Acute Pulmonary embolism: a complete case study | Medshoola

 

pulmonary embolism case study

Misdiagnosed Pulmonary Embolism – A case study. Pulmonary embolism (PE) is a blockage in the artery by a blood clot in the lungs that has been moved from somewhere else to the artery of lungs. It affects blood flow which results in low oxygen level in blood, which damages other body organs. Nov 18,  · The right atrial shunt-related complications haven’t been reported in more than thirty years. However, the patient in our case study was complicated with pulmonary embolism post operation, and there was very likelihood that the embolism was from this smdbook-d.cf: Wei J Yang, Qun J Duan, Hai Fang Cheng, Ai Q Dong. A case study by Perkins & Mitchell () documented a case of a patient who was thrombolised pre-hospital for a Massive Pulmonary Embolism. The patient presented with sudden onset dyspnoea and tachypnoea, with no associated chest pain.


Case Study #7: AMI or Pulmonary Embolism? - Prehospital Research Support Site


This is one case report of a year-old Chinese male with type A acute aortic dissection. Pulmonary embolism case study is an emergent surgery including Bentall procedure, interposition graft replacement of aortic arch, stented descending aorta with the modified right atrial shunt technique.

In the early post operation period, the patient was complicated with pulmonary embolism. Pulmanary arteriography showed that the right pulmonary embolism case study pulmonary embolism without an extrinsic compression. After the anticoagulant therapy, the patient was well recovered and discharged from hospital 1 month later, pulmonary embolism case study. The origin of pulmonary embolism in the patient was believed to be the thrombosis in the shunt fistula.

The right atrial shunt-related complications haven't been reported for more than thirty years. Pulmonary embolism could be a severe complication after the right atrial shunt in acute type A aortic dissection. The online version of this article doi In the aortic root replacement procedure, bleeding from the proximal anastomosis is one of the gravest complications.

Cabrol first applied right atrial shunt to reduce bleeding in [ 2 ], in which a fistula between the aneurysmal sac and the right atrial appendage was created to drain oozing from the prosthesis. When bleeding from the proximal anastomosis was reduced, the thrombosis was formed, and then the shunt passage was closed up. Generally, the forming of thrombosis in the fistula is satisfied [ 3 ]-[ 5 ].

The shunt settled the problem of bleeding in the aortic root replacement procedure, and shortened the operating time significantly. However, the patient in our case study was complicated with pulmonary embolism post operation, and there was very likelihood that the embolism was from this fistula.

A year-old Chinese male with a history of hypertension presented with sudden syncope and came pulmonary embolism case study his senses after ten minutes without headache. His respiratory rate was 21 breaths per min and the lungs were clear on auscultation. The pulse rate was 75 beats per min with normal sinus rhythm. No remarkable abnormal was found in abdominal examination. Coagulation tests were normal.

Echocardiography revealed pulmonary embolism case study aortic dissection and moderate aortic regurgitation with small to moderate pericardial effusion, pulmonary embolism case study.

Computed tomography scanning revealed ascending aortic to aortic arch dissecting aneurysm, in which the proximal part of right brachiocephalic trunk was also influenced.

The left and right pulmonary arteries were normally enhanced with contrast medium. The patient underwent emergency operation for the thoracic aortic dissection, including Bentall procedure, interposition graft replacement of aortic arch, stented descending aorta with a shunt from a chamber around the aortic root to the right atrium.

The patient was successfully weaned off pulmonary embolism case study and transferred to the intensive care unit. The ratio of PaO 2 to FiO 2 after pulmonary embolism case study was The haemodynamics was stable. However, the ratio of PaO 2 to FiO 2 fell to gradually after operation.

Two days after operation, the patient was conscious and cooperative, and his lung compliance and airway resistance were normal. But severe hypoxaemia ensued. In order to find out the cause of hypoxaemia, a chest computer temography was carried out but no evidence of atelectasis or pneumonia was shown. Considering the stable haemodynamics and the danger of haemorrhage, embolectomy and thrombolytic therapy were not applied in the patient.

We took the anticoagulant therapy with low molecular weight heparin and warfarinwhich sustained INR at Pulmanary arteriography was reexamined every day. According to the effectiveness of treatment, we made sure that the entire right lung field defect in pulmanary arteriography was due to thromboembolism. Unfortunately, ventilator-associated pneumonia VAP occurred.

Therefore, the tracheotomy pulmonary embolism case study was extubated until one month after operation. He survived for one year after discharging from the hospital without complications related to lung and heart. The Pulmonary Arteriography on the fourth day post operation. It showed that an entire right lung field defected near the crotch arrow indicates pulmonary embolism. The Pulmonary Arteriography on the twelfth day post operation. It showed that the right lung field open again, and pleural effusion happened.

