Archive for the 'Thromboembolic Occlusion' Category

24 Oct

Chronic Thromboembolic Occlusion in the Adult Can Mimic Pulmonary Artery Agenesis: Outcome

Thirty percent of our patients with C T-E PH have one or more characteristic flow murmurs over the lung fields, created by turbulent flow past partially occlusive thrombi. Rarely, such murmurs are present in UPPA, limited to the site of the agenetic pulmonary artery (presumably also due to turbulent blood flow). Detection of flow murmurs […]

23 Oct

Chronic Thromboembolic Occlusion in the Adult Can Mimic Pulmonary Artery Agenesis: UPAA

Unfortunately, not all patients with proven UPAA provide such an apparently definitive radiographic picture. For example, the extensive bronchial arterial circulation which these patients develop may increase vascularity of the involved lung in two ways. First, the bronchial arterial vessels themselves may be seen and can make the agenetic lung appear vascular. Second, luxuriant bronchial […]

22 Oct

Chronic Thromboembolic Occlusion in the Adult Can Mimic Pulmonary Artery Agenesis: Discussion

Cardiac catheterization disclosed pulmonary artery pressure of 90/45 mm Hg (mean: 62 mm Hg); wedge pressure, 9 mm Hg; CO, 5.4 L/min; calculated PVR, 792 dynes^s’cm. Pulmonary angiography disclosed smooth termination of the left pulmonary artery (Fig 8). On the right, there were multiple defects in all lobar branches. The study was believed to be […]

21 Oct

Chronic Thromboembolic Occlusion in the Adult Can Mimic Pulmonary Artery Agenesis: Case 3

Case 3 A 53-year-old white man was evaluated in September 1986 at the UCSD Medical Center for severe pulmonary hypertension. History disclosed that, at age 17 years, the patient had suffered leg trauma which resulted in a deep venous thrombosis and a subsequent clinically diagnosed episode of pulmonary embolism. A vein stripping operation was performed. […]

20 Oct

Chronic Thromboembolic Occlusion in the Adult Can Mimic Pulmonary Artery Agenesis: Chest x-ray film

A chest x-ray film disclosed cardiomegaly of right ventricular configuration, a hypoperfused left lung, a prominent right pulmonary artery and pleural thickening on the left side. Spirometry revealed mild expiratory obstruction. Lung volumes were normal. An ECG disclosed marked right axis deviation, incomplete right bundle branch block, nonspecific ST and T changes. Lung perfusion scan […]

19 Oct

Chronic Thromboembolic Occlusion in the Adult Can Mimic Pulmonary Artery Agenesis: Case 2

On January 25, 1988, pulmonary thromboendarterectomy was performed. Lobar branches of the right pulmonary artery were identified and traced back to the right main pulmonary artery. It was seen that the right pulmonary artery was occluded by a mushroom cap-like organized thrombus (Fig 5). This was dissected free and extensions from it into all lobar […]

18 Oct

Chronic Thromboembolic Occlusion in the Adult Can Mimic Pulmonary Artery Agenesis: CT scan

On arrival at this institution the patient was dyspneic at rest With normal blood pressure and a resting cardiac rate of 100 beats per minute. Jugular veins were pulsatile with giant V waves. The lungs were clear. The right hemidiaphragm was elevated. Cardiac examination disclosed a right ventricular heave, palpable P2, fixed split of S2, […]

17 Oct

Chronic Thromboembolic Occlusion in the Adult Can Mimic Pulmonary Artery Agenesis: Case Reports

He was then unavailable for follow-up and coumadin therapy was interrupted by another physician. In early 1986, he had a history of increasing dyspnea on exertion, edema in both legs and episodes of left pleuritic chest pain. He now had a markedly accentuated pulmonary closure sound, a right ventricular lift and the murmur of tricuspid […]

16 Oct

Chronic Thromboembolic Occlusion in the Adult Can Mimic Pulmonary Artery Agenesis

The demonstration that C T-E PH is potentially correctable by thromboendarterectomy has made recognition of the disorder clinically important. We have found that the varied clinical and laboratory findings in C T-E PH often lead to alternative diagnoses for some months or years. Among the first 100 patients in whom we have established the diagnosis […]

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