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Query: UMLS:C0019079 (hemoptysis)
 6,129 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 49 year old woman with syphilis of recent onset was repeatedly admitted to the hospital on account of recurrent dyspnoea and hemoptysis. The symptoms and radiological signs indicated the presence of a "cardiac lung". The ECG disclosed right ventricular overload which was confirmed by echocardiography. The left heart was normal, not only on echocardiography but also on cardiac catheterization, which documented severe pulmonary hypertension, partly precapillary, partly postcapillary. The presence of chronic lung congestion in the absence of pathological findings pertaining to the left heart lead to the diagnosis of pulmonary venous occlusive disease. However, pulmonary angiography showed notable and widespread arterial amputations which are not present in this syndrome. Autopsy provided the correct diagnosis: sclerosing mediastinitis localized at the hilum with prevalent involvement of both arterial and venous pulmonary vessels.
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PMID:[An unusual cause of arterial and venous pulmonary hypertension]. 400 73

Invasive pulmonary haemangiomatosis is a recently described disease in which exceedingly thin-walled vessels of capillary or venous dimensions infiltrate the lung parenchyma and pulmonary blood vessels. The angiomatous vessels, of obscure origin, infiltrate the media and intima of muscular pulmonary arteries, pulmonary veins and venules. The occlusion of the veins and venules by the thin-walled vessels, and the reactive intimal fibrosis they provoke, leads to pulmonary capillary dilatation, collections of intra-alveolar siderophages, fibrosis of alveolar walls and osseous nodules. This secondary pulmonary veno-occlusive disease in turn leads to hypertensive pulmonary vascular disease. Hence invasive pulmonary haemangiomatosis represents a fourth cause of 'unexplained pulmonary hypertension', the other three being unexplained plexogenic pulmonary arteriopathy, recurrent pulmonary thromboembolism, and pulmonary veno-occlusive disease. Two previously reported cases of invasive pulmonary haemangiomatosis presented with recurrent haemoptysis and the gradual development of chronic respiratory insufficiency associated with diffuse infiltrates in the chest radiograph. In one of these cases a haemothorax had developed. Such clinical features may be of importance in coming to the correct diagnosis.
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PMID:Invasive pulmonary haemangiomatosis. 401 59

The case history of a 38-year-old white housewife, Mrs. T, who was admitted to Touro Infirmary because of hemoptysis is presented. The patient was the mother of 9 children who began to take oral contraceptives after the eighth child. On discontinuing this form of prophylaxis, the ninth pregnancy ensued. Following the birth of the ninth baby, the patient resumed oral contraceptives (C-Quens), which she continued until a year before her admission to the hospital. The patient was always obese, and at one time she weighed 266 pounds. There was also a family history of hypertensive cardiovascular disease. The c linical impression on admission was that the patient had pulmonary embolism secondary to venous thrombosis of the left lower extremity. The clinical impression of severe pulmonary hypertension was confirmed by cardiac catheterization. Because the patient's long-term prognosis was hopeless, early hospital discharge was planned. Mrs. T. had irreversible and extensive cardiopulmonary damage. Dr. Bice was convinced that oral contraceptives played a significant part in the development of the patient's illness. He noted that oral contraceptives in most cases are apparently safe, but they should be given only to women who do not exhibit predisposing causes to thromboembolism.
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PMID:Medical Grand Rounds from Touro Infirmary. Pulmonary hypertension. 501 34

Three cases of unilateral pulmonary vein atresia are presented to illustrate part of the clinical and radiographic spectrum of this anomaly. One patient had major associated cardiovascular abnormalities and pulmonary hypertension, one had recurrent hemoptysis, and the other patient was asymptomatic with normal pulmonary artery pressure and no associated abnormalities. In one case, serial catheterizations indicated that the pulmonary vein atresia was acquired. This report stresses the radiographic, hemodynamic, and angiographic findings in patients with unilateral severe pulmonary venous obstruction. The embryology, pathology, and surgical approach are also discussed. The diagnosis should be strongly suspected before cardiac catheterization when typical features are present on the chest radiograph and isotopic ventilation perfusion scan.
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PMID:Unilateral pulmonary vein atresia: clinical and radiographic spectrum. 687 66

Six cases of pulmonary artery perforation associated with the use of Swan-Ganz catheters are reviewed. Risk factors included pulmonary hypertension, anticoagulation, and hypothermia. The mechanisms leading to perforation were clarified by the use of postmortem studies employing isolated whole lung preparations. These studies revealed that perforation results from (1) tip perforation of vasculature, (2) eccentric balloon configuration propelling the balloon through the vessel wall, and (3) balloon inflation disrupting the pulmonary artery (mean intraballoon pressure 250 mm Hg). Early clinical symptoms include hemoptysis of bright red blood and/or hypotension. Immediate evaluation may necessitate examination with a fiberoptic bronchoscope and "wedge" angiogram. If massive hemoptysis occurs, isolation of the unaffected lung by endobronchial intubation is mandatory. Pneumonectomy or lobectomy may be required. Revised guidelines for catheter insertion and pulmonary capillary wedge pressure (PCWP) measurements are presented. Finally, consideration is given to redesigning the pulmonary artery flow-guided catheter, particularly for use in patients undergoing cardiac operations with systemic anticoagulation. Modifications should be directed at (1) softer catheter tip with temperature-insensitive body, (2) low-pressure balloon, and (3) balloon pressure relief valve.
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PMID:Catheter-induced pulmonary artery perforation. Mechanisms, management, and modifications. 724 32

