在亚大肺栓塞的设置中右心室血栓
Rutul Patel1, Anuja Mahesh Mistry1, Venkatachalam Mulukutla2
1Internal Medicine, Texas Tech University Health Sciences Center El Paso, El Paso, USA.
Cureus
|August 1, 2023
概括
带有右心应变和右心室血栓的大量肺栓塞 (PE) 需要及时治疗. 机械血栓切除术为选定的患者提供了可行的治疗选择,改善了结果.
科学领域:
- 心脏病学 心脏病学
- 肺部医学 肺部医学
- 血管外科 血管外科
背景情况:
- 亚重型肺栓塞 (PE) 具有重大风险,特别是在右心应变和血栓时.
- 阻塞性睡眠呼吸暂停 (OSA) 和不遵守持续正气道压力 (CPAP) 治疗是潜在的导致因素.
- 早期识别风险因素和并发症对于有效管理至关重要.
研究的目的:
- 为了呈现一个带有右心应变和右心室血栓的亚质量PE病例.
- 讨论这种复杂病例的诊断和治疗方法.
- 突出机械血栓切除术在选定患者中的作用.
主要方法:
- 一个59岁男性的病例报告,呼吸短促变得越来越严重.
- 诊断成像显示双边亚大质量PE,右心应变和右心室血栓.
- 治疗包括使用INARI FlowTriever装置进行抗凝血和机械血栓切除术.
主要成果:
- 通过使用机械血栓切除术成功治疗右心室血栓的亚大PE.
- 在患有OSA和CPAP不合规的患者中证明有效的管理.
- 确认右心室血栓是PE的并发症.
结论:
- 机械血栓切除术是一个有价值的选择,用于选择的右心室血栓的亚质量PE病例.
- 综合性风险因素评估,包括OSA和增强剂的使用,至关重要.
- 及时识别和多学科管理是优化患者治疗结果的关键.
相关概念视频
Pulmonary Embolism I: Introduction
7
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...
7
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
10
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...
10
Venous Thrombosis I: Introduction
12
Venous thrombosis, the most common disorder of the veins, involves the formation of a thrombus or blood clot associated with vein inflammation. It can be classified as either superficial vein thrombosis or deep vein thrombosis.Superficial Vein Thrombosis: This involves the formation of a thrombus in a superficial vein, usually the greater or lesser saphenous vein. Though less severe than deep vein thrombosis (DVT), SVT can lead to complications if untreated.Deep Vein Thrombosis (DVT): This...
12
Pulmonary Embolism III: Nursing Management
15
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...
15
Venous Thrombosis III: Interprofessional Care
10
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
10
Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies
14
The key difference between Superficial Vein Thrombosis (SVT) and Deep Vein Thrombosis (DVT) lies in their location and severity.Clinical ManifestationsSVT typically presents with localized pain, tenderness, and redness along the course of a superficial vein, often accompanied by a palpable, cord-like structure under the skin. This condition is usually less dangerous than DVT but can be uncomfortable and may lead to complications such as cellulitis or, rarely, a clot extension into the deep...
14


