Focused Cardiac Ultrasound to Expedite Diagnosis of Pulmonary Hypertension in Children in the Emergency Department: A Case Series

Pulmonary hypertension (PH) is a rare but serious diagnosis in children and adolescents defined by increased pulmonary vascular resistance with pulmonary artery (PA) pressures greater than 25 mmHg [1]. Pediatric PH is pathophysiologically distinct from adult PH in that pediatric PH is typically secondary to long-term pulmonary overcirculation or chronic lung pathology. Common primary pediatric causes include congenital heart disease with intracardiac left-to-right shunting and Eisenmenger syndrome [2].
Source: The American Journal of Emergency Medicine - Category: Emergency Medicine Authors: Source Type: research

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By ANISH KOKA, MD Mr. Smith has a problem.  He can’t see.  Even this cardiologist knows why.  The not so subtle evidence lies in the cloudy lens in front of his pupils.  He is afflicted with cataracts that obstruct his vision to the point he can’t really do his job refurbishing antique furniture safely.  His other problem is that he hates doctors. He hasn’t had reason to see one for more than a decade.  He’s 68, takes no medications, smokes a pack of cigarettes a day, and is a master of one word answers. He’s in my office because he needs a medical eval...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Medical Practice Patients Physicians Anish Koka cardiology low-value testing Source Type: blogs
Conclusion: Pulmonary artery imaging artifacts in patients with preexisting heart disease during echocardiographic examination can mimic pulmonary artery dissection. Understanding the types and origins of these ultrasound artifacts is important to avoid a false-positive diagnosis. PMID: 31321237 [PubMed - indexed for MEDLINE]
Source: Biomed Res - Category: Research Authors: Tags: Biomed Res Int Source Type: research
We present the case of a 74-year-old woman with a history of hypertensive heart disease with preserved systolic function, atrial fibrillation and dyslipidemia. She had a DDDR pacemaker implanted in 2005 due to symptomatic complete atrioventricular block.The patient reported progressive fatigue, weakness, ascites with abdominal discomfort, and lower limb edema, accompanied by non-specific hepatic cholestasis on biochemical testing. Abdominal ultrasound revealed homogeneous hepatomegaly and dilatation of the inferior vena cava and upper hepatic veins, suggestive of congestive hepatopathy.Echocardiography revealed tricuspid r...
Source: Revista Portuguesa de Cardiologia - Category: Cardiology Source Type: research
This study demonstrated that the incidence of ischemic heart disease and death were three times higher among men with low birth weight compared to men with high birth weight (5). Epidemiological investigations of adults born at the time of the Dutch famine between 1944 and 1945 revealed an association between maternal starvation and a low infant birth weight with a high incidence of hypertension and coronary heart disease in these adults (23). Furthermore, Painter et al. reported the incidence of early onset coronary heart disease among persons conceived during the Dutch famine (24). In that regard, Barker's findin...
Source: Frontiers in Endocrinology - Category: Endocrinology Source Type: research
Conclusion: Applying of TE and measurement of CAP in pulmonary hypertension is possible. Both methods of investigation appear to be useful tools to demonstrate varying degrees of change in anatomical liver architecture in pulmonary hypertension. The small case series shown here suggests that the incidence and severity of cardiac induced hepatopathy is higher in patients with PH-LH compared to patients with PAH. Since maintaining liver function is important for the use of PAH-specific drug therapy, easy-to-use imaging as ultrasound scan in routine diagnostics could be considered.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Pulmonary hypertension Source Type: research
This case was written by one of ourgreat Hennepin 2nd year residents, Aaron Robinson, with lots of comments and edits by Smith.Thanks to Dr. Smith and Dr. Travis Olives for being part of this case. A 12 year old girl with a history of mild intermittent asthma presented to the emergency department with worsening shortness of breath over the past couple of days. She is up to date on her vaccinations and has no PMHx besides asthma and a noncontributory family history. She does not identify any specific triggers for her asthma. Initial screen in triage revealed normal vitals signs and a normal temperature. Upon interviewi...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
Right ventricular peak systolic longitudinal strain (RVLS)  has emerged as an approach for quantifying right ventricular function in diseases such as pulmonary hypertension and congenital heart disease. A major limitation in applying RVLS is that strain imaging and analysis are proprietary, which may result in systematic differences from vendor to vendor. The goal of this study was to test the reproducibility of right ventricular strain analysis among selected vendor-specific software (VSS) and vendor-independent software (VIS) on images obtained from different ultrasound scanners, as would be common in clinical pract...
Source: Journal of the American Society of Echocardiography - Category: Cardiology Authors: Source Type: research
Time limit: 0 Quiz-summary 0 of 20 questions completed Questions: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Information This test series requires login for attempting. You can login easily with your Facebook account (Use the CONNECT WITH icon on the upper part of right sidebar displaying t...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: General Cardiology Source Type: blogs
ConclusionThis is the first study of CPU during retrieval of high risk infants. Ultrasound in retrieval is feasible, allows accurate triage of babies to cardiac centres and may allow more accurate targeting of fluid and inotrope support.This article is protected by copyright. All rights reserved.
Source: Acta Paediatrica - Category: Pediatrics Authors: Tags: Regular Article Source Type: research
is the term coined for complete calcification of the left atrium in chronic rheumatic valvular heart disease [1]. The stimulus for calcification could be the chronic inflammatory process of rheumatic fever as well as the strain due to atrial overload. Reduced left atrial compliance leads to elevation in pressures which gets transmitted to the pulmonary venous system, pulmonary arteries and sequentially to the right heart. Chest X-ray will show the calcified outline of the left atrium [2], which can be further confirmed by computerized tomographic (CT) scan. Coconut atrium has also been called as ‘porcelain atrium&rs...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: Cardiac CT scan Cardiology X-ray Coconut atrium Coconut left atrium mold-like atrial calcification porcelain atrium Source Type: blogs
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