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Understanding Pulmonary Vein Thrombosis: Etiology, Risk Factors, and Management
Masoud Salim Kashoub1, Badar Al Rawahi2, Saif Al Mubaihsi1
1Department of Medicine, Sultan Qaboos University Hospital, Muscat, Oman.
Abstract:
Pulmonary vein thrombosis (PVT) is an uncommon but potentially fatal condition often misdiagnosed due to nonspecific symptoms such as cough, hemoptysis, and dyspnea. The true prevalence of PVT is difficult to determine and is mainly derived from case reports, influenced by the lung's robust venous collateral network. Specific clinical situations, including post-lobectomy, lung transplantation, and metastatic cancer, can precipitate PVT. Accurate and prompt diagnosis, requiring a high index of suspicion and advanced imaging techniques like computed tomography, magnetic resonance imaging, and echocardiography, is crucial to prevent severe complications such as peripheral embolization and acute stroke. Risk factors include surgical procedures, cancers, and potentially atrial fibrillation, with a high post-surgical thrombosis risk, especially after left upper lobectomy. Management must be tailored to the underlying pathology and can include antibiotics, anticoagulation, thrombectomy, and lung resection. This review underscores the need for increased clinical awareness and comprehensive diagnostic approaches to mitigate the severe consequences of PVT.
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