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1.
Internist (Berl) ; 61(1): 21-35, 2020 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-31889210

RESUMO

Dyspnea is a very common symptom leading to visits to a general physician (GP). Correct differential diagnosis is the major challenge for the GP. There are no guidelines on dyspnea. This review provides an overview of the main causal diseases for dyspnea, presents methods for history taking and differential diagnosis, and specifies the role of GPs in the primary care setting in the case of dyspnea.


Assuntos
Dispneia/diagnóstico , Atenção Primária à Saúde , Diagnóstico Diferencial , Dispneia/etiologia , Humanos
2.
Heart Fail Clin ; 16(1): 33-44, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31735313

RESUMO

Heart failure (HF) and chronic obstructive pulmonary disease (COPD) are both common causes of breathlessness and often conspire to confound accurate diagnosis and optimal therapy. Risk factors (such as aging, smoking, and obesity) and clinical presentation (eg, cough and breathlessness on exertion) can be very similar, but the treatment and prognostic implications are very different. This review discusses the diagnostic challenges in individuals with exertional dyspnea. Also highlighted are the prevalence, clinical relevance, and therapeutic implications of a concurrent diagnosis of COPD and HF.


Assuntos
Dispneia/etiologia , Insuficiência Cardíaca/fisiopatologia , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Comorbidade , Dispneia/diagnóstico , Dispneia/fisiopatologia , Eletrocardiografia , Saúde Global , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/epidemiologia , Humanos , Prevalência , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Radiografia Torácica , Fatores de Risco , Espirometria
3.
Support Care Cancer ; 28(1): 87-98, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30982093

RESUMO

PURPOSE: Dyspnea is frequently experienced in advanced cancer patients and is associated with poor prognosis and functional decline. This study used the Edmonton Symptom Assessment System (ESAS) to characterize the relationship between dyspnea and concurrent symptoms experienced by advanced cancer patients. METHODS: A prospective database was collected and analyzed to extract patient demographics and ESAS scores. Logistic regression analysis and generalized estimating equations (GEE) identified correlations of other ESAS symptoms in three categories: severity of dyspnea (none, mild, moderate, severe), moderate/severe dyspnea (ESAS ≥ 4), and presence of dyspnea (ESAS ≥ 1), at patients' first visit and over time, respectively. RESULTS: Multivariable analysis revealed drowsiness (p = 0.001), and anxiety (p = 0.01) and appetite loss (p = 0.02) were associated with increased severity of dyspnea at first visit. Over time, tiredness (p = 0.02), drowsiness (p = 0.04), nausea (p = 0.02), and anxiety (p = 0.0006) were more likely to experience increased dyspnea severity. Tiredness (p = 0.0003), depression (p = 0.03), and appetite loss (p = 0.003) were significant for moderate/severe dyspnea at first visit. Over multiple visits, tiredness (p < 0.0001), anxiety (p = 0.0008), and appetite loss (p = 0.0008) had higher probabilities of moderate/severe dyspnea. For the presence of dyspnea at the first visit, anxiety (p = 0.03) and drowsiness (p = 0.002) were significantly correlated with an increased frequency of dyspnea. Over time, anxiety (p < 0.0001) and drowsiness (p < 0.0001) remained significant with the addition of nausea (p = 0.0007). CONCLUSIONS: The highly interactive relationship between dyspnea and other common cancer symptoms necessitates the development of comprehensive symptom assessments and utilization of multimodal management approaches that consider concurrent symptoms for improved identification and treatment of dyspnea.


