11/280. Pulmonary thrombosis, homocysteinemia, and reperfusion edema in an adolescent.Deep vein thrombosis, pulmonary embolism, and pulmonary thrombosis in situ are rare in childhood and adolescence [1,2]. Unfortunately, these diagnoses may be unsuspected in a pediatric patient with dyspnea and chest pain. This article illustrates the diagnostic and therapeutic challenges that arose from unrecognized chronic thrombotic disease in an adolescent.- - - - - - - - - - ranking = 1keywords = chest pain, pain, chest (Clic here for more details about this article) |
12/280. Endoluminal treatment of acute aortoiliac thrombosis.A 55-year-old woman presented with an ulcerative stenosis of the distal abdominal aorta. She was scheduled to undergo percutaneous aortic balloon angioplasty the next day. Upon readmission, however, she complained of lower abdominal pain. A second abdominal angiogram revealed thrombosis of the infrarenal abdominal aorta and left common iliac artery. This was treated by means of simple transcatheter thrombus aspiration and thrombolysis, followed by stenting of the aorta.- - - - - - - - - - ranking = 0.14386188559278keywords = pain (Clic here for more details about this article) |
13/280. myocardial ischemia due to vascular systemic amyloidosis: a quantitative analysis of autopsy findings on stenosis of the intramural coronary arteries.A case is reported of a 65 year old man who suffered myocardial ischemia resulting from extensive stenosis of the intramural coronary arteries secondary to systemic vascular involvement by primary amyloidosis. In the myocardium, there were multiple fibrotic foci scattered mainly in the subendocardial region of the ventricle. Intramural coronary arteries were stenotic or occlusive due to amyloid-induced luminal narrowing, but there was no significant stenosis of the epicardial coronary arteries. Quantitative analysis of amyloid deposits in the intramural coronary arteries demonstrated that occlusive arteries were predominant in the surrounding area of myocardial fibrosis, and the extent of coronary stenosis by amyloid deposition was significantly more severe than in hearts of the five control patients who had coronary amyloidosis without myocardial fibrosis. These results indicate that myocardial fibrosis originates from coronary ischemia due to vascular amyloid deposition. This is the first time that the relationship between myocardial lesions and coronary amyloid deposition has been elucidated using histopathologic quantitative analysis.- - - - - - - - - - ranking = 0.02100921316161keywords = area (Clic here for more details about this article) |
14/280. Nonceliac diaphragm disease of the duodenum.A 58-year-old, Indo-Canadian man presented with upper abdominal pain and the clinical features of a partial, gastric outlet obstruction. Subsequent studies, including endoscopic examination, revealed diaphragm-like strictures in the descending duodenum. Other reported causes such as celiac disease and drug-induced small bowel diaphragms were excluded. Possibly, the changes seen in this patient were related to ethnic food-induced, mucosal injury to the upper gastrointestinal tract. Further studies are needed to evaluate potential toxicity or protective effects of different ethnic diets and their relationship with the development of different intestinal diseases.- - - - - - - - - - ranking = 0.14386188559278keywords = pain (Clic here for more details about this article) |
15/280. Acquired anomalous intrapulmonary venous connection secondary to pulmonary venous stenosis.An unusual case of acquired development of anomalous intrapulmonary venous connection with pulmonary venous stenosis is presented. Appearances on a chest radiograph resembled the "scimitar" sign in a patient with previous surgery for partial anomalous pulmonary venous return. Spiral CT and pulmonary arteriography showed stenosis of the right upper pulmonary vein and an anomalous intrapulmonary venous connection between the right upper pulmonary vein and the right lower pulmonary vein. We consider the slow progression of pulmonary vein stenosis led to anomalous intrapulmonary venous connection as an intrapulmonary collateral.- - - - - - - - - - ranking = 0.11224568545516keywords = chest (Clic here for more details about this article) |
