Antiphospholipid thrombosis syndrome with massive pulmonary embolism

The antiphospholipid thrombosis syndrome is a thrombotic disorder, which can occur in a primary form or more classically in systemic lupus erythromatosus. We describe for the first time in Jordan a young patient with a complete thrombosis of the right pulmonary artery, a raised serum IgG anticardiolipin antibody and a positive lupus anticoagulant. An invasive approach of management will be discussed. The importance of screening for the APL antibodies in patients with thrombotic episode is discussed

Endobroncheal hydatid cyst: Analysis of cases diagnosed at King Hussein Medical center over five years

Hydatid disease is a relatively common disease in the Middle East with variable prevalence rates among different countries. Lung involvement is a common site and patients may present with different clinical pictures. Serological tests may help to confirm the diagnosis but a negative serology does not necessarily exclude the diagnosis of cystic hydatid disease. Endobroncheal hydatid cyst [a hydatid membrane which can be seen endobroncheally via a fiberoptic bronchoscope] is a relatively rare clinical finding in pulmonary hydatid disease. We describe four cases of this clinical entity that were diagnosed at the bronchoscopy unit at King Hussein Medical Center over a five years period

Foreign body aspiration: utilizing flexible fiberoptic bronchoscopy

To define the clinical spectrum of tracheobronchial foreign body aspiration in adults, evaluate the efficacy of bronchoscopy, and determine outcome and complications at King Hussein Medical Center. Retrospective analysis of 33 consecutive clinical series from a referral-based medical center [King Hussein Medical Center] was conducted. Case records of 33 adult patients [over 14 years of age] suspected to have foreign body aspiration over the past eight years were analyzed. All had bronchoscopic evaluation. Clinical-radiological features, types and location of foreign body were studied. About 98% of patients had their foreign bodies identified and removed using Flexible Fiberoptic Bronchoscopy while rigid bronchoscopy was needed in only three [9%] cases. Of 33 consecutive patients, 25 patients [76%] were females and the majority was below 30 years of age. A total of 30 patients [91%] presented within the first 24 hours after foreign body inhalation. A radio-opaque foreign body was evident in chest X-rays of 85% of the patients. Pins used to fix head scarves constituted 64% of the foreign bodies removed. The rest included a piece of bone, food particles and seeds. A total of 29 patients [88%] were discharged on the same day of the procedure. Ttracheobronchial foreign body aspiration in adults can occur in various settings. High clinical suspicion is necessary for diagnosis. Removal of foreign bodies can usually be accomplished with fiberoptic bronchoscopy. In our series the most commonly removed foreign bodies were metallic pins

Mitral valve prolapse, symptoms, frequency of complications and echo review of 110 cases at Queen Alia heart institute

Objective: In order to evaluate the clinical sythptoms, ECG, 2D-echo findings and related complications of mitral valve prolapse. This is a retrospective study involving 110 patients with mitral valve prolapse seen at Queen Alia Heart Institute in the years between 1996-1999. Mean age was 42 years, there were 60 females [54.5%] and 50 males[45.5%]. 65 patients [59%] were clinically asymptomic and referred because of accidental abnormal auscultatory findings. Palpitation and atypical chest pain were initial symptoms in 23 patients [21%] and 10 patients [9%] respectively. Rare presentation as dyspnea, fatigue [5.6%], neuropsychiatric[2.7%] and transient cerebral ischaemic attacks in [2.7%]. ECO findings were either normal [80%] or abnormal atypical findings [20%]. 2D-echo revealed isolated anterior mitral valve leaflet involvement in 55 patients [50%], posterior mitral valve leaflet in 23 patients [21%] and the others involved both leaflets. Complications included significant mitral regurgitation in 15 patients [l3%], rare development of supraventricular tachycardia in 4 patients [3.6%], infective endocarditis in another 4 patients, all of them had significant regurgitation. Mitral valve prolapse is a common cause of palpitation and atypical chest pain specially in younger age group and mostly discovered accidentally. Individuals with uncomplicated mitral valve prolapse don't have risk of complications