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

Atresia of the pulmonary veins of the left lung and the right upper lobe with moderate pulmonary hypertension was diagnosed in a 20 year old man presenting with exertional dyspnoea and haemoptysis. After left pneumonectomy gas exchange appeared to have improved. This was shown by improved arterial oxygen pressures during all steps of exercise in a cycle ergometer test in comparison with values obtained before surgery. This improvement could be entirely attributed to a decrease in physiological dead space ventilation.
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PMID:Improved gas exchange after pneumonectomy in an adult with incomplete pulmonary vein atresia. 806 73

Pulmonary manifestations of the antiphospholipid syndrome (APS) include pulmonary hypertension, pulmonary embolism, and in patients with the catastrophic APS, respiratory insufficiency associated with diffuse pulmonary infiltrates. There are few descriptions of pathological findings associated with these pulmonary complications. We document pulmonary capillaritis, recurrent microvascular thrombosis and alveolar hemorrhage in patients with APS. These patients have a wide spectrum of clinical presentations, ranging from recurrent episodes of fever, minimal hemoptysis, and mild dyspnea, to respiratory insufficiency requiring mechanical ventilation. Pulmonary involvement can occur alone or simultaneously with other manifestations of APS and may range from mild to severe. Pulmonary capillaritis and alveolar hemorrhage are complications of APS, and whether they are causally related to recurrent thromboembolism and pulmonary hypertension remains undetermined.
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PMID:Pulmonary capillaritis, alveolar hemorrhage, and recurrent microvascular thrombosis in primary antiphospholipid syndrome. 837 Dec 25

Thrombocytosis in post-splenectomy patients with hereditary spherocytosis (HS) is usually not attended by an increased risk of thrombosis. Review of the literature revealed HS in association with pulmonary thrombosis, portal vein thrombosis, and cerebral infarction in two brothers, TTP in an asplenic patient and a patient with corpora cavernosum thrombosis causing segmental priapism. We report a case of a 30-year-old white male with HS who presented with hemoptysis 29 years after splenectomy. Work-up revealed a hypercoagulable state with thrombocytosis and recurrent pulmonary emboli resulting in severe pulmonary hypertension, cor pulmonale, atrial flutter, and syncope.
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PMID:Hereditary spherocytosis, thrombocytosis, and chronic pulmonary emboli: a case report and review of the literature. 942 23

A 38 year old woman with paroxysmal nocturnal hemoglobinuria was admitted to our hospital because of hemoptysis. Pulmonary infarction was diagnosed by the perfusion lung scan. In spite of the administration of prednisolone, dextran, low molecular weight heparin, and warfarin, she died of pulmonary infarction and secondary pulmonary hypertension. Autopsy revealed thromboembolism of both pulmonary arteries and hepatic central vein thrombosis. Recent understanding of the pathogenesis and incidence of thromboembolism in paroxysmal nocturnal hemoglobinuria was discussed.
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PMID:[Fatal pulmonary thromboembolism in a patient with paroxysmal nocturnal hemoglobinuria]. 954 29

For this article, the literature on the pathophysiology, clinical features, natural history, prognosis, and management of the Eisenmenger syndrome in adults was reviewed. English-language articles from 1966 to the present were identified through a search of the MEDLINE database by using the terms Eisenmenger, congenital heart disease, and pulmonary hypertension. Selected cross-referenced articles were also included. Articles on the pathophysiology, clinical presentation, evaluation, natural history, complications, and treatment of the Eisenmenger syndrome in adults were selected, and descriptive and analytical data relevant to the practicing physician were manually extracted. The Eisenmenger syndrome is characterized by elevated pulmonary vascular resistance and right-to-left shunting of blood through a systemic-to-pulmonary circulation connection. Most patients with the syndrome survive for 20 to 30 years. The hemostatic changes associated with the syndrome may lead to thromboembolic events, cerebrovascular complications, or the hyperviscosity syndrome. Erythrocytosis is present in most patients, but excessive phlebotomy may cause microcytosis and exacerbate the symptoms of hyperviscosity. Other complications associated with the Eisenmenger syndrome include hemoptysis, gout, cholelithiasis, hypertrophic osteoarthropathy, and decreased renal function. Pregnancy or noncardiac surgery is associated with a high mortality rate in patients with the Eisenmenger syndrome. Because most pediatric patients with the Eisenmenger syndrome survive to adulthood, primary care physicians should have a thorough understanding of the syndrome; its associated complications; and medical and surgical management, especially with regard to the appropriate timing of phlebotomy and lung or heart-lung transplantation. In addition, patients with the syndrome should undergo routine follow-up at a tertiary care center that has physicians and nurses with special expertise in congenital heart disease. In patients with the Eisenmenger syndrome who are pregnant or require noncardiac surgery, a multidisciplinary approach should be used to reduce the excessive mortality associated with these conditions.
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PMID:The Eisenmenger syndrome in adults. 955 69

