-
Thrombosis Research Sep 2012Data regarding the clinical relevance of pulmonary infarction (PI) in patients with pulmonary embolism (PE) are lacking. The aim of this study was to investigate the...
INTRODUCTION
Data regarding the clinical relevance of pulmonary infarction (PI) in patients with pulmonary embolism (PE) are lacking. The aim of this study was to investigate the clinical features of PE patients with PI and the prognostic role of PI for PE patients.
MATERIALS AND METHODS
Based on computed tomography scan, 509 patients with PE were divided into two groups, the infarction group (n=45) and the non-infarction group (n=464). A variety of clinical parameters were compared between the two groups.
RESULTS
In the infarction group, the largest pulmonary arteries involved by emboli were central rather than peripheral and more proximal as compared to the non-infarction group (p=0.01 and p<0.03, respectively). Thrombolytic agents tended to be more frequently administered in the infarction group (13.3% [n=6] versus 6.3% [n=29], p=0.07). In-hospital mortality, PE-related deaths, and the recurrence rate of PE did not differ between the two groups.
CONCLUSIONS
The present study did not demonstrate that PI is a prognostic indicator of recurrence and mortality in PE patients. We suggest the possibility that blood clot burden is greater in PE patients with PI, although PI by itself occurs in small pulmonary arteries.
Topics: Comorbidity; Female; Hospital Mortality; Humans; Male; Middle Aged; Prevalence; Pulmonary Embolism; Pulmonary Infarction; Recurrence; Republic of Korea; Risk Factors; Survival Analysis; Survival Rate; Tomography, X-Ray Computed
PubMed: 22482830
DOI: 10.1016/j.thromres.2012.03.012 -
RoFo : Fortschritte Auf Dem Gebiete Der... Jun 2015The aim of this study was to identify factors predisposing to lung infarction in patients with pulmonary embolism (PE). (Comparative Study)
Comparative Study
PURPOSE
The aim of this study was to identify factors predisposing to lung infarction in patients with pulmonary embolism (PE).
MATERIALS AND METHODS
We performed a retrospective analysis on 154 patients with the final diagnosis of PE being examined between January 2009 and December 2012 by means of a Toshiba Aquilion 64 CT scanner. The severity of clinical symptoms was defined by means of a clinical index with 4 classes. The pulmonary clot load was quantified using a modified severity index of PE as proposed by Miller. We correlated several potential predictors of pulmonary infarction such as demographic data, pulmonary clot burden, distance of total vascular obstruction and pleura, the presence of cardiac congestion, signs of chronic bronchitis or emphysema with the occurrence of pulmonary infarction.
RESULTS
Computed tomography revealed 78 areas of pulmonary infarction in 45/154 (29.2 %) patients. The presence of infarction was significantly higher in the right lung than in the left lung (p < 0.001). We found no correlation between pulmonary infarction and the presence of accompanying malignant diseases (r = -0.069), signs of chronic bronchitis (r = -0.109), cardiac congestion (r = -0.076), the quantified clot burden score (r = 0.176), and the severity of symptoms (r = -0.024). Only a very weak negative correlation between the presence of infarction and age (r = -0.199) was seen. However, we could demonstrate a moderate negative correlation between the distance of total vascular occlusion and the occurrence of infarction (r = -0.504).
CONCLUSION
Neither cardiac congestion nor the degree of pulmonary vascular obstruction are main factors predisposing to pulmonary infarction in patients with PE. It seems that a peripheral total vascular obstruction more often results in infarction than even massive central clot burden.
Topics: Adult; Age Distribution; Aged; Aged, 80 and over; Causality; Comorbidity; Female; Germany; Humans; Incidence; Lung Diseases, Obstructive; Male; Middle Aged; Pulmonary Embolism; Pulmonary Infarction; Reproducibility of Results; Risk Factors; Sensitivity and Specificity; Sex Distribution; Survival Rate; Tomography, X-Ray Computed
PubMed: 25750111
DOI: 10.1055/s-0034-1399006 -
The American Journal of Case Reports Nov 2019BACKGROUND Risk factors for venous thromboembolism can include a combination of genetic, anatomic, and physiologic factors, some of which are modifiable. Patients...
BACKGROUND Risk factors for venous thromboembolism can include a combination of genetic, anatomic, and physiologic factors, some of which are modifiable. Patients presenting to the hospital with venous thromboembolism may have multiple risk factors that require testing beyond the initial admission labs and hypercoagulability screening panel. CASE REPORT We describe a right-handed patient who lifts weights for exercise, who presented with pulmonary infarcts and clot in the right superior vena cava/subclavian vein. These were due to a combination of 1) an acquired hypercoagulability from minimal change disease and 2) dynamic anatomic narrowing of the subclavian vein, which is known as Paget-Schroetter syndrome. Despite normal serum levels of antithrombin, protein C and S, his serum albumin was low, which prompted workup for proteinuria. Testing revealed nephrotic range proteinuria as well as dynamic occlusion of the right subclavian vein on magnetic resonance venography only when the patient lifted and externally rotated his arms. CONCLUSIONS This case report highlights the need for a thorough history and physical examination, as well as additional testing in some patients beyond the initial admission laboratory tests and screening panel for hypercoagulability. Tests could include diagnostic imaging testing with provoking maneuvers, which can help elucidate dynamic physiology. Such testing, when appropriate, can help to inform the treatment plan and prevent recurrent thromboses.
Topics: Anticoagulants; Combined Modality Therapy; Diagnosis, Differential; Humans; Male; Mechanical Thrombolysis; Nephrotic Syndrome; Pulmonary Infarction; Upper Extremity Deep Vein Thrombosis; Young Adult
PubMed: 31727870
DOI: 10.12659/AJCR.919141 -
The Journal of the Louisiana State... Jul 1954
Topics: Humans; Infarction; Lung; Pulmonary Embolism; Pulmonary Infarction; Thrombosis
PubMed: 13174949
DOI: No ID Found -
Journal of the Belgian Society of... 2023The reversed halo sign, or atoll sign, is a specific sign with ring-shaped consolidation and central lucency, which is historically considered typical for cryptogenic...
The reversed halo sign, or atoll sign, is a specific sign with ring-shaped consolidation and central lucency, which is historically considered typical for cryptogenic organising pneumonia. The presence of this sign in subpleural, posterior basal parts of the lower lobes, especially when solitary, should however raise suspicion for other causes, such as pulmonary infarction. Here, we present a case of pulmonary embolism with pulmonary infarction that was detected on HRCT without contrast. The presence of a reversed halo sign, especially when solitary and located in the periphery of the lower lobes, should raise suspicion of a pulmonary infarction.
PubMed: 37694190
DOI: 10.5334/jbsr.3243 -
Internal Medicine (Tokyo, Japan) Mar 2024
PubMed: 38432978
DOI: 10.2169/internalmedicine.3368-23 -
Southern Medical Journal Jul 1952
Topics: Humans; Infarction; Lung; Pulmonary Infarction
PubMed: 12984206
DOI: 10.1097/00007611-195207000-00006 -
Bulletin of the U.S. Army Medical... Aug 1946
Topics: Humans; Infarction; Lung; Pulmonary Infarction
PubMed: 20993985
DOI: No ID Found -
GP Sep 1952
Topics: Humans; Pulmonary Embolism; Pulmonary Infarction; Thrombosis
PubMed: 12989350
DOI: No ID Found -
Archives of Internal Medicine Nov 1981
Topics: Adult; Altitude; Anemia, Sickle Cell; Female; Humans; Pulmonary Embolism
PubMed: 7305585
DOI: No ID Found