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Query: UMLS:C0149871 (deep vein thrombosis)
 12,364 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This report reviews the present status of cardiovascular surgery in West Africa and highlights some of the constraints of development in this field.Rheumatic heart disease is still endemic in the tropics, where it constitutes about 20 percent of all cases of cardiovascular disease (CVD) in Nigeria. Endomyocardial fibrosis is a disease of unknown etiology accounting for 10 to 20 percent of cases. Purulent pericarditis is a common complication of pyomyositis and osteomyelitis found in 5 percent of patients. Chronic constrictive pericarditis is a sequela of infective pericarditis found in 5 percent of all cases of CVD. Calcification is found in 30 percent of cases and pericardiectomy can be performed successfully without cardiopulmonary bypass. Infective endocarditis is equally rare, occurring in 2.5 percent of cases; it is a common source of septic emboli to coronary artery and a very difficult disease to treat in the West African environment.Ischemic heart disease is relatively uncommon, accounting for less than 0.5 percent of patients. The rarity of the disease in black Africans has been attributed to dietary habits and environment rather than to racial and psychosocial factors. Congenital heart disease accounts for 5 percent of all cases of CVD in this review. Ventricular septal defect and patent ductus arteriosus are the most common acyanotic defects, while tetralogy of Fallot and transposition of the great arteries are the most common cyanotic defects.Vascular diseases are uncommon in this series, with traumatic injuries accounting for most of the cases. Abdominal aortic aneurysms, peripheral occlusive vascular disease, and atherosclerotic aortic aneurysms are quite rare. This review further confirms the rarity of deep venous thrombosis and pulmonary embolism in Africans.
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PMID:The status of cardiovascular surgery in West Africa. 331 74

We describe a patient who presented with acute ischemia affecting the left lower limb. Because a transthoracic echocardiogram was abnormal, a transesophageal study was arranged. This demonstrated an atrial septal aneurysm and right-to-left shunting of contrast, raising the possibility of paradoxical embolism. The diagnosis was confirmed by contrast venography, which showed extensive thrombosis in the deep veins of the left thigh, and a ventilation-perfusion scan which was consistent with multiple pulmonary emboli. Among the lessons from this case was the finding that in patients with arterial embolism the likely origin of the embolus should be considered and, in the absence of common risk factors (atrial fibrillation, rheumatic heart disease, left ventricular dilatation, widespread atheroma), occult venous thrombosis and a right-to-left shunt should be sought. In this select group of patients, transesophageal echocardiography is significantly more sensitive than transthoracic study and should be the investigation of choice. Second, in the patient described in this report the clinical signs of deep venous thrombosis (DVT) were masked by the more prominent features of acute arterial ischemia. Without the incidental echocardiographic abnormality, it is likely that the important diagnoses of DVT, pulmonary embolism, and paradoxical embolism would not have been made.
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PMID:Venous thrombosis causing arterial embolization to the same limb through a patent foramen ovale. 937 29

The indications for the use of antithrombotic therapy are evolving as new drugs become available or new indications or dosages are recommended for drugs already in use. This document reviews and updates the former one published in 1994. To that end, an exhaustive revision of the literature published in the last 15 years has been undertaken. Following the evidence based medicine dictates, and aiming to select all the relevant publications for each pathology, all studies were selected through MEDLINE, using the specified key words for each subject, and were filtered using the following steps: a) only randomized, controlled studies, meta-analysis, guidelines and review articles were chosen; b) then, the Best-Evidence and Cochrane Collaboration databases were consulted; c) finally, the evidence based medicine validation, relevance and applicability criteria were assessed for each publication. The use of antiaggregants and anticoagulants are given for the following conditions: a) prevention of deep vein thrombosis and pulmonary embolism; b) prevention of systemic emboli in patients with lone atrial fibrillation, atrial fibrillation associated or not with rheumatic heart disease, in patients with biological or mechanical cardiac valvular prostheses and in dilated cardiomyopathy; c) antithrombotic therapy in coronary heart disease and in coronary intervention; d) the interactions with oral anticoagulants and how to control these therapies are also discussed.
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PMID:[Practice guidelines of the Spanish Society of Cardiology. Recommendations for the use of antithrombotic treatment in cardiology]. 1073 66

