Pulmonary embolism case studies: Difference between revisions

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==Case Studies==
==Case Studies==


====Case Study #1====
===Case Study #1===
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====Case Study #2====
===Case Study #2===
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===Example #3===
===Case Study #3===


*A patient with shortness of breath:
*A patient with shortness of breath:
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===Example #4===
===Case Study #4===


*A patient who had an acute [[RBBB]];
*A patient who had an acute [[RBBB]];
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===Example #5===
===Case Study #5===


Chronic Pulmonary embolism (PE) and Deep Venous Thrombosis (DVT): A 49 year old man with sudden onset of shortness of breathSOB. Doppler ultrasound examination of the lower extremities revealed femoral vein thrombus. VQ scan showed complete lack of perfusion of the right lung. A markedly dilated azygous vein is identified. Also, dilated azygous and hemiazygous veins are identified in the retrocrural space. There is acute thrombus within the common iliacs, external and internal iliac veins, and common femoral veins bilaterally. Above the confluence of the common iliac veins, the inferior vena cava is inapparent. Multiple collateral vessels are present around the aorta and the azygous and hemiazygous veins are prominent. The portal venous axis is patent.  
Chronic pulmonary embolism (PE) and Deep Venous Thrombosis (DVT): A 49 year old man complains of sudden onset of [[shortness of breath]]. Doppler ultrasound examination of the lower extremities revealed femoral vein thrombus. [[V/Q scan]] showed complete lack of perfusion of the right lung. A markedly dilated azygous vein is identified. Also, dilated azygous and hemiazygous veins are identified in the retrocrural space. There is acute [[thrombus]] within the common iliacs, external and internal iliac veins, and common femoral veins bilaterally. Above the confluence of the common iliac veins, the [[inferior vena cava]] is unapparent. Multiple collateral vessels are present around the [[aorta]] and the azygous and hemiazygous veins are prominent. The portal venous axis is patent.  


{Images shown below are courtesy of Professor Peter Anderson DVM PhD, and published with permission. [http://www.peir.net © PEIR, University of Alabama at Birmingham, Department of Pathology])
(Images shown below are courtesy of Professor Peter Anderson DVM PhD, and published with permission. [http://www.peir.net © PEIR, University of Alabama at Birmingham, Department of Pathology])


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===Example #6===
===Case Study #6===


*Central PE: 76 year old female had right lower lobe resection for stage II non-small cell carcinoma of the lung. Chest X-ray and CT images shown below.
*Central PE: 76 year old female had right lower lobe resection for stage II non-small cell carcinoma of the lung. Chest X-ray and CT images shown below.
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===Example #7===
===Case Study #7===


*Bilateral PE: A 74 year old male with recently diagnosed [[diabetes mellitus]] who presents with left sided [[chest pain]] and [[abdominal pain]] with a 50 pound weight loss.  
*Bilateral PE: A 74 year old male with recently diagnosed [[diabetes mellitus]] who presents with left sided [[chest pain]] and [[abdominal pain]] with a 50 pound weight loss.  
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[[Category:Emergency medicine]]
[[Category:Emergency medicine]]
[[Category:Intensive care medicine]]
[[Category:Intensive care medicine]]
[[Category:Needs content]]
[[Category:Needs overview]]


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Latest revision as of 18:04, 15 July 2014



Resident
Survival
Guide

Pulmonary Embolism Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Pulmonary Embolism from other Diseases

Epidemiology and Demographics

Risk Factors

Triggers

Natural History, Complications and Prognosis

Diagnosis

Diagnostic criteria

Assessment of Clinical Probability and Risk Scores

Pulmonary Embolism Assessment of Probability of Subsequent VTE and Risk Scores

History and Symptoms

Physical Examination

Laboratory Findings

Arterial Blood Gas Analysis

D-dimer

Biomarkers

Electrocardiogram

Chest X Ray

Ventilation/Perfusion Scan

Echocardiography

Compression Ultrasonography

CT

MRI

Treatment

Treatment approach

Medical Therapy

IVC Filter

Pulmonary Embolectomy

Pulmonary Thromboendarterectomy

Discharge Care and Long Term Treatment

Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Follow-Up

Support group

Special Scenario

Pregnancy

Cancer

Trials

Landmark Trials

Case Studies

Case #1

Pulmonary embolism case studies On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Pulmonary embolism case studies

CDC on Pulmonary embolism case studies

Pulmonary embolism case studies in the news

Blogs on Pulmonary embolism case studies

Directions to Hospitals Treating Pulmonary embolism case studies

Risk calculators and risk factors for Pulmonary embolism case studies

Editor(s)-In-Chief: The APEX Trial Investigators, C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Case Studies

Case Study #1

Case Study #2

Case Study #3

  • A patient with shortness of breath:

Images shown below are courtesy of RadsWiki and copylefted.

Case Study #4

  • A patient who had an acute RBBB;

Images shown below are courtesy of RadsWiki and copylefted.

Case Study #5

Chronic pulmonary embolism (PE) and Deep Venous Thrombosis (DVT): A 49 year old man complains of sudden onset of shortness of breath. Doppler ultrasound examination of the lower extremities revealed femoral vein thrombus. V/Q scan showed complete lack of perfusion of the right lung. A markedly dilated azygous vein is identified. Also, dilated azygous and hemiazygous veins are identified in the retrocrural space. There is acute thrombus within the common iliacs, external and internal iliac veins, and common femoral veins bilaterally. Above the confluence of the common iliac veins, the inferior vena cava is unapparent. Multiple collateral vessels are present around the aorta and the azygous and hemiazygous veins are prominent. The portal venous axis is patent.

(Images shown below are courtesy of Professor Peter Anderson DVM PhD, and published with permission. © PEIR, University of Alabama at Birmingham, Department of Pathology)

Case Study #6

  • Central PE: 76 year old female had right lower lobe resection for stage II non-small cell carcinoma of the lung. Chest X-ray and CT images shown below.
  1. Chronic pulmonary embolism within the right pulmonary artery.
  2. Persistence of air within the decreased right pleural fluid collection with adjacent retraction of inflamed esophagus raises the suspicion for esophageal pleural fistula.

(Courtesy of Professor Peter Anderson DVM PhD © PEIR, University of Alabama at Birmingham, Department of Pathology)

Case Study #7

The scan is performed to evaluate for occult malignancy. The patient has an apparent pulmonary embolus. Thoracoabdominal CT findings are as follow:

  1. Bilateral pulmonary thromboemboli involving both upper and both lower lobe pulmonary arteries, greater on the right side.
  2. Wedge shaped, pleural based opacities in the left upper lobe which may represent pleural effusions are probably related to the emboli.
  3. Dilated right ventricle. This may also be related to the pulmonary emboli.
  4. No signs of mass or lymphadenopathy.
  5. No evidence of malignancy or other significant abnormality within the abdomen or pelvis.
  6. Incidental findings included small calcification in the right adrenal gland, small left renal cyst, and enlarged prostate gland.


{Images shown below are courtesy of Professor Peter Anderson DVM PhD, and published with permission. © PEIR, University of Alabama at Birmingham, Department of Pathology)


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