Assuntos
Dispneia/diagnóstico , Dispneia/etiologia , Neoplasias/complicações , Neoplasias/patologia , Avaliação de Sintomas/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Bases de Dados Factuais , Progressão da Doença , Dispneia/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/diagnóstico , Neoplasias/terapia , Cuidados Paliativos/métodos , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença , Doente Terminal , Adulto Jovem
4.
Medicine (Baltimore) ; 98(48): e18169, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31770266

RESUMO

INTRODUCTION: Sinus of Valsalva aneurysm (SVA) protruding into the mitral anterior leaflet is an extremely rare clinical condition; herein, we present a case of unruptured noncoronary SVA protruding into the mitral anterior leaflet. PATIENT'S CONCERNS: A 46-year-old male was referred to hospital for exertional dyspnea. DIAGNOSIS: Transthoracic echocardiography (TTE) and coronary computed tomography angiography (CTA) suggested a noncoronary SVA protruding into the mitral anterior leaflet, causing mitral regurgitation and aortic insufficiency. INTERVENTIONS: The aneurysm was resected and the aortic and mitral valves were replaced with mechanical valves via a transaortic approach. OUTCOMES: Postoperative recovery was uneventful. CONCLUSIONS: A rare noncoronary SVA protruding into the mitral anterior leaflet can be diagnosed via TTE and CTA. Transaortic mitral surgery is feasible in patients with a dilated aortic annulus ring and mitral valve diseases.


Assuntos
Aneurisma Aórtico , Insuficiência da Valva Aórtica , Dispneia , Implante de Prótese de Valva Cardíaca/métodos , Insuficiência da Valva Mitral , Valva Mitral , Procedimentos Cirúrgicos Vasculares/métodos , Aneurisma Aórtico/complicações , Aneurisma Aórtico/diagnóstico por imagem , Aneurisma Aórtico/fisiopatologia , Aneurisma Aórtico/cirurgia , Valva Aórtica/diagnóstico por imagem , Valva Aórtica/fisiopatologia , Insuficiência da Valva Aórtica/diagnóstico , Insuficiência da Valva Aórtica/etiologia , Insuficiência da Valva Aórtica/fisiopatologia , Insuficiência da Valva Aórtica/cirurgia , Angiografia por Tomografia Computadorizada/métodos , Dispneia/diagnóstico , Dispneia/etiologia , Dispneia/fisiopatologia , Ecocardiografia/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Valva Mitral/diagnóstico por imagem , Valva Mitral/fisiopatologia , Insuficiência da Valva Mitral/diagnóstico , Insuficiência da Valva Mitral/etiologia , Insuficiência da Valva Mitral/fisiopatologia , Insuficiência da Valva Mitral/cirurgia , Seio Aórtico/diagnóstico por imagem , Seio Aórtico/fisiopatologia , Resultado do Tratamento
5.
Medicine (Baltimore) ; 98(48): e18251, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31770288

RESUMO

RATIONALE: Small cell carcinoma (SCC) occurs mostly in the lung, and small cell lung cancer accounts for 13% of newly diagnosed lung cancers. Only 2.5% of SCC occurs in extrapulmonary sites, and SCC of pleural origin is especially very uncommon. PATIENT CONCERNS: An 85-year-old man presenting with progressive dyspnea for more than 7 days. DIAGNOSES: Computed tomography scan of the chest showed massive pleural effusion and diffuse nodular thickening of the pleura on the right chest. Sonography-guided needle biopsy of the pleural mass was performed and histologic and immunohistochemical findings revealed SCC. Since no parenchymal lung lesion was observed, the patient was finally diagnosed with SCC of the pleura (SCCP). INTERVENTIONS: Due to the patient's old age and poor performance status, chemotherapy was not performed and only drainage of pleural effusion was conducted for symptom relief. OUTCOMES: Dyspnea improved after pleural effusion drainage. The patient was discharged and transferred to a local medical center for hospice care. LESSONS: Although primary SCCP is extremely rare, SCCP should also be considered as well as mesothelioma in case of presence of a pleural-based mass with massive pleural effusion.


Assuntos
Carcinoma de Células Pequenas , Dispneia , Derrame Pleural Maligno , Neoplasias Pleurais , Toracentese/métodos , Idoso de 80 Anos ou mais , Carcinoma de Células Pequenas/complicações , Carcinoma de Células Pequenas/patologia , Carcinoma de Células Pequenas/fisiopatologia , Dispneia/diagnóstico , Dispneia/etiologia , Cuidados Paliativos na Terminalidade da Vida , Humanos , Biópsia Guiada por Imagem/métodos , Masculino , Pleura/diagnóstico por imagem , Pleura/patologia , Derrame Pleural Maligno/diagnóstico , Derrame Pleural Maligno/etiologia , Derrame Pleural Maligno/fisiopatologia , Derrame Pleural Maligno/terapia , Neoplasias Pleurais/complicações , Neoplasias Pleurais/patologia , Neoplasias Pleurais/fisiopatologia , Tomografia Computadorizada por Raios X/métodos , Ultrassonografia de Intervenção/métodos
7.
Praxis (Bern 1994) ; 108(11): 741-749, 2019 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-31480954