Patient M, a 45-year old female, was admitted for extractions with local anaesthetic, sedation and monitoring. This was to be carried out on an in patient basis due to the patient's extensive medical history which included rheumatic heart disease, previous deep vein thrombosis and severe ulcerative colitis. Patient M also gave a history of allergy to penicillin and lignocaine. The procedure was completed without incident, local anaesthesia having been achieved using Citanest with Octapressin (prilocaine 30 mg/ml and felypressin 0.03 unit/ml 2 ml cartridge). However, on recovery Patient M's oxygen saturations dropped to 90% on air and although she had no symptoms, the levels could not be improved with supplemental oxygen. A diagnosis of methaemoglobinaemia (MetHb) was established, a rare complication associated with the administration of prilocaine. Patient M was transferred to the high dependency unit and was given methylthioninium chloride (methylene blue) intravenously. Her oxygen saturations quickly returned to normal and she was discharged the following day. This case highlights issues relating to the risk of developing MetHb, what is considered the maximum safe dose of prilocaine and some incongruities the authors feel exist in the literature.
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PMID:Prilocaine induced methaemoglobinaemia in a medically compromised patient. Was this an inevitable consequence of the dose administered? 1803 45

Prosthetic valve thrombosis is a dangerous and unfortunately not uncommon medical situation, often seen as a medical emergency. Patients with previously unseen and more confounding medical problems are presenting, making the decision regarding therapeutic options even more complicated. In this case report, we describe a complicated patient with mechanical mitral valve prosthesis placed secondary to rheumatic heart disease, with multiple co-morbidities including severe left ventricular dysfunction, permanent atrial fibrillation, left femoral deep vein thrombosis, and non-sustained ventricular tachycardia, who presented with acute valve thrombosis. The patient' history of hemorrhagic stroke and multiple acute ischemic strokes represented an absolute contraindication to more conventional forms of therapy such as intravenous systemic thrombolytics. In the following case report, we present an unprecedented approach to prosthetic valve thrombosis in this seemingly no-option patient.
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PMID:Localized left atrial administration of tPA for the treatment of mechanical mitral valve thrombosis. 1865 16

Venous thromboembolism (VTE), which consists of deep vein thrombosis (DVT) and pulmonary embolism, is a potentially fatal disease. The existing Asian literature has shown a wide variation in the prevalence of VTE, with very limited data from India. In the present study, the risk factors for VTE in Indian patients were compared with Caucasians and Blacks. We used data prospectively collected from total of 1396 Indian patients (716 males, 680 females) enrolled over a decade and compared with White (n = 2002) and Black (n = 395) patients objectively diagnosed with VTE. When compared with females, males had significantly higher episodes of pulmonary embolism and VTE (P = 0.0001). Amongst the known thrombophilia markers, only homocysteine was found to be significantly higher in males as compared with females (P = 0.006). Males had a higher proportion of rheumatic heart disease (RHD) and ischaemic heart disease (IHD) as compared with females. The prevalence of DVT amongst Indians was significantly higher as compared with Whites and Blacks. However, the rate of pulmonary embolism and VTE was lower in Indians as compared with both the races. Amongst the baseline characteristics identified as risk factors for VTE, Indians had a higher prevalence of infection as compared to both Whites and Blacks, but lower HIV infection as compared to Blacks. As compared to Whites, Indians had lower prevalence of idiopathic VTE (but similar to blacks) and had higher prevalence of idiopathic pulmonary embolism (P < 0.0001). This can be explained by different inherited and environment risk factors between these three populations.
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PMID:Cause of deep venous thrombosis and pulmonary embolism in young patients from India as compared with other ethnic groups. 2249 80

Cardiovascular diseases are a group of disorders consisting importantly of coronary heart disease, peripheral arterial disease, cerebrovascular disease, rheumatic heart disease, congenital heart disease, deep vein thrombosis and pulmonary embolism. Severe cardiovascular disease conditions lead to acute myocardial infarction and stroke. One of the reasons for this is formation of blood clots inside the vessel. Anticoagulants and antiplatelet drugs are used for managing cardiovascular diseases for a long time. However, they were unable to dissolve an existing thrombus. Fibrinolytic enzymes have become more substantial for treating cardiovascular diseases since they could lyse the fibrin clot within the blood vessel. Inability of plasma fibrinolytic system demands better thrombolytic drugs. Major thrombolytic enzymes belonging to plasminogen activators and plasmin like enzymes. Currently used fibrinolytic enzymes and their limitations are revisited in the present chapter. Reported enzymes from various sources with potential to be used as cardiovascular therapeutic is also discussed here.
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PMID:Fibrinolytic Enzymes for Thrombolytic Therapy. 3148 6