Pregnancy as a predictor of deviations from the recommended diagnostic pathway in women with suspected pulmonary embolism: ZATPOL registry data.

Introduction: Pulmonary embolism (PE) is a leading cause of mortality in pregnancy and a great diagnostic challenge. Deviations from the recommended diagnostic pathway in suspected PE contribute to greater mortality in the general population. The deviations from the guidelines of the European Society of Cardiology (ESC) for diagnosis of PE were analyzed, with particular emphasis on pregnant women with suspected PE.

Intrapericardial fibrinolysis in purulent pericarditis-case report.

Purulent pericarditis (PP) continues to result in a very serious prognosis and high mortality. The most serious complication of pericarditis is constriction. Intrapericardial administration of fibrinolytic agents, although controversial, can prevent the development of constrictions.

Pulmonary artery stenosis due to embryonal carcinoma with primary mediastinal location.

A 29-year old man was admitted to the intensive care unit after losing consciousness. On physical examination, a loud systolic murmur over the heart was found. Echocardiography revealed narrowing of pulmonary artery with high pressure gradient.

Outcome of Medically Versus Surgically Treated Patients With Chronic Thromboembolic Pulmonary Hypertension.

Chronic thromboembolic pulmonary hypertension (CTEPH) is an ominous disease leading to progressive right heart failure. Selected patients can be treated by pulmonary endarterectomy (PEA). We assessed long-term clinical outcome of patients with CTEPH who underwent PEA and patients who remained on medical treatment alone.

Pulmonary artery dilatation correlates with the risk of unexpected death in chronic arterial or thromboembolic pulmonary hypertension.

Background: Right ventricular failure does not explain all cases of death in patients with chronic pulmonary hypertension. Searching for alternative explanations, we evaluated the prognostic significance of main pulmonary artery (PA) dilatation in patients with pulmonary arterial hypertension (PAH) or chronic thromboembolic pulmonary hypertension (CTEPH).

Methods: A retrospective outcome analysis was made of 264 patients (aged 46 ± 17 years; women, 69%; PAH, 82%) who underwent both CT scan measurement of the PA and right-sided heart catheterization (mean PA pressure, 57.

[Normal D-dimer concentration in hospitalized patients with lung diseases].

Introduction: The use of D-dimer testing is an established part of the diagnosis of suspected pulmonary embolism (PE). However, in hospitalized patients many various factors might be responsible for increased D-dimer concentration and they could lower utility of D-dimer in exclusion of PE in such population. According to some published data, calculating the index D-dimer/fibrinogen could increase the specificity of D-dimer in the recognition of venous thromboembolism (VTE).

Characteristics and prognosis of patients with decompensated right ventricular failure during the course of pulmonary hypertension.

Background: New therapies for pulmonary arterial hypertension have prolonged survival but simultaneously increased the number of hospital admissions because of decompensated right heart failure (DRHF). The optimal approach in DRHF has not been established yet.

Aim: Analysis of clinical course of DRHF in a group of patients with pulmonary hypertension treated in a single referral centre.

[The insufficiency of low molecular weight heparin (LMWH) prophylaxis in patients with hereditary antithrombin (AT) deficiency].

A 39 year old man with normal, stable blood pressure was admitted to the Cardio-Pulmonary Intensive Care Unit due to diagnosed spiral CT pulmonary embolism (PE) and deep venous thrombosis (DVT). In 1999, a hereditary antithrombin (AT) deficiency was confirmed in the presented case. In 2006, because of a knee injury, the patient was provided with a plaster cast and primary antithrombotic prophylaxis with low molecular weight heparin (LMWH) (80 mg of enoxaparin) was administered subcutaneously once a day (patient's weight was 80 kg).

Atrial septostomy in treatment of end-stage right heart failure in patients with pulmonary hypertension.

Background: Right ventricular (RV) failure is the main cause of death in patients with pulmonary hypertension (PH). Balloon atrial septostomy (BAS) is believed to relieve symptoms of PH by increasing systemic flow and reducing RV preload.

Methods: Fourteen BAS procedures were performed in 11 patients (5 men and 6 women; mean [+/- SD] age, 33 +/- 12 years) with RV failure in the course of PH that was refractory to conventional treatment.

[Thrombocytopenia probably heparin-induced in women with tumor of the heart and pulmonary embolism].

43 years old women with tumor of the right ventricle was admitted to ICU due to pulmonary embolism and suspicion for heparin-induced thrombocytopenia. Thrombocytopenia was successfully treated with Arixtra and the patient was qualified for the cardio surgery intervention. Heparin is widely used in treatment and prophylaxis of venous thromboembolism and other diseases.

[A case of a patient with idiopathic pulmonary arterial hypertension treated with lung transplantation: a "bumpy road" to success].

