John Hunter is credited with the first reported venous ligations for the treatment of suppurative thrombophiebitis in 1784.’ However, ligation of the inferior vena cava (IVC) to prevent the progression and embolization of infected thrombi in patients with puerperal sepsis was first recommended by Trendelenberg in 1910. Little attention was paid to the potential need for venous interruption unti...

Inferior sinus venosus arterial septal defect (ASD) is a rare congenital cardiac anomaly. As with other types of ASDs and patent foramen ovale (PFO), this results in arteri-venous shunting the risk developing paradoxical embolism (PDE) to systemic circulation from venous emboli. We report case 67-year-old lady presented emergency department (ED) massive pulmonary (PE) recurrent acute limb ischa...

There is still considerable debate about the optimal diagnostic imaging modality for acute pulmonary embolism. If imaging is deemed necessary from an initial clinical evaluation such as d-dimer testing, options include nuclear medicine scanning, catheter pulmonary angiography, and spiral CT. In many institutions, spiral CT is becoming established as the first-line imaging test in daily clinical...

background:  pericardial effusion (pe) in down syndrome (ds) patients  usually occur s   secondary to hypothyroidism,  but  we have   no  report of massive pericardial effusion in   euthyroid   down syndrome patient with  supravalvar  pulmonary stenosis . case presentation:  we  report ed   an   11-month-old  male with down syndrome   with  massive  pericardial  effusion that  had conservative ...

Right-sided endocarditis accounts for 5–10% of all cases of infective endocarditis.1 Its epidemiology, diagnosis, and treatment differ from that of left-sided endocarditis, making it a distinct entity. This article presents a case of tricuspid valve endocarditis in an intravenous drug user, and discusses the presentation, diagnosis, and therapeutic considerations unique to right-sided endocardi...

BACKGROUND In patients with hemodynamically significant pulmonary embolism, physiological fibrinolysis fails to dissolve thrombi acutely and r-tPA (recombinant tissue-type plasminogen activator) therapy may be required, despite its bleeding risk. To examine potential mechanisms, we analyzed the expression of key fibrinolytic molecules in experimental pulmonary emboli, assessed the contribution ...

To determine the accuracy and limitations of Xe-133 ventilation and Tc-99m perfusion lung images (V-P images) in detecting pulmonary emboli (PE), these studies were performed in 23 dogs after experimental production of PE by a modified Wessler technique. Fourteen of the animals also underwent selective pulmonary angiography. Xenon-133 abnormalities were seen immediately after embolization in tw...

BACKGROUND The differential diagnosis of acute chest pain is challenging, especially in patients with normal ECG findings, and may include coronary thrombosis or pulmonary emboli. The aim of this study was to investigate the novel fibrin-specific contrast agent EP-2104R for molecular targeted MR imaging of coronary thrombosis and pulmonary emboli. METHODS AND RESULTS Fresh clots were engineer...

Pulmonary hemodynamics were studied in 11 patients with hepatic cirrhosis who had undergone surgical portal decompression several years earlier. Four of the patients had both clinical and physiological evidence of pulmonary hypertension; two others had mild, subelinical pulmonary hypertension. Autopsy examination of two patients who had clinical evidence of pulmonary hypertension revealed thick...

We report a case of a 40-year-old female with cirrhosis, hepatocellular carcinoma, and upper gastrointestinal bleeding who developed multiple pulmonary emboli after endoscopic injection sclerotherapy for gastric variceal bleeding. The patient did not have any respiratory symptoms after the sclerotherapy. A chest radiograph obtained one day after the procedure for the evaluation of fever showed ...