RESUMO

CME: Nocturnal Dyspnea Abstract. Nocturnal dyspnea has a broad range of differential diagnoses of sometimes serious and even life-threatening illnesses. Systematic assessment starts with taking a detailed medical history to characterize the dyspnea and evaluate possible underlying diseases. The subsequent clinical and complementary evaluation should be targeted to detect possible diseases of the upper and lower respiratory tract, the lungs, disorders of control of breathing, heart diseases as well as neurological and, after exclusion of other causes, mental illnesses.


Assuntos
Dispneia , Cardiopatias , Diagnóstico Diferencial , Dispneia/diagnóstico , Dispneia/etiologia , Cardiopatias/complicações , Cardiopatias/diagnóstico , Humanos
8.
Ann Biol Clin (Paris) ; 77(4): 439-445, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31418706

RESUMO

A 67 years old woman with a Waldenström disease was admitted in the intensive care unit for dyspnea and fever. During hospitalization, episodes of undetectable glycemia were observed without any hypoglycemia symptoms. Plasma glucose was determined with the hexokinase method (recommended). From this observation, a literature review on PubMed was performed to investigate similar cases. In patients with protides in excess (e.g. immunoproliferative syndrome), absorption measurements could be disrupted by the precipitation of excess protein (IgM in most cases). Other parameters could be affected: bilirubin, phosphate, HDL cholesterol, GGT, CRP and calcemia. In our case, the main difficulty was to identify the cause of the interference and then correct it. Using a series of dilution, we prevented protide precipitation allowing correct glucose determination. Those interferences are rare, but present a real analytical difficulty. Biologists should be aware of those interferences because of dramatics consequences.


Assuntos
Análise Química do Sangue/métodos , Glicemia/análise , Hexoquinase/metabolismo , Hipoglicemia/diagnóstico , Paraproteínas/efeitos adversos , Macroglobulinemia de Waldenstrom/sangue , Idoso , Artefatos , Análise Química do Sangue/normas , Glicemia/metabolismo , Diagnóstico Diferencial , Dispneia/sangue , Dispneia/diagnóstico , Dispneia/etiologia , Reações Falso-Positivas , Feminino , Febre/sangue , Febre/diagnóstico , Febre/etiologia , Hexoquinase/química , Humanos , Hipoglicemia/sangue , Paraproteínas/metabolismo , Hemorragia Retiniana/sangue , Hemorragia Retiniana/diagnóstico , Hemorragia Retiniana/etiologia , Macroglobulinemia de Waldenstrom/complicações , Macroglobulinemia de Waldenstrom/diagnóstico
9.
Int J Chron Obstruct Pulmon Dis ; 14: 1633-1638, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31413558

