The Experts below are selected from a list of 192 Experts worldwide ranked by ideXlab platform
Phillips Perera - One of the best experts on this subject based on the ideXlab platform.
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Pulmonary Hypertension, Hemoptysis and an Echocardiographic Finding of a Ventricular Septal Defect
The western journal of emergency medicine, 2012Co-Authors: Karen Olaes, Thomas Mailhot, Phillips PereraAbstract:A 63-year-old female with pulmonary hypertension presented to the emergency department (ED) with hemoptysis. Vital signs were significant for tachypnea, with respirations of 30 per minute, and hypoxia, with an oxygen saturation of 88%. Physical examination revealed a systolic cardiac murmur. Bedside emergency ultrasound (EUS) demonstrated a right ventricle that appeared to be enlarged in relation to the left ventricle, consistent with a diagnosis of pulmonary hypertension. In addition, a ventricular septal defect (VSD) was present. Color flow doppler showed a left to right shunt through the VSD (Video). VSDs are the most common cardiac congenital defect at birth and account for 40% of all cardiac anomalies.1 The normal directionality of blood flow across a VSD is left to right, due to the relatively higher pressure in the left ventricle. Eisenmenger syndrome is defined by the presence of systemic-to-pulmonary cardiovascular circulation, progressive pulmonary hypertension and increased right ventricular pressure. This leads to reversal of normal shunt flow with formation of a right-to-left shunt and resultant hypoxemia and cyanosis. Eisenmenger syndrome in association with VSD is often referred to as Eisenmenger Complex.2 Patients with Eisenmenger Complex generally have poor outcomes due to increased strain on the heart, with shunting of oxygenated blood away from the core organs.3,4 This case details how EUS can aid the emergency physician in further evaluating the patient presenting to the ED with shortness of breath, hemoptysis and a cardiac murmur. In this case, a VSD with left-to-right shunt was diagnosed on EUS, simultaneously with right ventricular strain, underscoring the need for aggressive treatment of the patient’s pulmonary disease due to the ominous possibility for the future development of Eisenmenger Complex. Video: Parasternal long axis view of the heart. Click here to view.(7.1M, mov)
Kae-woei Liang - One of the best experts on this subject based on the ideXlab platform.
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Familial clustering of congenital deafness, patent ductus arteriosus, Eisenmenger Complex, and differential cyanosis: A case report.
Medicine, 2017Co-Authors: Ting-wei Lin, Chih-wei Tseng, Chi-yao Huang, Kuo-yang Wang, Kae-woei LiangAbstract:RATIONALE Few studies had reported syndromes that include patent ductus arteriosus (PDA) with Eisenmenger syndrome and congenital deafness clustered in male siblings without facial, skeletal, or mental abnormalities. PATIENT CONCERNS Two brothers, who were deaf and had PDA with Eisenmenger Complex, were first seen at our Cardiology clinic at the ages of 25 and 41, respectively. They presented with progressive dyspnea on exertion. Upon physical examination, both brothers had clubbing and/or cyanotic toes, normal fingers, and without facial, skeletal, ophthalmological, or mental abnormalities. DIAGNOSES AND INTERVENTIONS Echocardiography and multidetector computed tomography revealed large PDAs in both brothers. Cardiac catheterization showed bidirectional shunting via the PDA. OUTCOMES AND LESSONS Familial clustering of Eisenmenger PDA and congenital deafness is rare. Further studies are warranted to define possible genetic links.
Karen Olaes - One of the best experts on this subject based on the ideXlab platform.