Acute rejection after lung transplantation occurs commonly and is usually characterized histologically by a perivascular mononuclear infiltrate. We report five cases of pulmonary capillaritis with a histologic appearance distinct from typical rejection, occurring in patients ranging in age from 18 to 45 years, with a variety of underlying diseases including alpha1 antitrypsin deficiency, pulmonary hypertension, cystic fibrosis, and rheumatoid arthritis. Four of the five patients had alveolar hemorrhage histologically, and two had frank hemoptysis. Time of onset ranged from 3 weeks to many months after transplantation. Three cases were fulminant, and there were two deaths. In only one case, with methicillin-resistant Staphylococcus aureus bronchitis, could infection be established. All were treated with intensification of immunosuppressive therapy. Plasmapheresis was carried out in two cases and coincided with temporary improvement, but its efficacy was questionable because of concurrent immunosuppressive therapy. Two had recurrent biopsy-proven acute rejection within 6 weeks of treatment, and one had recurrent severe pulmonary hemorrhage that abated with total lymphoid irradiation. Our experience suggests that pulmonary capillaritis in lung transplant recipients can be an acute, fatal illness with the potential for recurrence in the survivors. We speculate that it represents a form of acute vascular rejection. Early pathologic diagnosis and aggressive immunosuppressive therapy are recommended. Although a humoral component was not documented, the possible response to plasmapheresis requires continued evaluation.
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PMID:Pulmonary capillaritis: a possible histologic form of acute pulmonary allograft rejection. 958 87

Primary malignant mesenchymoma involving the heart is extremely rare. It usually has a poor prognosis. We report a case of malignant mesenchymoma originating in the left atrium with protrusion into the right pulmonary veins. Clinically, this patient presented with congestive heart failure, hemoptysis and systemic arterial embolization. Transthoracic and transesophageal echocardiography revealed a huge mass originating in the posterior wall of the left atrium with extension into both upper and lower right pulmonary veins. An elevated pulmonary arterial wedge pressure, moderate pulmonary hypertension and stenosis of the lower abdominal aorta were found during cardiac catheterization. Magnetic resonance imaging with angiography disclosed a tumor mass over the abdominal aorta above the bifurcation with protrusion into the right common iliac artery. This patient underwent surgical resection of the cardiac tumor and postoperative adjuvant chemotherapy. The pathological finding of a tumor containing several cellular types of sarcoma confirmed the diagnosis of malignant mesenchymoma.
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PMID:Primary left atrial malignant mesenchymoma: a case report. 960 71

We report two very rare cases of solitary peripheral pulmonary arterial aneurysm. Case 1: An 83-year-old man treated for myocardial infarction died of multiple organ failure and hemoptysis. Autopsy disclosed rupture of a pulmonary arterial aneurysm 1.5 cm in diameter in the right A3. Case 2: A 75-year-old man was found to have a pulmonary arterial aneurysm, 3 cm in diameter of the right A1. Surgical treatment was not indicated, because of severe pulmonary emphysema. The aneurysms in these two cases were idiopathic: (1) there were no histologic findings that would implicate specific chronic inflammation. (2) the period from the occurrence of secondary pulmonary hypertension to hemoptysis was short, and there was no (3) history of trauma.
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PMID:[Two cases of solitary peripheral pulmonary arterial aneurysm]. 969 55

We report the case of a 34-year-old white woman with a history of progressive systemic scleroderma (PSS) and diffuse alveolar hemorrhage (DAH) that may be either a rare complication of PSS or induced by D-penicillamine. The DAH progressed to hemoptysis and led to intubation for airway protection. The patient progressed to acute renal failure. Her chest x-ray revealed diffuse bilateral infiltrates. She developed pulmonary fibrosis with secondary pulmonary hypertension. She experienced a brief period of improvement of her respiratory status after steroid treatment. We also report a database of 21,442 decedents with PSS over a 15-year period from 1979 to 1994. Our report demonstrates that of over 21,000 decedents, only 0.2% had pulmonary hemorrhage or hemoptysis or both listed as a cause of death. The data also demonstrate that PSS was the underlying cause of death more frequently in younger people. Age-adjusted mortality rates were higher for blacks than for whites and for women than for men.
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PMID:A case study and national database report of progressive systemic sclerosis and associated conditions. 986 87

The flow directed balloon-tipped pulmonary artery catheter introduced by Swann and Ganz 1970 has made possible the measurement of filling pressures in the heart and is extensively used in operating rooms, in catheterization laboratories and in intensive care units. The rupture of the pulmonary artery is an uncommon complication associated with a high mortality rate exceeding 50 percent. Main symptoms are cough, hemoptysis, dyspnea and cardiac shock. Complications occur if guidelines for the safe use of the balloon-tipped catheters are not strictly followed: Excessive catheter manipulation, advancing the catheter tip too far peripherally and leaving the inflated balloon in the wedge position for long periods should be avoided. Patients with pulmonary hypertension as well as elderly and anticoagulated patients are at greater risk.
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PMID:[Rupture of the pulmonary artery - fatal complication by pulmonary artery balloon-tipped catheter]. 1066 18


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