دورية أكاديمية
Recurrent pulmonary embolus despite adequate anticoagulation: the case for routine cancer screening, prompted by an uncommon cause.
| العنوان: | Recurrent pulmonary embolus despite adequate anticoagulation: the case for routine cancer screening, prompted by an uncommon cause. |
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| المؤلفون: | Bendel D; Department of Anaesthetics and Critical Care, Northampton General Hospital, Northampton, UK., Loong CY; Department of Cardiovascular Medicine, The Whittington Hospital, London, UK. |
| المصدر: | BMJ case reports [BMJ Case Rep] 2014 Sep 25; Vol. 2014. Date of Electronic Publication: 2014 Sep 25. |
| نوع المنشور: | Case Reports; Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: BMJ Pub. Group Country of Publication: England NLM ID: 101526291 Publication Model: Electronic Cited Medium: Internet ISSN: 1757-790X (Electronic) Linking ISSN: 1757790X NLM ISO Abbreviation: BMJ Case Rep Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: London : BMJ Pub. Group |
| مواضيع طبية MeSH: | Lung Neoplasms/*complications , Pulmonary Embolism/*etiology , Sarcoma/*complications , Vascular Neoplasms/*complications, Anticoagulants/therapeutic use ; Early Detection of Cancer ; Humans ; Male ; Middle Aged ; Pulmonary Embolism/prevention & control ; Recurrence ; Warfarin/therapeutic use |
| مستخلص: | A middle-aged patient presented with dyspnoea, haemoptysis and weight loss following a recent admission for pulmonary embolus, diagnosed on CT pulmonary angiogram (CTPA). The patient was anticoagulated with warfarin to a therapeutic range 2-3. There was no relevant medical history. On examination, the pulse was 105 bpm and blood pressure was 70/50 mm Hg. Oxygen saturation was 94% on air. Repeat CTPA revealed extension of the clot burden, now a saddle embolus occluding pulmonary outflow. The patient underwent emergency surgical embolectomy, and histology of the excised clot revealed the underlying cause--a malignant, high-grade sarcoma of the pulmonary vasculature. The target international normalised ratio was increased to 3-4. Postoperatively, the patient developed a large malignant pericardial effusion which required urgent percutaneous drainage. The patient eventually underwent targeted chemotherapy, which extended patient survival. The patient passed away a year later from progressive right-sided heart failure as a result of cor pulmonale. (2014 BMJ Publishing Group Ltd.) |
| References: | Thorax. 2003 Jun;58(6):470-83. (PMID: 12775856) J Thromb Haemost. 2004 Jun;2(6):884-9. (PMID: 15140122) Eur J Cardiothorac Surg. 2013 Jan;43(1):90-4; discussion 94. (PMID: 22466693) |
| المشرفين على المادة: | 0 (Anticoagulants) 5Q7ZVV76EI (Warfarin) |
| تواريخ الأحداث: | Date Created: 20140927 Date Completed: 20150604 Latest Revision: 20220317 |
| رمز التحديث: | 20240628 |
| مُعرف محوري في PubMed: | PMC4180566 |
| DOI: | 10.1136/bcr-2013-202295 |
| PMID: | 25257885 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1757-790X |
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| DOI: | 10.1136/bcr-2013-202295 |