Typical errors pulmonary artery verification on the example of a clinical case

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Abstract


The difficulties of verification of pulmonary embolism (PE) are well known and have not been overcome to date, despite significant progress in approaches to managing patients with this pathology over the past 10–15 years. Due to the nonspecific clinical picture, cases of a long and difficult journey to this diagnosis are not exclusive. In large studies have shown that the most frequent symptom of pulmonary embolism – shortness of breath. However, it is not always associated with doctors of different specialties with the need to exclude this diagnosis, purposefully collect anamnesis, identify risk factors. Modern low-dose oral contraceptives are considered quite prosperous in terms of the development of thrombotic complications and cause a slight (10–20%) increase in fibrinogen concentration, factors VII, VIII and X, as well as a decrease in the content of active protein S by 10–20%. But in the case of the presence of diseases and conditions that increase the risk of venous embolism, this effect may be sufficient for the realization of life-threatening pulmonary embolism. In this regard, it is important to provide a combined effect on the prognosis of the pathology of the patients and the chosen method of contraception.


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About the authors

O. Ya. Vasiltseva

Tomsk National Research Medical Center

Author for correspondence.
Email: vasiltseva@cardio-tomsk.ru
ORCID iD: 0000-0002-2932-3159

Russian Federation, Tomsk

д.м.н., с.н.с. отд-ния атеросклероза и хронической ИБС, НИИ кардиологии

I. N. Vorozhtsova

Tomsk National Research Medical Center; Siberian State Medical University

Email: vasiltseva@cardio-tomsk.ru
ORCID iD: 0000-0002-1610-0896

Russian Federation, Tomsk

проф., в.н.с. отд-ния функциональной и лабораторной диагностики НИИ кардиологии; зав. каф. эндокринологии и диабетологии 

I. L. Bukhovets

Tomsk National Research Medical Center

Email: vasiltseva@cardio-tomsk.ru
ORCID iD: 0000-0001-9466-6097

Russian Federation, Tomsk

д.м.н., с.н.с. отд-ния рентгеновских и томографических методов диагностики НИИ кардиологии

V. M. Gulyaev

Tomsk National Research Medical Center

Email: vasiltseva@cardio-tomsk.ru
ORCID iD: 0000-0001-6191-1914

Russian Federation, Tomsk

врач отд-ния рентгеновских и томографических методов диагностики НИИ кардиологии

K. N. Vitt

Tomsk National Research Medical Center

Email: vasiltseva@cardio-tomsk.ru
ORCID iD: 0000-0002-2629-6466

Russian Federation, Tomsk

учебный ординатор НИИ кардиологии

R. S. Karpov

Tomsk National Research Medical Center; Siberian State Medical University

Email: vasiltseva@cardio-tomsk.ru
ORCID iD: 0000-0002-7011-4316

Russian Federation, Tomsk

акад. РАН, д.м.н, проф., науч. рук. НИИ кардиологии; проф. каф. факультетской терапии 

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Supplementary files

Supplementary Files Action
1.
Fig. 1 a. Thrombi in the upper lobar branch of the left aircraft.

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2.
Fig. 1 b The upper lobar branch of the left aircraft is passable.

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3.
Fig. 2 a. Thrombi in the right LA and lower lobar branch of the left LA.

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4.
Fig. 2, b. The right aircraft and the lower lobar branch of the left aircraft are passable.

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5.
Fig. 3 a. Thrombi in the lower lobe branch of the left LA and the lower lobe branch of the right LA.

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6.
Fig. 3, b. Thrombosis of the lower lobar branch of the right LA is preserved.

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7.
Fig. 4 a. Thrombi in the left LA and its branches.

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8.
Fig. 4, b. Thrombosis of the left LA (descending branch) was not detected, thrombosis of the lower lobar branch of the left LA remains.

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9.
Fig. 5. Echocardiography, apical four-chamber position. Note. RV is the right ventricle, LV is the left ventricle, Ao is the aorta, RA is the right atrium, LA is the left atrium.

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10.
Fig. 6. Echocardiography, right departments, tricuspid regurgitation of 0-1 degree.

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11.
Fig. 7. Echocardiography, a constant wave study of tricuspid regurgitation from the apical four-chamber position, measurement of systolic pressure in the right ventricle.

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