RESUMO

Objective: To investigate the prevalence and predictors of COPD in a large cohort of symptomatic smokers and ex-smokers in a primary care setting. Methods: General practitioners (n=390) consecutively recruited individuals ≥35 years, with current or previous tobacco exposure, at least one respiratory symptom, and no previous diagnosis of obstructive airways disease; and obtained data on tobacco exposure, body mass index (BMI), and dyspnea (Medical Research Council dyspnea scale). All individuals with airflow obstruction, ie, FEV1/FVC <0.70 at initial lung function test, had diagnostic spirometry, including bronchodilator reversibility test. COPD was defined as respiratory symptom(s), tobacco exposure, and nonreversible airflow limitation. Results: Of the 6,710 at-risk individuals screened with spirometry (52% male sex, mean age 58 years [SD 10.9]), 1,185 were diagnosed with COPD (17.7%). Apart from age and pack-years, multivariate logistics regression analysis, adjusted for FEV1, revealed that BMI <25 kg/m2 (OR 4.2, 95% CI 3.0-5.9, p<0.001), BMI 35+ kg/m2 (OR 1.6, 95% CI 1.2-2.3), self-reported dyspnea (OR 1.2, 95% CI 1.1-14, p=0.04), wheeze (OR 1.3, 95% CI 1.1-1.6, p=0.001), phlegm (OR 1.4, 95% CI 1.1-1.6, p<0.001), and MRC ≥3 (OR 1.6, 95% CI 1.2-2.0, p=0.001) were associated with a significantly higher likelihood of being diagnosed with COPD. No association was found between sex, cough, and recurrent respiratory tract infections and a diagnosis of COPD. Conclusion: The prevalence of COPD is high among smokers and ex-smokers with one or more respiratory symptoms seen in primary care, and the presence of wheeze, phlegm and dyspnea, together with both low BMI and obesity identify a subgroup with an even higher likelihood of COPD.


Assuntos
Dispneia , Atenção Primária à Saúde , Doença Pulmonar Obstrutiva Crônica , Sons Respiratórios , Fumantes/estatística & dados numéricos , Espirometria , Adulto , Índice de Massa Corporal , Dinamarca/epidemiologia , Dispneia/diagnóstico , Dispneia/etiologia , Diagnóstico Precoce , Feminino , Humanos , Pulmão/fisiopatologia , Masculino , Programas de Rastreamento/métodos , Pessoa de Meia-Idade , Prevalência , Atenção Primária à Saúde/métodos , Atenção Primária à Saúde/estatística & dados numéricos , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Sons Respiratórios/diagnóstico , Sons Respiratórios/etiologia , Fatores de Risco , Fumar/epidemiologia , Espirometria/métodos , Espirometria/estatística & dados numéricos , Avaliação de Sintomas/métodos , Avaliação de Sintomas/estatística & dados numéricos
10.
Eur J Oncol Nurs ; 42: 14-20, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31446259

RESUMO

PURPOSE: Symptoms experienced by breast cancer patients often cluster together in groups known as "symptom clusters". The aim was to determine the symptom clusters in women with non-metastatic breast cancer treated by radiation therapy (RT). METHODS: Edmonton Symptom Assessment Scale (ESAS) scores were taken from breast cancer patients receiving RT before, at completion of RT, and after RT. Exploratory factor analysis (EFA), principal component analysis (PCA), and hierarchical cluster analysis (HCA) were used to identify symptom clusters among the nine ESAS items at all three time points. RESULTS: This study included 1224 patients. The PCA and EFA identified the same two symptom clusters before the start of RT: 1) pain, tiredness, nausea, drowsiness, appetite, and dyspnea; 2) depression, anxiety, and wellbeing. The HCA further split the symptoms into three clusters. Wellbeing, depression, and anxiety consistently clustered together. Among the ESAS scores collected at the end of and after RT, each statistical method identified different symptom clusters. For the symptom clusters experienced at the end of RT, the following symptoms were always in the same cluster: wellbeing, depression, and anxiety; nausea and appetite; drowsiness and dyspnea. Following RT, depression and anxiety consistently clustered together, with nausea and appetite in a second cluster. CONCLUSION: Among the symptom clusters derived before, at the end of RT, and after RT, the following symptoms consistently presented together: depression and anxiety, nausea and appetite, pain and tiredness, and drowsiness, dyspnea, and tiredness. Understanding symptom clusters in this population can improve management of symptoms.


Assuntos
Neoplasias da Mama/complicações , Neoplasias da Mama/radioterapia , Adulto , Idoso , Ansiedade/diagnóstico , Ansiedade/epidemiologia , Neoplasias da Mama/psicologia , Dor do Câncer/diagnóstico , Dor do Câncer/epidemiologia , Análise por Conglomerados , Depressão/diagnóstico , Depressão/epidemiologia , Dispneia/diagnóstico , Dispneia/epidemiologia , Análise Fatorial , Fadiga/diagnóstico , Fadiga/epidemiologia , Transtornos da Alimentação e da Ingestão de Alimentos/diagnóstico , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Feminino , Humanos , Pessoa de Meia-Idade , Náusea/diagnóstico , Náusea/epidemiologia , Análise de Componente Principal , Avaliação de Sintomas/métodos
11.
BMJ Case Rep ; 12(8)2019 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-31451468

