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Pulmonary embolism (PE) occurs when a thrombus, fat or air embolus, amniotic fluid, or tumor tissue blocks one or more pulmonary arteries. These blockages originate in the venous system or the right side of the heart.EtiologyPE primarily arises from deep vein thrombosis (DVT) and other hypercoagulable states, such as inherited thrombophilias. Additional etiological factors include venous stasis, commonly seen in obesity, and endothelial injury from surgery and trauma. Less common causes include...
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A blood clot, or thrombus, is a semi-solid mass composed of fibrin, platelets, and red blood cells. When it forms within a vessel, it can obstruct blood flow, known as thrombosis. If part of the clot detaches, it becomes an embolus that can travel and block distant vessels. When this occurs in the pulmonary arteries, it causes a condition known as pulmonary embolism (PE).Origin and ImpactMost often, the embolus originates from a thrombus in the deep veins of the lower limbs, a condition called...
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Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
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Pulmonary Embolism III: Nursing Management01:27

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A pulmonary embolism occurs when a thrombus, amniotic fluid, tumor tissue, fat, or air embolus blocks one or more pulmonary arteries. Effective nursing management and patient education are crucial for improving outcomes and preventing recurrence.Nursing management starts with obtaining a comprehensive patient history, particularly noting any history of deep vein thrombosis (DVT). Assess for clinical manifestations, including dyspnea, chest pain, crackles, heart murmurs, and signs of right-sided...
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Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
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Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
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"Air embolism during fontan operation".

Madan Mohan Maddali1, Eapen Thomas, Mohd M Malik

  • 1Department of Anaesthesia, Royal Hospital, Muscat, Oman.

Annals of Cardiac Anaesthesia
|July 5, 2014
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Summary
This summary is machine-generated.

Air embolism typically causes systemic embolization in patients with right-to-left shunts. However, a child with single ventricle physiology demonstrated non-embolization due to a "diving bell" effect and aortic regurgitation.

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Area of Science:

  • Cardiology
  • Pediatric Cardiology
  • Cardiovascular Surgery

Background:

  • Right-to-left intracardiac shunts create a direct pathway for systemic air embolism.
  • Single ventricle physiology presents unique challenges in managing intracardiac blood flow and potential emboli.
  • Surgical interventions like bidirectional Glenn shunt and Damus-Kaye-Stansel anastomosis alter intracardiac hemodynamics.

Observation:

  • Intraoperative transesophageal echocardiography detected air entrainment during a procedure in a child with single ventricle physiology.
  • Despite the presence of a right-to-left shunt, systemic embolization of the entrained air did not occur.

Findings:

  • The study suggests a "diving bell" phenomenon, where air becomes trapped, prevented systemic embolization.
  • Mild aortic valve regurgitation was also implicated as a contributing factor in confining air within the ventricle.
  • This case highlights an unusual protective mechanism against air embolism in a complex congenital heart defect.

Implications:

  • Understanding these protective mechanisms can inform surgical strategies and patient management in complex congenital heart disease.
  • This finding may lead to new approaches for preventing paradoxical embolism in at-risk pediatric populations.
  • Further research into the "diving bell" phenomenon and its interaction with valvular function is warranted.