Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0231807 (exertional dyspnea)
 3,402 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 33-year-old male presented with a productive cough of yellowish sputum which he had had for several years and progressive dyspnea on exertion that had been present for one year. Physical examination on admission disclosed clubbing of the fingers, diffuse inspiratory crackles and some rhonchi on auscultation. Plain chest film showed diffuse fine nodular lesions in both lungs. Pulmonary function tests demonstrated obstructive ventilatory impairment with a positive bronchodilator response. A CT scan of the chest showed diffuse fine nodular infiltrations in both lung fields. Arterial blood gas analysis of the patient, while breathing room air, revealed mild hypoxemia. The histologic findings of an open lung biopsy specimen were compatible with a diagnosis of diffuse panbronchiolitis. The patient was treated with erythromycin and a bronchodilator, and was regularly followed at the outpatient department. In this report, clinical manifestations, diagnostic criteria and recent advances in the treatment of diffuse panbronchiolitis are discussed.
 ...
PMID:Diffuse panbronchiolitis: report of a case. 136 94

A 67-year-old male was admitted with cyanosis, digital clubbing and exertional dyspnea. Laboratory data revealed severe polycythaemia with 26 mg/dl hemoglobin, red blood cell; 866 x 10(-4)/mm3, hematocrit 72.8% and PaO2 44.6 mmHg. Selective pulmonary angiography demonstrated a large arteriovenous fistula involving the right middle lobe. After venesection of 1,200 ml of blood, the middle lobectomy was performed safely. In a case of pulmonary arteriovenous fistula with such severe polycythaemia, preoperative venesection is useful to decrease perioperative complications.
 ...
PMID:[A case of pulmonary arteriovenous fistula accompanied with marked polycythaemia]. 202 Jan 55

A 12-year-old boy with Wilson's disease developed exertional dyspnea, cyanosis, and finger clubbing 10 months after diagnosis. The hypoxemia was caused by arteriovenous shunting, demonstrated by radionuclide scanning and pulmonary arteriography. Orthotopic liver transplantation was performed after the development of severe hypoxemia. There was no apparent reversal of the intrapulmonary arteriovenous shunting and he died 10 days posttransplantation of multiple organ failure secondary to hypoxemia. Monitoring arterial oxygen saturation in children with cirrhosis is warranted since the presence of significant arteriovenous shunting may influence prognosis and decisions regarding liver transplantation.
 ...
PMID:Failure of liver transplantation in Wilson's disease with pulmonary arteriovenous shunting. 230 74

This report describes characteristic features and clinical presentation of six young patients (ranging in age from five to 25 years) with various congenital forms of pulmonary arteriovenous fistulas as well as one 21-year old patient with traumatic intrapulmonary arteriovenous fistula. The former six patients were cyanotic, had clubbing of the digits and exertional dyspnea; two, additionally, had telangiectasia. All patients underwent cardiac catheterization and pulmonary angiography. None had pulmonary hypertension. Angiographically, four had diffuse arteriovenous fistulas in both lungs (Figures 1 and 3 to 5) and two had arteriovenous fistulas localized in one pulmonary segment. Four patients were additionally studied with radionuclide angiography and pulmonary perfusion scintigraphy. In three of these, substantial right-to-left shunt in the region of the lungs was detected; the diagnosis could not be established in only one of the latter with a small traumatic intrapulmonary arteriovenous shunt of less than 10%. While noninvasive methods provide adjunctive diagnostic support, pulmonary angiography is still required to assess, with certainty, the nature and localization of the lesion. In cyanotic patients with no evidence of cardiac disease, differential diagnostic consideration should be given to pulmonary arteriovenous fistulas.
 ...
PMID:Pulmonary arteriovenous fistulas. Case presentations and clinical recognition. 622 71

A 22-year-old woman is seen for progressive dyspnea on exertion experienced for the past six months. She has no dyspnea at rest, orthopnea, cough, or other symptoms. There is no history of heart murmurs, rheumatic fever, or pulmonary disease. Physical examination shows a healthy-appearing young woman with no cyanosis or clubbing. The jugular venous pulse shows a prominent A wave, with normal mean venous pressure. The lungs are clear to examination. The cardiac examination is normal except for a loud second heart sound that is narrowly split in expiration and a little more widely split in inspiration. The chest roentgenogram shows slight cardiac enlargement of nonspecific contour, with a considerably enlarged main pulmonary artery segment and moderately prominent central pulmonary artery branches. The peripheral lung fields are unremarkable. The electrocardiogram is shown.
 ...
PMID:Dyspnea, right-axis deviation, and abnormal P waves in a young woman. 641 83