RESUMO

Electrical injuries are a common occurrence and can be minor or even fatal depending on the voltage to which an individual has been exposed to. Electrical current causes tissue damage by producing heat due to local tissue resistance. Serious electrocution may manifest with cutaneous burns, visceral injuries, organ perforation, and cardiac and respiratory effects. Pneumothorax as a complication of electrical injury is a very rare entity. We report one such case of electrical burn injury with right-sided pneumothorax as an immediate complication.


Assuntos
Queimaduras por Corrente Elétrica/complicações , Pneumotórax , Toracentese/métodos , Adulto , Dor no Peito/diagnóstico , Dor no Peito/etiologia , Tosse/diagnóstico , Tosse/etiologia , Dispneia/diagnóstico , Dispneia/etiologia , Humanos , Masculino , Pneumotórax/diagnóstico , Pneumotórax/etiologia , Pneumotórax/fisiopatologia , Pneumotórax/terapia , Radiografia Torácica/métodos , Cavidade Torácica/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento
12.
S D Med ; 72(7): 322-327, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31461588

RESUMO

An elderly female presented to the emergency department with a two-month history of dyspnea on exertion and productive cough. Imaging revealed miliary nodular pattern involving both lungs. She underwent extensive work up evaluating different possible pathological processes. The condition was ultimately lethal. In this educational case report, we review the common - and not-so-common - etiologies that might present with this constellation of signs and symptoms, along with the diagnostic strategies and thought processes used to identify the final diagnosis.


Assuntos
Tosse , Dispneia , Idoso , Tosse/diagnóstico , Dispneia/diagnóstico , Serviço Hospitalar de Emergência , Feminino , Humanos
14.
Arch. bronconeumol. (Ed. impr.) ; 55(8): 427-433, ago. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-186100

RESUMO

En la mayoría de los ámbitos de la neumología se sigue utilizando un principio osleriano (basado en los síntomas y signos) en los que la enfermedad es el centro de toda actividad, pero este paradigma está cambiando. Actualmente, gracias al reconocimiento de la heterogeneidad y complejidad de las enfermedades pulmonares, la tendencia es a realizar una medicina más personalizada, de precisión, o centrada en el paciente. En la presente revisión se intentará establecer la situación actual sobre el conocimiento de las bronquiectasias, o mejor, del síndrome bronquiectásico, como una enfermedad multidimensional, sistémica, heterogénea y compleja, los pasos que ya se han dado en este sentido, y sobre todo, en los muchos que quedan por dar. Asimismo, se propondrán algunas herramientas que podrían facilitar la traslación de estos conceptos a la práctica clínica, y con ellos seguir avanzando hacia una imagen más holística de esta enfermedad


Most areas of respiratory medicine continue to use an Oslerian approach, based on signs and symptoms, in which the disease is the center of all activity. However, this paradigm is changing. Now that lung diseases have been recognized as heterogeneous and complex, we are moving towards more personalized, precise, patient-oriented medicine. The aim of this review was to define the current state of the knowledge on bronchiectasis, or, more accurately, the bronchiectasis syndrome, as a multidimensional, systemic, heterogeneous, complex disease. We explore the advances that have already been made, and above all the many steps that are still to be taken. We also propose some tools which might facilitate the application of these concepts in clinical practice, and help us continue our journey towards a more holistic view of this disease


Assuntos
Humanos , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Bronquiectasia/epidemiologia , Bronquiectasia/diagnóstico , Fenótipo , Dispneia/diagnóstico , Dispneia/epidemiologia , Pseudomonas aeruginosa , Doença Pulmonar Obstrutiva Crônica/complicações , Recidiva , Qualidade de Vida , Saúde Holística
18.
Ann Otol Rhinol Laryngol ; 128(11): 1086-1091, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31291740