Twenty-four patients with subacute massive pulmonary embolism were studied both during their initial illness and up to nine years after it. The most common mode of presentation was progressive dyspnoea over a two to 12 week period, which in some, but not all, patients was accompanied by pleuritic chest pain and haemoptysis. Physical signs at diagnosis usually suggested right heart strain and ventilation/perfusion mismatch and in the five patients with the highest pulmonary artery pressures the pulmonary component of the second sound was accentuated. The chest x-ray and electrocardiogram provided useful diagnostic information in most patients though occasionally they were normal. Early response to thrombolytic treatment was poor when compared with patients with acute pulmonary embolism but was occasionally dramatically successful, and heparin alone provided satisfactory treatment in the eight patients receiving it. Pulmonary embolectomy provided poor results and four of the five patients undergoing this form of treatment died. Nine patients died during the initial illness and in seven death was directly related to embolic disease. One patient died from neoplastic disease during follow-up. Though the prolonged illness, poor initial response to treatment, and absence of predisposing factors suggest that recurrent embolic disease and late pulmonary hypertension might occur three was no evidence of this during a follow-up period of one to nine years (median five years).
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PMID:Subacute massive pulmonary embolism. 725 18

A case of haemoptysis following pulmonary artery rupture by a Swan-Ganz catheter is described. The most likely pathogenesis appears to be spontaneous migration of the catheter into a peripheral vessel due to a redundant loop in the right ventricle. This, in association with possible hyperreactivity of the vessel, caused a tight fit; on inflation of the balloon a shearing force ruptured the vessel, with subsequent haemoptysis. Severe pulmonary hypertension does not appear to be an absolute perequisite for the occurrence of this rare but potentially fatal complication. The most important preventive measures are the early removal of any redundant loop of the catheter in the right ventricle seen on the radiograph taken after insertion, and gradual inflation of the balloon.
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PMID:Pulmonary haemorrhage following Swan-Ganz catheterization in a patient without severe pulmonary hypertension. 740 46

Two adult cases of unilateral absence of the right pulmonary artery with markedly different clinical presentations are reported. One patient was a 21-year-old female without any known history of a coexisting congenital anomaly. An abnormal chest roentgenogram (small right hemithorax, deviation of the mediastinum toward the right side and a dilated left pulmonary artery) was noted and prompted further evaluation. No pulmonary hypertension was noted and the patient remained asymptomatic. The other patient was a 42-year-old male who had unilateral absence of the right pulmonary artery and a peripheral stenosis of the left pulmonary artery. The clinical course of this patient had been complicated by impaired exercise tolerance and occasional hemoptysis since adolescence. At the age of 29 years, a cardiac catheterization revealed pulmonary hypertension, but no left-to-right shunt. Progressive respiratory failure resulted in a premature death at the age of 42 years. The prognosis of patients with unilateral absence of the pulmonary artery largely depends on the coexisting cardiac anomaly (left-to-right shunt) and pulmonary hypertension. A combination of unilateral absence of the pulmonary artery and contralateral peripheral pulmonary arterial stenosis is very rare, but is an important cause of pulmonary hypertension and gives a worse prognosis for this entity.
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PMID:Two adult cases of unilateral absence of the right pulmonary artery with markedly different clinical presentations. 747 2

This report concerns a twenty-seven-year-old woman with scimitar syndrome of abnormal origin of the left circumflex artery from the pulmonary artery. Operation was performed to redirect the abnormal venous return to the left atrium and abnormal origin of the left circumflex artery to the aorta. Unfortunately, pulmonary hypertension with hemoptysis occurred nineteen months after the operation. A second angiogram showed total occlusion of the graft to the left circumflex artery and impaired left ventricle function, rather than thrombosis of the anastomosis to the scimitar vein, as the cause of pulmonary hypertension.
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PMID:Anomalous origin of left circumflex artery in a scimitar syndrome. A case report. 748 18

Progressive shortness of breath developed in an elderly woman with a 25-year history of recurrent superficial phlebitis and hemoptysis. Extensive mural thrombosis and ectasia of the large and medium-sized pulmonary arteries and aorta were revealed on echocardiography and computerized tomography. The patient died 2 months later. On autopsy, the gross morphologic findings were similar with those observed by imaging. Histologically, there was mild inflammation in the intima and media of the aorta and the large pulmonary arteries, consistent with nonspecific arteritis. The extensive thrombosis and ectasia of the pulmonary arteries and aorta differ from previously published cases and cannot be assigned to a known nosologic entity. Two alternative explanations are proposed. First, an endothelial disorder was responsible for a diffuse vasculopathy that involved veins, pulmonary arteries, and aorta. Second, a vasculopathy of the Hugh-Stovin type, characterized by phlebitis and pulmonary thromboembolism, caused pulmonary hypertension and low cardiac output. The low flow state favorized aortic thrombosis and, at the site of interaction between the clot and the arterial wall, arteritis developed as an epiphenomenon, which induced arterial dilatation. Combined idiopathic pulmonary artery and aortic thrombosis and ectasia is rare and calls for corroboration of sporadic observations such as the current one.
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PMID:Case report: extensive pulmonary and aortic thrombosis and ectasia. 760 38


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