Acute aortic dissection AAD is the most common aortic catastrophe and is associated with extremely high morbidity and mortality. Pulmonary embolism is a relatively common cardiovascular emergency, which may lead to acute life-threatening but potentially reversible right ventricular failure by occluding the pulmonary arterial bed [ 10 ]. When the patient of type A acute aortic dissection is complicated with pulmonary embolism, the prognosis may be even worse.

In most cases pulmonary embolism is a consequence of deep vein thrombosis. The patient in our case report was a middle-aged man without history of bone fraction, deep vein thrombosis or long-term bed pre-operation. In L, pulmonary embolism case study.

Buja described that severe obstruction of the right main pulmonary artery as a consequence of acute dissection of the ascending aorta, appearing to have resulted from compression of this artery [ 11 ]. Case reports were reported with imaging data or autopsy results later [ 12 ]-[ 15 ]. These reports confirmed that the dilated ascending aortic or the periaortic haematoma compressed the right pulmonary artery. So the blood flow in pulmonary artery was slow and it was susceptible to thrombosis. The Aortic Arteriography before operation.

It showed that pulmonary artery was free without extrinsic compression or pulmonary embolism. After exclusion of other possible factors, the origin of pulmonary embolism in the pulmonary embolism case study was believed to be the thrombosis in the shunt chamber.

In order to reduce the bleeding post operation, a chamber around the aortic root was created by suturing residual aortic piece and patch of autologous pericardium, then the chamber was communicated with the right atrium to drain the blood from the proximal anastomosis. Dopplers ultrasonic examination showed no flow in the chamber four days post operation. A conclusion was drawn that pulmonary embolism from the thrombus of shunt chamber could be a severe complication after the right atrial shunt in acute type A aortic dissection.

Written informed consent was obtained from the patient for publication of this case report and accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal. WJY contributed in pre-operative and post-operative care.

She also collected data and participated directly in the writing pulmonary embolism case study the manuscript. QJD contributed in reoperative, intraoperative and post-operative care. He also revised the article thoroughly and critically.

HFC contributed in preoperative, intraoperative and post-operative care. AQD contributed in preoperative, intraoperative and post-operative care. All authors approved the final version to be published. We are grateful to all staffs that provided their care in the management of the patient especially the general surgical team in the Second Affiliated Hospital of Zhejiang University School of Medicine. Competing interests. Wei J Yang, Email: moc. Qun J Duan, pulmonary embolism case study, Email: moc.

Hai F Cheng, pulmonary embolism case study, Email: moc. Ai Q Dong, Email: moc, pulmonary embolism case study. National Center for Biotechnology InformationU, pulmonary embolism case study. Journal List J Cardiothorac Surg v. J Cardiothorac Surg. Published online Nov Author information Article notes Copyright and License information Disclaimer. Corresponding author. Received Aug 14; Accepted Oct This article is published under license to BioMed Central Ltd.

Abstract This is one case report of a year-old Chinese male with type A acute aortic dissection. Electronic supplementary material The online version of this article doi Keywords: Aortic dissection, Postoperative complications, Pulmonary embolism. Background In the aortic root replacement procedure, bleeding from the proximal anastomosis is one of the gravest complications.

Case presentation A year-old Chinese male with a history of hypertension presented with sudden syncope and came to his senses after ten minutes without headache. Open in a separate window. Figure 1. Figure 2. Conclusions Acute aortic dissection AAD is the most common aortic catastrophe and is pulmonary embolism case study with extremely high morbidity and mortality.

Figure 3. Consent Written informed consent was obtained from the patient for publication of this case report and accompanying images. Acknowledgements We are grateful to all staffs that provided their care in the management of the patient especially the general surgical team in the Second Affiliated Hospital pulmonary embolism case study Zhejiang University School of Medicine.

Footnotes Competing interests The authors declare that they have no competing interests. References 1. Use of pericardium to control bleeding after ascending aortic graft replacement.

Ann Thorac Surg. Complete replacement of the ascending aorta with reimplantation of the coronary arteries: new surgical approach. J Thorac Cardiovasc Surg.

 

Pulmonary Embolism Misdiagnosed – A case study

 

pulmonary embolism case study

 

PE VTE diseases clinical case scenarios. June () Page 8 of 68 Clinical case scenarios: pulmonary embolism Clinical case scenarios are an educational resource that can be used for individual or group learning. They are also available in slide set format to support group learning. Each question should be considered by the individual or. Acute Pulmonary embolism: a case study. Acute Pulmonary embolism: a case study. A 28 years old patient came to my clinic for seeking my help. He was not feeling good and he told me that he had pain in his chest. He added more than he also had a problem with his breathing like he couldn’t breathe good and I felt that the moment he arrived. J La State Med Soc VOL July/August CliniCal Case of the Month Massive Pulmonary Embolism: A Case Report and Review of Literature Credit The LSMS Educational and Research Foundation designates this educational activity for a maximum of.