Introduction The treatment for chronic thromboembolic pulmonary hypertension (CTEPH) is limited to pulmonary endarterectomy (PEA), drug therapy, and percutaneous balloon pulmonary angioplasty (BPA). The gold-standard treatment is PEA, and patients with CTEPH and proximal lesions are generally good surgical candidates. Perioperative complications and persistent pulmonary hypertension due to incomplete endarterectomy or secondary vasculopathy are typical problems after the procedure. A meta-analysis has shown that the efficacy of drug therapy for severe CTEPH is limited, and many patients do not achieve […]

Abstract Background: Acute pulmonary embolism (APE) has a variable clinical outcome. Computed tomography pulmonary angiography (CTPA) is the gold standard for this diagnosis. Objective: To evaluate if the pulmonary vascular volume (PVV) quantified by automated software is a mortality predictor after APE. Methods: Retrospective cohort study where the CTPA imaging of 61 patients with APE was reanalyzed. Pulmonary vascular volume (PVV) and pulmonary volume (PV) were automatically estimated using the Yacta software. We calculated the adjusted PVV by the ratio: […]

Introduction The COVID-19 caused by new coronavirus, named by the World Health Organization as Severe Acute Respiratory Syndrome CoronaVirus 2 (SARS-CoV-2), has spread all over the world with astonishing speed. In Brazil, the spread risk (R0) of COVID-19 has been 3.0, which explains its rapid dissemination all over the states. Individuals with cardiovascular diseases, systemic arterial hypertension, diabetes mellitus, chronic obstructive pulmonary disease, and immunosuppressed patients are at higher risk for adverse outcomes. […]

Clinical aspects This is about a 59-year-old woman with double mitral lesions with pulmonary hypertension who, while awaiting surgery, had arterial hypotension, respiratory failure with hypotransparency in the right lung field. It evolved without improvement with vasoactive drugs, orotracheal intubation and antibiotic therapy, and she passed away in electrical activity without pulse. The etiology of this patient’s valve disease should be attributed to rheumatic fever, although there is no description of an acute outbreak of that disease in the patient’s […]

A 79-year-old female with no relevant past medical history was admitted in our emergency department for dyspnea on minimal exertion and chest discomfort over 2 weeks. Blood gas analysis showed severe hypoxemia and hypocapnia. Troponin was slightly positive. Despite a negative D-dimer assay, contrast-enhanced chest CT was performed to exclude pulmonary embolism. It showed a large filling defect centered in the pulmonary valve plane (Panels A and B). Bedside transthoracic echocardiogram showed a large echodense mass, apparently mobile, extending across […]