ABSTRACT
A 62-year-old man was admitted to the hospital due to sepsis secondary to a hemodialysis catheter-related infection that, upon diagnostic evaluation, demonstrated to be caused by P. aeruginosa and was treated with meropenem. Eradication of the infectious episode was confirmed by blood workup, including cultures. One month after the initial episode, the patient was readmitted due to a symptomatic penetrating aortic ulcer, which was classified as a cardiovascular emergency. The patient underwent an aortic stent-graft placement. Four weeks later, he presented to the emergency department with a 2-hour onset of thoracic pain and massive hematemesis. The esophagus and aortic segment with aortic stent graft were resected en bloc after an aortoesophageal fistula was diagnosed.
Subject(s)
Aortic Aneurysm, Thoracic , Aortic Diseases , Blood Vessel Prosthesis Implantation , Esophageal Fistula , Vascular Fistula , Aortic Aneurysm, Thoracic/complications , Aortic Aneurysm, Thoracic/diagnostic imaging , Aortic Aneurysm, Thoracic/surgery , Aortic Diseases/diagnostic imaging , Aortic Diseases/etiology , Aortic Diseases/surgery , Blood Vessel Prosthesis Implantation/adverse effects , Esophageal Fistula/diagnostic imaging , Esophageal Fistula/etiology , Esophageal Fistula/surgery , Humans , Male , Middle Aged , Vascular Fistula/diagnostic imaging , Vascular Fistula/etiology , Vascular Fistula/surgeryABSTRACT
Recent advances in ultrasound technology have made modern handheld ultrasound devices and are contributing to make bedside ultrasound evaluation a practice available to all physicians. A 46-year-old woman with history of systemic erythematosus presented to our hospital with 14 days of COVID-19. The patient suddenly presented greater respiratory distress, tachycardia, hypotension, and increased supplemental oxygen requirements; so she required mechanical ventilation. Point-of-care ultrasound assessment with handheld ultrasound device was observed on the apical view an apical thrombus in the right ventricle, McConnell's sign. The patient underwent systemic thrombolysis with alteplase showing improvement in mechanical ventilation parameters and is currently continuing treatment for COVID-19 in the intensive care unit of our hospital. Emerging technologies such as handheld ultrasound devices can provide high-quality care to the patients. Routine screening of patients with COVID-19 using handheld ultrasound is feasible, may be able to define prognosis and treatment of cardiovascular complications.
