Left pulmonary artery thrombosis diagnosed by transesophageal echocardiography/Transozofajiyal ekokardiyografi ile tani konulan sol pulmoner arter trombozu.A 65-year-old male patient was admitted with complaints of dyspnea and cough that has lasted for one week. On examination, the patient was tachypneic and cyanotic Cyanotic
Marked by bluish discoloration of the skin due to a lack of oxygen in the blood. It is one of the types of congenital heart disease.
Mentioned in: Congenital Heart Disease . His blood pressure was 130/80 mmHg, pulse rate was 120 beats/min, respiratory rate was 28/min. On cardiovascular examination, a grade 2/6 pansystolic murmur was heard at the left sternal border and right ventricular heave was palpable. His electrocardiogram showed an incomplete right bundle branch block right bundle branch block Cardiology A condition in which the electrical impulse from the bundle of His to the ventricles is delayed or fails to conduct along the right bundle branch, resulting in right ventricular depolarization by cell-to-cell conduction and sinus tachycardia. The laboratory tests were normal except a mild leukocytosis Leukocytosis Definition
Leukocytosis is a condition characterized by an elevated number of white cells in the blood.
Leukocytosis is a condition that affects all types of white blood cells. . The arterial blood gases disclosed a Pa02 of 50 mmHg, a PaC02 of 38 mmHg and a pH of 7.45. The D-dimer level was <500 ng/ml. The transthoracic echocardiography revealed severe tricuspid regurgitation, mild mitral regurgitation, marked dilatation of the main pulmonary artery and the right ventricle. The systolic Systolic
The phase of blood circulation in which the heart's pumping chambers (ventricles) are actively pumping blood. The ventricles are squeezing (contracting) forcefully, and the pressure against the walls of the arteries is at its highest. pulmonary artery pressure was 50 mmHg. The transesophageal echocardiography demonstrated an occlusion in the left pulmonary artery (Fig. 1, Video 1. See corresponding video/movie images at www.anakarder.com). In the subsequent computed tomography (CT) angiography, the left pulmonary artery was found to be totally occluded (Fig. 2). Thromboembolism thromboembolism /throm·bo·em·bo·lism/ (-em´bo-lizm) obstruction of a blood vessel with thrombotic material carried by the blood from the site of origin to plug another vessel.
n. was no consistent with the CT angiography findings. The venous Doppler ultrasonography of the lower extremity and abdomen were normal. Screenings for connective tissue disease connective tissue disease Autoimmune disease, collagen-vascular disease Any of the diseases affecting connective tissues, with an autoimmune component, and immunologic/inflammatory defects Clinical Arthritis, connective tissue defects, endocarditis, myositis, and thrombophilia were negative. It was decided to proceed with thromboendarterectomy, but he refused it. Upon this, heparin and warfarin were initiated and warfarin therapy was adjusted according to INR goal of between 2-3.
[FIGURE 1 OMITTED]
Pulmonary artery thrombosis is seen in Eisenmenger's syndrome, atrial septal defect Atrial Septal Defect Definition
An atrial septal defect is an abnormal opening in the wall separating the left and right upper chambers (atria) of the heart. and connective tissue diseases. However, none of these causes was in our case. The CT angiography and transesophageal echocardiography are being used in cases of pulmonary artery occlusion. Apart from treatment directed towards the causes, anticoagulants, fibrinolytics and surgical methods are being used.
It can be concluded that in patients with severe dyspnea together with the dilatation of the right heart chambers on transthoracic echocardiography, further investigation of the main pulmonary artery together with proximal left and right pulmonary arteries should be evaluated with transesophageal echocardiography.
[FIGURE 2 OMITTED]
Note: This case was presented at National Echocardiography Echocardiography Definition
Echocardiography is a diagnostic test that uses ultrasound waves to create an image of the heart muscle. Ultrasound waves that rebound or echo off the heart can show the size, shape, and movement of the heart's valves and Meeting, 4-6 May 2006, Konya, Turkey
Hamza Duygu, Filiz Ozerkan, Mustafa Akin
Department of Cardiology, Faculty of Medicine, Ege University, Izmir, Turkey
Address for Correspondence/Yazisma Adresi: Hamza Duygu, MD 4834 sokak, No: 20, Kat: 2, Yenicamlik, 35400, Izmir-Turkey Phone: +90 232 390 40 01 Fax: +90 232 390 32 87 E-mail: email@example.com