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Pulmonary Hypertension, Hemoptysis and an Echocardiographic Finding of a Ventricular Septal Defect
The western journal of emergency medicine, 2012Co-Authors: Karen Olaes, Thomas Mailhot, Phillips PereraAbstract:A 63-year-old female with pulmonary hypertension presented to the emergency department (ED) with hemoptysis. Vital signs were significant for tachypnea, with respirations of 30 per minute, and hypoxia, with an oxygen saturation of 88%. Physical examination revealed a systolic cardiac murmur. Bedside emergency ultrasound (EUS) demonstrated a right ventricle that appeared to be enlarged in relation to the left ventricle, consistent with a diagnosis of pulmonary hypertension. In addition, a ventricular septal defect (VSD) was present. Color flow doppler showed a left to right shunt through the VSD (Video). VSDs are the most common cardiac congenital defect at birth and account for 40% of all cardiac anomalies.1 The normal directionality of blood flow across a VSD is left to right, due to the relatively higher pressure in the left ventricle. Eisenmenger syndrome is defined by the presence of systemic-to-pulmonary cardiovascular circulation, progressive pulmonary hypertension and increased right ventricular pressure. This leads to reversal of normal shunt flow with formation of a right-to-left shunt and resultant hypoxemia and cyanosis. Eisenmenger syndrome in association with VSD is often referred to as Eisenmenger Complex.2 Patients with Eisenmenger Complex generally have poor outcomes due to increased strain on the heart, with shunting of oxygenated blood away from the core organs.3,4 This case details how EUS can aid the emergency physician in further evaluating the patient presenting to the ED with shortness of breath, hemoptysis and a cardiac murmur. In this case, a VSD with left-to-right shunt was diagnosed on EUS, simultaneously with right ventricular strain, underscoring the need for aggressive treatment of the patient’s pulmonary disease due to the ominous possibility for the future development of Eisenmenger Complex. Video: Parasternal long axis view of the heart. Click here to view.(7.1M, mov)
Robert M R Tulloh - One of the best experts on this subject based on the ideXlab platform.
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Pulmonary hypertension in congenital heart disease.
Future cardiology, 2018Co-Authors: Emma Pascall, Robert M R TullohAbstract:Pulmonary hypertension is defined as a mean pulmonary arterial pressure ≥25 mmHg. We focus on its relevance in congenital heart disease, reviewing pathophysiology, diagnosis and management. Pulmonary hypertension is a relatively common complication of congenital heart disease, with adult prevalence between 5 and 10%. A multifactorial cause is recognized, relating to the size and nature of cardiac defect as well as environmental and genetic factors. More Complex disease is increasingly recognized rather than pure Eisenmenger Complex. Remodeling of the pulmonary vascular bed causes increased pulmonary vascular resistance diagnosed by a collection of investigations including echocardiography, exercise testing, cardiac catheterization, MRI and CT scanning. Management employs disease-modifying medications which are now used with increasing benefit.
Thomas Mailhot - One of the best experts on this subject based on the ideXlab platform.
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Pulmonary Hypertension, Hemoptysis and an Echocardiographic Finding of a Ventricular Septal Defect
The western journal of emergency medicine, 2012Co-Authors: Karen Olaes, Thomas Mailhot, Phillips PereraAbstract:A 63-year-old female with pulmonary hypertension presented to the emergency department (ED) with hemoptysis. Vital signs were significant for tachypnea, with respirations of 30 per minute, and hypoxia, with an oxygen saturation of 88%. Physical examination revealed a systolic cardiac murmur. Bedside emergency ultrasound (EUS) demonstrated a right ventricle that appeared to be enlarged in relation to the left ventricle, consistent with a diagnosis of pulmonary hypertension. In addition, a ventricular septal defect (VSD) was present. Color flow doppler showed a left to right shunt through the VSD (Video). VSDs are the most common cardiac congenital defect at birth and account for 40% of all cardiac anomalies.1 The normal directionality of blood flow across a VSD is left to right, due to the relatively higher pressure in the left ventricle. Eisenmenger syndrome is defined by the presence of systemic-to-pulmonary cardiovascular circulation, progressive pulmonary hypertension and increased right ventricular pressure. This leads to reversal of normal shunt flow with formation of a right-to-left shunt and resultant hypoxemia and cyanosis. Eisenmenger syndrome in association with VSD is often referred to as Eisenmenger Complex.2 Patients with Eisenmenger Complex generally have poor outcomes due to increased strain on the heart, with shunting of oxygenated blood away from the core organs.3,4 This case details how EUS can aid the emergency physician in further evaluating the patient presenting to the ED with shortness of breath, hemoptysis and a cardiac murmur. In this case, a VSD with left-to-right shunt was diagnosed on EUS, simultaneously with right ventricular strain, underscoring the need for aggressive treatment of the patient’s pulmonary disease due to the ominous possibility for the future development of Eisenmenger Complex. Video: Parasternal long axis view of the heart. Click here to view.(7.1M, mov)