慢性血栓栓塞性肺动脉高压成人脊柱裂和脑室-心房脑脊液原位分流

IF 0.2 Q4 RESPIRATORY SYSTEM
Rajendram R, J. A
{"title":"慢性血栓栓塞性肺动脉高压成人脊柱裂和脑室-心房脑脊液原位分流","authors":"Rajendram R, J. A","doi":"10.5005/jp-journals-11010-04111","DOIUrl":null,"url":null,"abstract":"A 31 year old man with spina bifida and a ventriculo-atrial (VA) cerebrospinal fluid (CSF) shunt in situ presented with sudden onset dyspnoea and pleuritic chest pain. He reported a nine month history of increasing breathlessness. Clinical signs of right heart strain were present. Echocardiography estimated the pulmonary artery pressure to be 86 mm Hg. Computed tomography pulmonary angiogram confirmed acute pulmonary embolism (PE) and chronic pulmonary thromboembolic disease. He was anticoagulated but unfortunately had a cardiac arrest and succumbed. VA CSF shunts were used for the treatment of hydrocephalus between the 1950s and 1980s. Although most VA shunts sited for hydrocephalus in childhood have been removed, some may remain in situ in adults. These patients are at risk of PE and development of chronic thromboembolic pulmonary hypertension (CTEPH). Removal of the VA shunt should be considered when patients are shown to be shunt independent. We advise the regular screening of patients with VA CSF shunts for pulmonary hypertension with pulse oximetry, electrocardiography, chest radiography and echocardiography as it is preventable, detectable and treatable.","PeriodicalId":53846,"journal":{"name":"Indian Journal of Respiratory Care","volume":" ","pages":""},"PeriodicalIF":0.2000,"publicationDate":"2022-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Chronic thromboembolic pulmonary hypertension in an adult with spina bifida and a ventriculo-atrial cerebrospinal fluid shunt in situ\",\"authors\":\"Rajendram R, J. A\",\"doi\":\"10.5005/jp-journals-11010-04111\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"A 31 year old man with spina bifida and a ventriculo-atrial (VA) cerebrospinal fluid (CSF) shunt in situ presented with sudden onset dyspnoea and pleuritic chest pain. He reported a nine month history of increasing breathlessness. Clinical signs of right heart strain were present. Echocardiography estimated the pulmonary artery pressure to be 86 mm Hg. Computed tomography pulmonary angiogram confirmed acute pulmonary embolism (PE) and chronic pulmonary thromboembolic disease. He was anticoagulated but unfortunately had a cardiac arrest and succumbed. VA CSF shunts were used for the treatment of hydrocephalus between the 1950s and 1980s. Although most VA shunts sited for hydrocephalus in childhood have been removed, some may remain in situ in adults. These patients are at risk of PE and development of chronic thromboembolic pulmonary hypertension (CTEPH). Removal of the VA shunt should be considered when patients are shown to be shunt independent. We advise the regular screening of patients with VA CSF shunts for pulmonary hypertension with pulse oximetry, electrocardiography, chest radiography and echocardiography as it is preventable, detectable and treatable.\",\"PeriodicalId\":53846,\"journal\":{\"name\":\"Indian Journal of Respiratory Care\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":0.2000,\"publicationDate\":\"2022-12-02\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Indian Journal of Respiratory Care\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.5005/jp-journals-11010-04111\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"RESPIRATORY SYSTEM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Indian Journal of Respiratory Care","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5005/jp-journals-11010-04111","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
引用次数: 0

摘要

一例31岁男性脊柱裂并发脑室-心房(VA)脑脊液(CSF)原位分流,表现为突发性呼吸困难和胸膜炎性胸痛。他报告有九个月的呼吸困难病史。有右心劳损的临床表现。超声心动图估计肺动脉压为86毫米汞柱,计算机断层肺血管造影证实急性肺栓塞(PE)和慢性肺血栓栓塞性疾病。他是抗凝血的,但不幸的是心脏骤停,死亡了。在20世纪50年代至80年代,VA脑脊液分流术被用于脑积水的治疗。虽然大多数儿童脑积水的VA分流器已被移除,但有些可能在成人中保留原位。这些患者有PE和慢性血栓栓塞性肺动脉高压(CTEPH)发展的风险。当显示患者能够独立进行分流时,应考虑移除VA分流器。我们建议定期用脉搏血氧仪、心电图、胸片和超声心动图筛查VA CSF分流术患者的肺动脉高压,因为它是可以预防、检测和治疗的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Chronic thromboembolic pulmonary hypertension in an adult with spina bifida and a ventriculo-atrial cerebrospinal fluid shunt in situ
A 31 year old man with spina bifida and a ventriculo-atrial (VA) cerebrospinal fluid (CSF) shunt in situ presented with sudden onset dyspnoea and pleuritic chest pain. He reported a nine month history of increasing breathlessness. Clinical signs of right heart strain were present. Echocardiography estimated the pulmonary artery pressure to be 86 mm Hg. Computed tomography pulmonary angiogram confirmed acute pulmonary embolism (PE) and chronic pulmonary thromboembolic disease. He was anticoagulated but unfortunately had a cardiac arrest and succumbed. VA CSF shunts were used for the treatment of hydrocephalus between the 1950s and 1980s. Although most VA shunts sited for hydrocephalus in childhood have been removed, some may remain in situ in adults. These patients are at risk of PE and development of chronic thromboembolic pulmonary hypertension (CTEPH). Removal of the VA shunt should be considered when patients are shown to be shunt independent. We advise the regular screening of patients with VA CSF shunts for pulmonary hypertension with pulse oximetry, electrocardiography, chest radiography and echocardiography as it is preventable, detectable and treatable.
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
66.70%
发文量
1
审稿时长
16 weeks
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信