RESUMO

BACKGROUND: Spindle cell lipomas (SCLs) are benign tumors that are characteristically present on the upper back and neck, but in rare cases present throughout the respiratory mucosa, causing hoarseness, stridor, dyspnea, and obstruction. OBJECTIVE: To highlight the importance of considering SCL in the diagnosis of benign respiratory tract tumors, a literature review identified all published cases of respiratory tract SCLs, including 2 from our institution: one case in the nasopharynx and 1 in the nasal valve. METHODS: All case reports, series and literature reviews from the English literature from 1975 through March 2018 were systematically identified for review in the MEDLINE, EMBASE, and Scopus databases. Two additional cases from our institution were described. RESULTS: In total, 24 cases of SCL in the respiratory tract were identified for review. Two cases from our institution are described here, bringing the total of reported cases to 26. Extensive analyses of oral cavity SCLs already exist, so we excluded this site from our review and focused on sites where SCLs may present with respiratory symptoms. Excluding the oral cavity and oropharynx, the most common location described is the larynx. All 26 cases were treated with excision. One tumor required a second surgery, but there were no other complications nor recurrences. CONCLUSION: Although rare, SCLs may arise from throughout the respiratory tract and cause dyspnea, hoarseness and stridor. Spindle cell lipoma should be considered in the differential diagnosis of a respiratory tract mass. This diagnosis confers a good prognosis and patients may be reassured that surgery is almost always curative.


Assuntos
Dispneia/diagnóstico , Lipoma/diagnóstico , Neoplasias Bucais/diagnóstico , Idoso , Biópsia , Diagnóstico Diferencial , Dispneia/etiologia , Humanos , Lipoma/complicações , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/complicações , Tomografia Computadorizada por Raios X
19.
Int J Pediatr Otorhinolaryngol ; 125: 164-167, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31326733

RESUMO

Castleman's disease is a very rare entity in pediatric population and its presentation in the neck is scarcely described in the literature. We present the case of a 10-year-old-girl with an expanding neck mass over several months causing dysphagia and dyspnea. Surgical excision of the mass was performed and the analysis revealed unicentric Castleman's Disease. This is the second largest reported case of neck pediatric CD in the literature, and it presented with a symptomatology that differs from the other cases described. This fact highlights the need to include CD in the differential diagnosis of pediatric neck masses.


Assuntos
Hiperplasia do Linfonodo Gigante/complicações , Hiperplasia do Linfonodo Gigante/diagnóstico , Transtornos de Deglutição/etiologia , Dispneia/etiologia , Criança , Transtornos de Deglutição/diagnóstico , Diagnóstico Diferencial , Dispneia/diagnóstico , Feminino , Humanos , Pescoço/cirurgia
20.
BMJ Case Rep ; 12(7)2019 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-31340942

RESUMO

Right ventricular thrombus (RVT) can be life-threatening, since it has the potential to embolise and cause saddle pulmonary embolism (PE). We present a patient who initially presented with haemodynamically stable PE with evidence of RVT on echocardiogram. She was placed on heparin drip; however, she later developed cardiac arrest and died due to embolisation of RVT to the pulmonary vasculature. Although management of haemodynamically stable PE in patients with RVT is still a matter of debate, 1 given the outcome we suggest that thrombolysis or emergent embolectomy at the presentation, in this case, may have had a favourable outcome.


Assuntos
Tomada de Decisão Clínica , Parada Cardíaca/mortalidade , Embolia Pulmonar/terapia , Terapia Trombolítica/métodos , Trombose/diagnóstico por imagem , Trombose/terapia , Idoso de 80 Anos ou mais , Dor no Peito/diagnóstico , Dor no Peito/etiologia , Progressão da Doença , Dispneia/diagnóstico , Dispneia/etiologia , Ecocardiografia/métodos , Embolectomia/métodos , Serviço Hospitalar de Emergência , Evolução Fatal , Feminino , Parada Cardíaca/etiologia , Ventrículos do Coração/diagnóstico por imagem , Ventrículos do Coração/patologia , Hemodinâmica/fisiologia , Heparina/uso terapêutico , Humanos , Embolia Pulmonar/diagnóstico por imagem
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