A 16-year-old boy with congenital hepatic fibrosis, on whom a portocaval anastomosis was performed because of bleeding esophageal varices, developed lip cyanosis, exertional dyspnea, and clubbing of the fingers 7 years postoperatively. This progressive syndrome was caused by a right-to-left shunt due to the presence of pulmonary arteriovenous fistulas. Increased erythrocyte sedimentation rate, hypergammaglobulinemia, and histological features of cholangitis were also present. It is proposed that this unusual pulmonary complication of congenital hepatic fibrosis could be due either to congenital pulmonary abnormalities or to a chronic unrecognized cholangitis causing a progressive deterioration of liver histology and function, with subsequent opening of pulmonary arteriovenous shunts.
 ...
PMID:Pulmonary arteriovenous fistulas: an unusual complication of congenital hepatic fibrosis. 688 43

We report the experience with and evaluation of treatment strategies in fibrosing alveolitis and desquamative interstitial pneumonitis (FA/DIP) over the last 16 years by a review of all cases referred to a tertiary referral center. There were 25 cases, 16 boys and 9 girls (mean age at onset, 2.3 years; range, 7 days to 11.6 years). In each case the diagnosis was confirmed by open lung biopsy at a mean age of 3.3 years (range, 7 weeks to 15.1 years). Presently features were tachypnea (19), cyanosis (15), cough (12), exertional dyspnea (7), recurrent chest infections +/- wheezing (9), and clubbing (8). Four patients recovered without antiinflammatory medication. The others received specific treatment. Of 11 patients given only prednisolone, six improved, two did not, and three died despite treatment. Of five patients receiving only chloroquine, four responded. Five patients received both prednisolone and chloroquine; one died, two responded well. There was poor progress in the remaining two. Of the 10 patients receiving chloroquine six (60%) showed a good response. A younger presentation carried a worse prognosis, but chest radiology at presentation and outcome were not interrelated. Those with mild histological changes all survived, but severe desquamation or fibrosis at biopsy was not related to outcome. In four cases there was a family history (16%). Patients with FA/DIP probably represent a disease spectrum of multiple etiology with a variable prognosis and response to treatment.
 ...
PMID:Fibrosing alveolitis and desquamative interstitial pneumonitis. 809 Jun 6

A 55-year-old man was admitted to our hospital with chief complaints of exertional dyspnea and chest x-ray abnormalities. On physical examinations, clubbing and systolic murmur were detected. The patient's hemoglobin rose to a level of 19.0 g/dl, with a rise in hematocrit to 58.8%. While the patient was breathing room air, the PaO2 was 52.8 mmHg, the PaCO2 33.3 mmHg and the pH 7.43. In chest x-ray film, oval well-margined 38 x 30 mm density with enlarged afferent and efferent vessels in the left upper lobe (lts4) and 15 x 13 mm "coin lesion" in the right lower lobe (rts7) were observed. Pulmonary angiography demonstrated that these lesions were arteriovenous fistulas. In cardiac catheterization, an estimated right to left shunt of 31.1% was calculated. Because of the exertional dyspnea and the large shunt, a segmentectomy of the lingula and a wedge resection of the rts7 were simultaneously performed. After the treatment, exertional dyspnea, hypoxia and polycythemia disappeared. As far as we know, this patient is one of the most elderly patients in Japan to be successfully treated surgically for bilateral pulmonary arteriovenous fistulas.
 ...
PMID:[A case of successful surgical treatment for bilateral pulmonary arteriovenous fistulas]. 833 19

Pulmonary arteriovenous fistulas are a very infrequent illness. The majority of these cases are associated with hereditary haemorrhagic telangiectasia, therefore their isolated presentation is exceptional. We present a patient that was diagnosed of two arteriovenous fistulas non associated with hereditary haemorrhagic telangiectasia. His main symptom was progressive dyspnea on exertion, with cyanosis and clubbing. His evolution after surgery was satisfactory. Theirs clinical, diagnosis and therapeutic peculiarities ware discussed.
 ...
PMID:[Congenital pulmonary arteriovenous fistulas]. 937 80

Neurologic manifestations occur in 8-12% of the patients with Rendu-Osler-Weber disease or hereditary hemorrhagic telangiectasia (HHT), principally infectious and hemorrhagic and, less frequently, ischemic ones. More than a half of these neurologic complications are associated with pulmonary arterio-venous malformations (PAVM). The diagnosis of HHT is based on the presence of telangiectases, hemorrhagic events and a family history with an autosomal dominant pattern. We report a case of a patient diagnosed as having HHT with transient ischemic attacks and a PAVM, which was occluded by the use of embolotherapy. Cerebral ischemia in HHT is related to the existence of a PAVM and results from three mechanisms: 1) secondary poliglobulia and hyperviscosity because of the hypoxemia due to a right-left shunt; 2) communication between the airway and the pulmonary circulation during cough access, which produces gas embolism and hemoptysis; 3) and, finally, paradoxical embolism trough the PAVM, the same mechanism proposed to the infectious neurologic manifestations of the disease. When the diagnosis of HHT is suspected, early search and treatment of PAVM, with embolotherapy or surgery, are necessary in order to avoid respiratory problems (hemoptysis, exertional dyspnea, cianosis, clubbing) and neurologic complications.
 ...
PMID:[Cerebral ischemia in Rendu-Osler-Weber disease]. 1076 36


1 2 3 Next >>