15: CTEPH? But the Lung Scan Is Normal!
Figure 15.1 CT angiogram imaging the proximal pulmonary vessels (a), progressing down to the lower lobe arteries (b–d). Lining thrombus is noted throughout the proximal vessels, which does not extend…
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6: Distal Vessel Thromboendarterectomy— How Far Can We Go?
Figure 6.1 Preoperative chest radiograph showing a prominent right atrial shadow, with central PA enlargement Ventilation perfusion scan showed perfusion defects to the apical posterior segments of the left upper…
7: It’s Not CTEPH, but It Is Chronic Thromboembolic Disease (CTED)
Figure 7.1 Chest radiograph at time of evaluation for thromboendarterectomy Lung scintigraphy (Fig. 7.2) demonstrated large right upper lobe and lingular perfusion defects, with a smaller unmatched defect in the…
Diuretic Resistance in a Patient with Acute Heart Failure
Na = sodium; eGFR = estimated glomerular filtration rate, BSA = body surface area, Cr Serum = serum creatinine; Cr Urine = urine creatinine; h = hours; Na Urine = urinary sodium concentration Predicted sodium output using this equation has a strong correlation with…
Congestion: When to Use Ultrafiltration?
Fig. 18.1 Pathophysiology of congestion. Abbreviations: RV right ventricular, RA right atrial, PA pulmonary artery, PCWP pulmonary capillary wedge pressure, LA left atrial, LV left ventricular, LVDP left ventricular diastolic…
Patient with Abdominal Congestion
Fig. 13.1 Transvesical method for measuring intra-abdominal pressure. (Adapted from Mullens with permission) Pathophysiology of Abdominal Congestion Leading to Kidney Dysfunction Abdominal Venous Congestion WRF often complicates the trajectory of…
on Diuretic Therapy from Clinical and Pharmacologic Perspectives
Loop diuretics Hypersensitivity reactions Extracellular fluid volume depletion Hypokalemic alkalosis Hypomagnesemia∗ Ototoxicity Distal convoluted tubule diuretics Hypersensitivity reactions Hyponatremia Hypokalemic alkalosis hyperglycemia/diabetes hyperuricemia/gout Hypomagnesemia Hypokalemia and prerenal azotemia, when combined…
with Severe Right Heart Failure and Preserved Left Ventricular Ejection Function
Fig. 17.1 Definition and incidence of renal and right ventricular complications in heart failure with preserved ejection fraction (HFpEF). Blue: chronic features; purple: acute features. CKD, chronic kidney disease defined…
Syndrome in a Patient with Mechanical Circulatory Support
Study MCS type N= Pre-implantation renal function Follow up Post-implantation renal function Conclusion Sandner SE, et al. Ann Thorac Surg. 2009;87(4):1072–8. CF 86 Group with eGFR > 60 mL/min/1.73 m 2 BUN: 21 ± 7 mg/dL…
Output Heart Failure: The Cold and Wet Patient
Fig. 15.1 Schematic for assessment of clinical profiles. Congestion was assessed by the presence of orthopnea, jugular venous distention, rales, hepatojugular reflux, ascites, peripheral edema, leftward radiation of the pulmonic…