We describe a case of 29 year old man, a first Polish patient with idiopathic arterial hypertension (IPAH) listed from Poland and successfully treated with lung transplantation in Vienna. Time from diagnosis to lung transplant was merely 11 months. Rapid clinical deterioration required treatment with most of currently approved or emerging methods, including oral and parenteral prostacyclin analogues administration by inhalation and chronic subcutaneous infusion.

Effectiveness of intrapericardial administration of streptokinase in purulent pericarditis.

Background And Purpose: Purulent pericarditis is very rare. However, among patients suffering from this disease the mortality rate is very high. The aim of this study was to evaluate the effectiveness and side effects of intrapericardial streptokinase administration in patients with confirmed purulent pericarditis.

[Effect of long-term therapy with oral Beraprost on survival of patients with arterial and inoperable thromboembolic pulmonary hypertension].

Beraprost sodium (BPS)--an orally active prostacyclin analogue--improves haemodynamic parameters and quality of life in group of patients with pulmonary arterial hypertension. Effect of long-term therapy with BPS is not well defined. This study assesses influence of long-term therapy with BPS on the survival of patients with precapillary pulmonary hypertension.

[Inhaled nitric oxide (NO) for vasoreactivity testing in pulmonary hypertension].

Unlabelled: Thirty patients (24F, 6M, aged 40.5 +/- 15.4 years) with chronic precapillary pulmonary hypertension (primary pulmonary hypertension--PPH)--20 pts, associated with connective tissue disease--6 pts, due to thromboembolism--2 pts and Eisenmenger syndrome--2 pts) were submitted to 5 min inhalation of 10 and 20 ppm of nitric oxide (NO) during right heart catheterization.

[Value of spiral computed tomography in pulmonary hypertension].

Unlabelled: Pulmonary hypertension (PH) represents an important diagnostic problem, because of its non-specific clinical presentation.

Aims Of The Study: Estimation of sensitivity and specificity of spiral computed tomography (SCT) in diagnosis of PH. Estimation of the influence of the cause and character of PH on morphology of pulmonary arteries and right ventricle-pulmonary artery coupling.

Evaluation of intrapericardial cisplatin administration in cases with recurrent malignant pericardial effusion and cardiac tamponade.

Goals: To evaluate the effectiveness and side effects of intrapericardial administration of cisplatin in prevention of recurrent malignant pericardial effusion.

Patients And Methods: Forty-six patients (33 men, 13 women; mean age 55.6+/-10.

Atrial septostomy for severe primary pulmonary hypertension - report on two cases.

Atrial septostomy (AS) emerges as a potential therapeutic option in severe primary pulmonary hypertension (PH). AS isa transluminal intervention consisting of perforation of interatrial septum and balloon dilatation. During the procedure an atrial septal defect is created to a diameter permitting right-to-left shunt with the aim of correcting abnormal preload of both ventricles, leading to hemodynamic and functional consequences.

Detectable serum cardiac troponin T as a marker of poor prognosis among patients with chronic precapillary pulmonary hypertension.

Background: Right ventricular failure is a leading cause of death in patients with chronic pulmonary hypertension (PH). We checked whether detection of cardiac troponin T (cTnT), a specific marker of myocyte injury, could be useful in prognostic stratification of those patients.

Methods And Results: Initial evaluation of 56 clinically stable patients (age 41+/-15 years) with pulmonary arterial (51 patients) or inoperable chronic thromboembolic (5 patients) PH (mean pulmonary arterial pressure 60+/-18 mm Hg) included cTnT test, allowing detection of its serum levels > or =0.

[Mechanical ventilation with lower, as compared with traditional tidal volumes, for acute respiratory distress syndrome due to aspiration pneumonia].

54-years old patient with ARDS syndrome due to aspiration pneumonia is described. Mechanical ventilation with lower as compared with traditional tidal volumes in the treatment was successfully performed.

[Differential diagnosis of pneumonia and pulmonary embolism].

34-years old patient with suspected massive pulmonary embolism (PE) is described. D-dimer test, venous ultrasonography and spiral-CT were used to rule out suspected PE. Bilateral pneumonia was diagnosed.

Disturbed right ventricular ejection pattern as a new Doppler echocardiographic sign of acute pulmonary embolism.

Transthoracic echocardiography (TTE) is frequently performed in patients with suspected acute pulmonary embolism (APE) to search for right ventricular (RV) pressure overload. We prospectively assessed the diagnostic value of a new Doppler echocardiographic sign of APE based on the disturbed RV ejection pattern ("60/60 sign") and compared its diagnostic performances with that of the presence of RV pressure overload, as well as with "McConnell sign" based on RV regional wall motion abnormalities. We assessed 100 consecutive patients with clinical suspicion of APE, including those with previous cardiorespiratory diseases.