Right heart thrombus(RHTh) with concurrent acute pulmonary embolism(PE) is rare and can seriously destabilize hemodynamics, leading to an emergency situation with high mortality. Diagnosis and treatment of RHTh with a...Right heart thrombus(RHTh) with concurrent acute pulmonary embolism(PE) is rare and can seriously destabilize hemodynamics, leading to an emergency situation with high mortality. Diagnosis and treatment of RHTh with acute PE are not yet standardized. There are few reports of acute PE concurrent with RHTh and even less is known about patients with a right heart mural thrombus. For physicians, the diagnostic choice and treatment of these patients are particularly difficult due to the lack of knowledge. Here, we report a rare case of partial mural RHTh(type C RHTh) with acute PE. The mural mass in the right heart was initially diagnosed as atrial myxoma according to transthoracic echocardiography(TTE), and both pulmonary embolus and the mural mass were completely absorbed after administering Rivaroxiban. This case suggests that TTE alone is insufficient to identify and diagnoses a right heart mural mass such as this. However, novel oral anticoagulants may be effective at alleviating PE with type C RHTh.展开更多
Asthma is characterized by chronic airway inflammation and airway hyper-responsiveness.However,the differences in pathophysiology and phenotypic symptomology make a diagnosis of"asthma"too broad hindering in...Asthma is characterized by chronic airway inflammation and airway hyper-responsiveness.However,the differences in pathophysiology and phenotypic symptomology make a diagnosis of"asthma"too broad hindering individualized treatment.Four asthmatic inflammatory phenotypes have been identified based on inflammatory cell profiles in sputum:eosinophilic,neutrophilic,paucigranulocytic,and mixed-granulocytic.Paucigranulocytic asthma may be one of the most common phenotypes in stable asthmatic patients,yet it remains much less studied than the other inflammatory phenotypes.Understanding of paucigranulocytic asthma in terms of phenotypic discrimination,distribution,stability,surrogate biomarkers,underlying pathophysiology,clinical characteristics,and current therapies is fragmented,which impedes clinical management of patients.This review brings together existing knowledge and ongoing research about asthma phenotypes,with a focus on paucigranulocytic asthma,in order to present a comprehensive picture that may clarify specific inflammatory phenotypes and thus improve clinical diagnoses and disease management.展开更多
基金supported by the Sichuan Science and Technology Project(Grant No.2022YFS0105)。
文摘Right heart thrombus(RHTh) with concurrent acute pulmonary embolism(PE) is rare and can seriously destabilize hemodynamics, leading to an emergency situation with high mortality. Diagnosis and treatment of RHTh with acute PE are not yet standardized. There are few reports of acute PE concurrent with RHTh and even less is known about patients with a right heart mural thrombus. For physicians, the diagnostic choice and treatment of these patients are particularly difficult due to the lack of knowledge. Here, we report a rare case of partial mural RHTh(type C RHTh) with acute PE. The mural mass in the right heart was initially diagnosed as atrial myxoma according to transthoracic echocardiography(TTE), and both pulmonary embolus and the mural mass were completely absorbed after administering Rivaroxiban. This case suggests that TTE alone is insufficient to identify and diagnoses a right heart mural mass such as this. However, novel oral anticoagulants may be effective at alleviating PE with type C RHTh.
基金Sichuan Science and Technology Project(No.2022YFS0105)
文摘Asthma is characterized by chronic airway inflammation and airway hyper-responsiveness.However,the differences in pathophysiology and phenotypic symptomology make a diagnosis of"asthma"too broad hindering individualized treatment.Four asthmatic inflammatory phenotypes have been identified based on inflammatory cell profiles in sputum:eosinophilic,neutrophilic,paucigranulocytic,and mixed-granulocytic.Paucigranulocytic asthma may be one of the most common phenotypes in stable asthmatic patients,yet it remains much less studied than the other inflammatory phenotypes.Understanding of paucigranulocytic asthma in terms of phenotypic discrimination,distribution,stability,surrogate biomarkers,underlying pathophysiology,clinical characteristics,and current therapies is fragmented,which impedes clinical management of patients.This review brings together existing knowledge and ongoing research about asthma phenotypes,with a focus on paucigranulocytic asthma,in order to present a comprehensive picture that may clarify specific inflammatory phenotypes and thus improve clinical diagnoses and disease management.
