ABSTRACT
Chronic thromboembolic pulmonary hypertension (CTEPH) is a unique form of pulmonary hypertension resulting from obstruction of the pulmonary artery by fibrotic thromboembolic material, usually initiated by recurrent or incomplete resolution of pulmonary embolism. This distinct form of pulmonary hypertension is classified under Group 4 of the World Health Organization classification. Further investigations are usually initiated, with transthoracic echocardiography followed by right heart catheterisation and pulmonary angiography as the gold standard. Definitive treatment is usually in the form of surgical pulmonary endarterectomy. Inoperable CTEPH is medically treated with pharmacological agents such as phosphodiesterase Type 5 inhibitors, endothelin receptor antagonists, soluble guanylate cyclase stimulators and prostacyclin. Recent developments have made balloon pulmonary angioplasty a viable option as well.
ABSTRACT
ABSTRACT Objective: The use of advanced techniques of computed tomography (CT) has resulted in increased incidentally detected pulmonary embolism in oncology patients undergoing routine cancer staging CT scans. The aim of this study was to compare the symptomatic and incidental pulmonary emboli cases in oncologic patients. Methods: The medical data of the patients diagnosed with pulmonary embolism (ICD: I.26) and had an underlying malignancy were evaluated retrospectively from their hospital records between the years of 2009 and 2013. The results of their right ventricle dilatations were evaluated from the thorax CT. Results: There were 38 women (44.2%) and 48 men (55.8%), totalling 86 patients. Their mean age was 61.7 ± 11.9 years and the median duration of their follow-up was 6 months. Their most common underlying malignancies were gastrointestinal (29.4%), lung (22.4%), genitourinary (21.2%) and breast cancers (10.6%). Their pulmonary thromboembolism was diagnosed incidentally on routine control thorax CT in 39 of the cases (45.3%). When the incidental cases were compared with the symptomatic ones, no statistically significant difference was found with respect to the type of malignancy, history of chemotherapy, the presence of metastasis and evidence of septum flattening on the thorax CT. The presence of bilateral thrombus was found to be increased in the symptomatic cases compared with the incidental ones and the difference was statistically significant (p = 0.026). It was found that the right ventricle/left ventricle ratio was significantly higher in symptomatic cases (p = 0.03) than in the incidental ones. Conclusion: A considerable number of pulmonary thromboemboli episodes could be asymptomatic in malignant patients. It is suggested that the submassive clinical course and preserved right ventricle functions could be the reason for the asymptomatic events.
ABSTRACT
Introduction@#Although we have known for almost last few years that Atrial fibrillation has been increasing by patients in Mongolia. Atrial fibrillation, the most common sustained chronic arrhythmia, with atrial rates of 200-500 beats per minute in patients. Most patients atrial fibrillation have structural heart disease such us mitral stenosis or regurgitation, acute myocardial infarction, Wolff-Parkinson-White syndrome, thyrotoxicosis, recent cardiothoracic surgery, cardiomyopathy, myocarditis or pulmonary disease. Atrial Fibrillation increases the risk of stroke, thromboemboli and mortality of adults with structural heart disease [4]. The symptoms most frequently reported by patients with atrial fibrillation is a rapid, irregullar heartbeat, chest pain, shortness of breath, lightheadedness and dizziness.@*Goal@#For that reason we decided to research patients with atrial fibrillation who are treated by the inpatient cardiology department of General hospital of defense and Law Enforcement between 2010-2014 years.@*Conclusion@#</br> 1. The hospitalized patients are observed only 6 cases of atrial fibrillation in 2010 years, even though the prevalence of atrial fibrillation has been increasing 75 cases in 2014 years, as a result it developed 30% during 4 years in hospitalized patients </br> 2. CHA2DS2-VАSc score was high risk of stroke /62.5% of them /most patients with both paroxysmal and chronic atrial fibrillation should be anticoagulated to reduce the occurrence of thromboemboli </br> 3. HAS-BLЕD score has became highest rick of bleeding /32.7% of all patients. For the reason we should be select correctly drugs for patients an anticoagulation treatment and they are controled INR every month