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Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
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Does Right Ventricular Dysfunction Predict Mortality in Hemodynamically Stable Patients With Acute Pulmonary

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|September 5, 2017
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Summary

Right ventricular dysfunction (RVD) in hemodynamically stable patients with acute pulmonary embolism (APE) does not increase 30-day mortality. This study found no significant difference in outcomes, questioning the routine use of fibrinolysis based solely on RVD.

Keywords:
Acute pulmonary embolismFibrinolysisRight ventricular dysfunction

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Area of Science:

  • Cardiology
  • Pulmonology
  • Critical Care Medicine

Background:

  • Acute pulmonary embolism (APE) causes significant annual mortality.
  • Right ventricular dysfunction (RVD) is a known poor prognostic factor in APE.
  • The prognostic value of RVD in hemodynamically stable APE patients remains unclear.

Purpose of the Study:

  • To investigate the association between RVD and mortality in hemodynamically stable APE patients.
  • To clarify the prognostic significance of RVD in this specific patient population.

Main Methods:

  • Retrospective review of electronic medical records for hemodynamically stable APE patients (July 2014-July 2016).
  • Patients categorized into groups with or without echocardiographic/CT evidence of RVD.
  • Statistical analysis including Chi-square/Fisher's exact test, t-tests, and multivariable logistic regression.

Main Results:

  • No statistically significant difference in 30-day mortality between RVD and no RVD groups (7.8% vs. 5.3%, P=0.563).
  • RVD prevalence was 57%; associated with elevated troponin and central thrombus location.
  • Marginally significant longer hospital stay for patients with RVD (P=0.061).

Conclusions:

  • RVD does not impact 30-day mortality in hemodynamically stable APE patients.
  • Routine systemic fibrinolysis is not recommended based solely on radiographic evidence of RVD in this cohort.