative cardiac arrest, severe right ventricular failure and pulmonary hypertension in a 60-yr-old woman with interstitial pulmonary fibrosis. Inhaled nitric oxide therapy rapidly improved arterial oxygenation and haemodynamic variables, allowing recovery and weaning from mechanical ventilation. Subsequently, the patient was discharged from the cardiac intensive care unit.- - - - - - - - - - ranking = 1keywords = pulmonary hypertension, hypertension (Clic here for more details about this article) |
5/36. Pulmonary fibrosis induced by cyclophosphamide.OBJECTIVE: To report a case of pulmonary fibrosis resulting from use of cyclophosphamide as chemotherapy to treat a patient with breast cancer. CASE SUMMARY: We describe the case of a 52-year-old woman with breast cancer who developed pulmonary fibrosis after four cycles of chemotherapy that included cyclophosphamide. Pulmonary function tests revealed the presence of a severe ventilatory restriction. The open lung biopsy revealed pulmonary fibrosis with vascular sclerosis and signs of pulmonary hypertension. DISCUSSION: cyclophosphamide is an alkylating agent that has been associated with interstitial pneumonia and pulmonary fibrosis. The frequency of these unwanted effects is <1%. The clinical picture consists of the progressive appearance of dyspnea and a non-productive cough that progresses to severe pulmonary insufficiency. The risk factors described for these complications have been the use of chemotherapy regimens that include other drugs with known pulmonary toxicities, the cumulative total dose, the addition of radiotherapy, and the use of high doses of cyclophosphamide. CONCLUSIONS: Even though the frequency of pulmonary fibrosis in patients treated with cyclophosphamide-based chemotherapy regimens is low, the presence of dyspnea and an interstitial pattern in a patient makes it necessary to consider that possible drug toxicity. The open lung biopsy is the most accurate diagnostic technique for these cases. The discontinuation of cyclophosphamide and treatment with corticosteroids is usually followed by clinical recovery in approximately 50% of patients and, in some cases, reversal of the lung injury.- - - - - - - - - - ranking = 1keywords = pulmonary hypertension, hypertension (Clic here for more details about this article) |
6/36. Pulmonary hypertension, interstitial lung fibrosis, and lung iron deposition in thalassaemia major.Although restrictive lung disease is the predominant abnormality of pulmonary function in patients with thalassaemia major (TM), its aetiology and its association with pulmonary hypertension (PH) detected in some patients with TM remains unknown. We report a patient with TM, iron overload, frequent pulmonary infections, and progressive severe precapillary PH over the previous 5 years. A severe restrictive pattern and interstitial lung fibrosis were revealed by pulmonary function tests and high resolution computed tomography, respectively. This presentation suggests that interstitial fibrosis may complicate lung involvement in TM and can significantly contribute to the development of PH.- - - - - - - - - - ranking = 1.3092335370157keywords = pulmonary hypertension, hypertension (Clic here for more details about this article) |
7/36. Outpatient inhaled nitric oxide in a patient with idiopathic pulmonary fibrosis: a bridge to lung transplantation.Inhaled nitric oxide (INO) has been shown to improve oxygenation and decrease intrapulmonary shunt and pulmonary hypertension in various lung diseases. In this study we report a patient with end-stage idiopathic pulmonary fibrosis and pulmonary hypertension who received INO after coronary artery bypass surgery, with significant improvement in arterial oxygenation and pulmonary arterial pressure. Using a pulsing delivery system, the patient continued to receive outpatient INO for 30 months while waiting for lung transplantation. Exercise study and two-dimensional echocardiogram, after 3 months of inhaled NO, demonstrated continued benefits of INO for improvement of arterial oxygenation, pulmonary arterial pressure and exercise tolerance.- - - - - - - - - - ranking = 2keywords = pulmonary hypertension, hypertension (Clic here for more details about this article) |
8/36. Recurrent unilateral bacterial pneumonias and interstitial fibrosis associated with pulmonary vein atresia: successful treatment with endovascular stent implantation.A variety of pulmonary vascular disorders, such as hemangiomatosis, telangectasia, and veno-occlusive disease, may be involved in the pathogenesis of interstitial lung diseases. We describe the case of a girl with recurrent bacterial pneumonia and progressive interstitial fibrosis affecting the right lung. Morphologic evaluation of the lung biopsy showed structural changes of the vessel walls suggesting pulmonary hypertension. The echocardiogram showed the presence of centripetal blood flow in the right pulmonary artery from the periphery of the lung to the heart. A selective right angiography demonstrated the presence of pulmonary venous obstruction at the veno-atrial junction, successfully treated by endovascular stent implantation during cardiac catheterization.- - - - - - - - - - ranking = 1keywords = pulmonary hypertension, hypertension (Clic here for more details about this article) |
9/36. Pulmonary capillary hemangiomatosis: report of a case and review of the literature.We describe a case of pulmonary capillary hemangiomatosis in a 60-year-old woman with a 1-year history of progressive exertional dyspnea. Four years before admission a diagnosis of breast cancer was made, and she underwent mastectomy plus radiation therapy and treatment with oral antiestrogens. The chest X-ray showed bilateral interstitial infiltrates. Pulmonary function studies revealed a severe restrictive pattern. Abundant red blood cells were found in the bronchoalveolar lavage fluid. On the basis of open lung biopsy, interstitial fibrosis was diagnosed. cardiac catheterization revealed pulmonary hypertension. steroids were prescribed, but the patient's condition continued to deteriorate and she died approximately 3 years after presentation. The identification of proliferating and invasive capillaries, which are unique to pulmonary capillary hemangiomatosis, led to the correct diagnosis at autopsy.- - - - - - - - - - ranking = 1keywords = pulmonary hypertension, hypertension (Clic here for more details about this article) |
10/36. Pulmonary vascular changes in scleroderma.To determine the incidence and significance of pulmonary vascular changes in scleroderma, all necropsy reports of patients with scleroderma who died at the massachusetts General Hospital were analyzed and correlated with clinical data. The records of 30 such patients were available. Fourteen had moderate or marked abnormalities in the pulmonary arterial tree. Nine of these 14 patients had predominantly respiratory symptoms. The arterial changes consisted pathologically of intimal and medial hyperplasia affecting pulmonary arteries of all sizes. Of the eight patients with the most severe pathologic changes in the pulmonary arteries, five had slight or no interstitial fibrosis. Three of these five patients had rapidly progressive respiratory failure and severe pulmonary hypertension leading to death. Such cases form a distinct clinicopathologic entity of malignant pulmonary hypertension in scleroderma, comparable to the better recognized entity of malignant renal hypertension in scleroderma.- - - - - - - - - - ranking = 2.0773083842539keywords = pulmonary hypertension, hypertension (Clic here for more details about this article) |
| | Next -> |