I have a data about pleural effusion quantification:
Measure the distance between lung base and diaphragm (in milimeters) and multiplye by 20... know you have the estimated volume of the pleural effusion.
For example: />if you measure 35 mm... the pleural effusion is about 700 ml... /> Best Pablo
You are right, there is a atrial kick! (Very good look by you!!) In clinical history there is a permanent brady-arrhythmia absoluta and condition after VVI-pacemaker-implantation. I THINK that is a wrong information. I think it is a VDD-pacemaker. I could measure an E- and A-velocity so there must be a sinus-rhythm. So I think there is a paroxysmale AF and a high-grade AV-blockade.
I assume there is a postcapillary PH (PH type 2) AND a PH (type 3; lung deaseases). The patient has a COPD by condition after chronic nikotin-consumption, but no specific inhalative therapy. So I think there is a distinct chronic lung problem. But to evaluate this we have to do a PA-cath. No hyponatriaemia (Na 136 mmol/l), but that don´t speak to the contrary of hyperaldosteronism as the underlying mechanism of that distinct pleural effusion. In this case I think the patient has a profit by aldosterone or eplerenone.
By the way: I have done a tapping of pleural effusion and have given that patient loop diuretics. After 5 days in echocardiography: LVEDP about 16 mmHg and RVSP about 50 mmHg and a distinct improvement of clinical symptoms, but no increase of LV-EF.
Hello my friend. Very very good clip. Congratulations.
The leads of PM in RV are seen very nice!
Do you measure mitral inflow pattern just when atrial kick find open MV and E and A wave or just when patient was in sinus rythm?
LV function looks very depressed... PHT is postcapillary alone or patient have chronic lung problems?
The US B lines are great! and pleural effusion tell you about chronic cardiac failure and secundary hyperaldosteronism!. If this patient hyponatremic? it is probably! /> Amazing my friend, your approach is really good.
about 80 y old patient with dyspnoea. The patient was admitted to our internal ER from surgical ward. Condition after implantation of VVI-pacemaker in context of bradyarrhythmia absoluta (actually the patient is pacemaker-dependent).
In TTE we found us-b-lines and distinct pleural effusion right.
There was alos a distinct decrease of cardial function, a severe pulmonary hypertension (RVSP about 65 mmHg) and a disorder of LV-compliance (approach to LVEDP about 20 mmHg; DecT 180 msec, E7A 2,3, E-velocity about 1 m/s, E`-velocity 0,5 m/sec, E/E´about 20 mmHg, Velocity-prolongation about 0,36 m/sec). IVC 19-20 mm without undulation.
Hello Jörg.
I have a data about pleural effusion
quantification:
Measure the distance between lung base and
diaphragm (in milimeters) and multiplye by 20... know you have the
estimated volume of the pleural effusion.
For example:
/>if you measure 35 mm... the pleural effusion is about 700 ml...
/>
Best
Pablo
Hello Pablo!
You are right, there is a atrial kick! (Very
good look by you!!) In clinical history there is a permanent
brady-arrhythmia absoluta and condition after
VVI-pacemaker-implantation. I THINK that is a wrong information. I
think it is a VDD-pacemaker. I could measure an E- and A-velocity so
there must be a sinus-rhythm. So I think there is a paroxysmale AF and
a high-grade AV-blockade.
I assume there is a postcapillary
PH (PH type 2) AND a PH (type 3; lung deaseases). The patient has a
COPD by condition after chronic nikotin-consumption, but no specific
inhalative therapy. So I think there is a distinct chronic lung
problem. But to evaluate this we have to do a PA-cath.
No
hyponatriaemia (Na 136 mmol/l), but that don´t speak to the contrary
of hyperaldosteronism as the underlying mechanism of that distinct
pleural effusion. In this case I think the patient has a profit by
aldosterone or eplerenone.
By the way: I have done a
tapping of pleural effusion and have given that patient loop
diuretics. After 5 days in echocardiography: LVEDP about 16 mmHg and
RVSP about 50 mmHg and a distinct improvement of clinical symptoms,
but no increase of LV-EF.
Thanks a lot once more for
helpful comments!
Jörg.
Hello my friend. Very very good clip. Congratulations.
The
leads of PM in RV are seen very nice!
Do you measure
mitral inflow pattern just when atrial kick find open MV and E and A
wave or just when patient was in sinus rythm?
LV function
looks very depressed... PHT is postcapillary alone or patient have
chronic lung problems?
The US B lines are great! and
pleural effusion tell you about chronic cardiac failure and secundary
hyperaldosteronism!. If this patient hyponatremic? it is probably!
/>
Amazing my friend, your approach is really good.
/>Pablo