16/280. Isolated dissection of the celiac artery--a case report.Isolated arterial dissection, which occurs with the absence of aortic dissection, has been reported in carotid and renal arteries but rarely in visceral arteries. A case of isolated celiac artery dissection is reported here. A healthy 58-year-old man experienced sudden upper abdominal pain, which continued for several days. A body computed tomogram (CT) showed a multiple low-density wedge-shaped area in the spleen, which was diagnosed as splenic infarction, and an aneurysm with thrombus in the celiac artery. A selective angiogram showed dilatation of the celiac artery with wall irregularity, and proximal occlusion of the hepatic artery. The distal hepatic artery was fed by collateral arteries from the superior mesenteric artery. splenic infarction was probably due to the embolism from the thrombus in the dissected celiac artery. The absence of other vascular lesions and causes or risks for the arterial dissection would suggest the occurrence of spontaneous dissection. The dissection of visceral arteries should be considered in diagnosing acute abdominal pain.- - - - - - - - - - ranking = 0.30873298434717keywords = pain, area (Clic here for more details about this article) |
17/280. Crushed stents in benign left brachiocephalic vein stenoses.Two hemodialysis patients presenting with left venous arm congestion due to benign catheter-induced stenosis of the left brachiocephalic vein were treated by angioplasty and stent placement. External compression of the stents was responsible for rapid recurrence of the symptoms. No osseous or vascular malformation could be identified. Mechanical constraints induced by respiratory chest wall motion and aortic arch flow-related pulsation are proposed to explain this observation. This potential hazard should be considered when stent placement into the left brachiocephalic vein is advocated.- - - - - - - - - - ranking = 0.11224568545516keywords = chest (Clic here for more details about this article) |
18/280. Complicated emergent endovascular repair of a life-threatening bilateral internal jugular vein occlusion.A 62-year-old woman had painful facial swelling that progressed to extensive periorbital and perioral edema with loss of vision, hearing, and consciousness. Her past surgical history was significant for right radical neck dissection including internal jugular vein (IJV) resection, laryngectomy, partial esophagectomy, tracheoesophageal fistula repair, and tracheostomy for squamous cell carcinoma of the oropharynx. In addition, the patient had received radiation therapy to the neck. A venogram revealed occlusion of the left IJV. A guidewire from the femoral vein was passed through the occluded segment; however, attempts to introduce an angioplasty balloon failed. A percutaneous basilic vein approach allowed passage of a dilator sheath over a guidewire, thereby enabling Wallstent deployment across the IJV occlusion. A second Wallstent was inserted across a stenosis in the brachiocephalic vein; however, this second stent reoccluded the IJV. Surgical removal of the second Wallstent was required through a segmental claviculectomy and venotomy. Patency was restored in the IJV and the brachiocephalic vein with the return of baseline neurologic function. This case demonstrates a complicated emergent endovascular repair of a life-threatening IJV occlusion that required surgical salvage.- - - - - - - - - - ranking = 0.14386188559278keywords = pain (Clic here for more details about this article) |
19/280. Left cervical aortic arch with aortic coarctation and saccular aneurysm.Cervical aortic arch is a very rare malformation and is occasionally accompanied by other cardiovascular anomalies. A 48-year-old male patient had a left cervical aortic arch with aortic coarctation and saccular aneurysm distal to the coarcted segment. The major clinical manifestations were upper body hypertension with a 50-mmHg discrepancy between the upper and lower limbs and a loud continuous murmur in the upper chest and back. magnetic resonance angiography successfully depicted the anomalous aorta, and the aortic coarctation and aneurysm were surgically resected and the thoracic aorta was reconstructed. The discrepancy in blood pressure diminished after the operation, but antihypertensive medication was continued to satisfactorily control the hypertension.- - - - - - - - - - ranking = 0.11224568545516keywords = chest (Clic here for more details about this article) |
20/280. Persistent pulmonary hypertension after maternal naproxen ingestion in a term newborn: a case report.Constricting effect of indomethacin on the ductus arteriosus of the fetus is well known. The fetal effects of other nonsteroid anti-inflammatory drugs (NSAIDs) like naproxen are not well reported. We report here a case of a 3,790-g term neonate who developed persistent pulmonary hypertension after birth with a closed ductus arteriosus. The mother admitted to taking naproxen sodium immediately prior to the birth of the infant. The course of illness was progressively better on conservative management. Like indomethacin, other NSAIDs can also cause premature closure of fetal ductus arteriosus, pulmonary hypertension, and life-threatening problems to the neonate. Patient education regarding over-the-counter pain medication during pregnancy should be emphasized.- - - - - - - - - - ranking = 0.14386188559278keywords = pain (Clic here for more details about this article) |
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