• Title/Summary/Keyword: Pulmonary heart disease

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Indications for Lung Transplantation and Patient Selection

  • Son, Joohyung;Shin, Changwon
    • Journal of Chest Surgery
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    • v.55 no.4
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    • pp.255-264
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    • 2022
  • Globally, thousands of patients undergo lung transplantation owing to end-stage lung disease each year. As lung transplantation evolves, recommendations and indications are constantly being updated. In 2021, the International Society for Heart and Lung Transplantation published a new consensus document for selecting candidates for lung transplantation. However, it is still difficult to determine appropriate candidates for lung transplantation among patients with complex medical conditions and various diseases. Therefore, it is necessary to analyze each patient's overall situation and medical condition from various perspectives, and ongoing efforts to optimize the analysis will be necessary. The purpose of this study is to review the extant literature and discuss recent updates.

Early Diagnosis and Management of Chronic Obstructive Pulmonary Disease (만성 폐쇄성 폐질환의 조기 진단과 관리)

  • Lee, Sei-Won;Yoo, Jee-Hong;Park, Myung-Jae;Kim, Eun-Kyung;Yoon, Ho-Il;Kim, Deog-Kyeom;Lee, Chang-Hoon;Park, Yong-Bum;Park, Joo-Hun;Hwang, Yong-Il;Jung, Ki-Suck;Yoo, Kwang-Ha;Park, Hye-Yoon;Lee, Jae-Seung;Huh, Jin-Won;Oh, Yeon-Mok;Lim, Seong-Yong;Jung, Ji-Ye;Kim, Young-Sam;Kim, Hui-Jung;Rhee, Chin-Kook;Kim, Young-Kyoon;Kim, Jin-Woo;Yoon, Hyoung-Kyu;Lee, Sang-Do
    • Tuberculosis and Respiratory Diseases
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    • v.70 no.4
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    • pp.293-300
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    • 2011
  • Chronic obstructive pulmonary disease (COPD) is a substantially under-diagnosed disorder, and the diagnosis is usually delayed until the disease is advanced. However, the benefit of early diagnosis is not yet clear, and there are no guidelines in Korea for doing early diagnosis. This review highlights several issues regarding early diagnosis of COPD. On the basis of several lines of evidence, early diagnosis seems quite necessary and beneficial to patients. Early diagnosis can be approached by several methods, but it should be confirmed by quality-controlled spirometry. Compared with its potential benefit, the adverse effects of spirometry or pharmacotherapy appear relatively small. Although it is difficult to evaluate the benefit of early diagnosis by well-designed trials, several lines of evidence suggest that we should try to diagnose and manage patients with COPD at early stages of the disease.

Primary Pulmonary Carcinoma Ex-pleomorphic Adenoma of the Salivary Gland Type (일차성 폐의 침샘형 악성 다형선종)

  • Park, Sang-Jun;Cho, Sung-Woo;Lee, Hee-Sung
    • Journal of Chest Surgery
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    • v.43 no.2
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    • pp.217-220
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    • 2010
  • Pleomorphic adenoma is also called a mixed tumor and it most commonly occurs in the salivary gland. This neoplasm has a low grade malignant potential, but it may also show aggressive clinical behavior like recurrence or metastasis. We report here on a case of a tumor that was confirmed to be primary pulmonary carcinoma ex-pleomorphic adenoma by the pathologic examination after complete resection, and it had the characteristics of malignant neoplasms, such as multiple metastases.

A case report of Cardiac chest pain with dizziness and headache treated by Oriental Medicine (현훈(眩暈), 두통(頭痛)을 동반한 심장성(心臟性) 흉통(胸痛) 환자 1례의 한방치료에 의한 증례보고)

  • Koh, Young-Tak;Yoo, Yeoung-Eun;Shim, Sang-Min;Chung, Young-Hoon;Lee, Ki-Ha;Kim, Ki-Joo;Han, Eul-Joo
    • Journal of Oriental Neuropsychiatry
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    • v.18 no.3
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    • pp.309-319
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    • 2007
  • Chest pain is classified into two major categories of cardiac chest pain and non-cardiac chest pain. Cardiac chest pain is caused by cardiovascular disease, for example, myocardial infarction, angina pectoris, valvular heart disease, cardiac enlargement or hypertrophy, dissecting aortic aneurysm, pericarditis, myocarditis, etc. When the chest pain is not attributed to heart disease, it is termed non-cardiac chest pain. Non-cardiac chest pain is caused by pulmonary, gastrointestinal, musculoskeletal disease, psychiatric factor, etc. In tills case, we treated a 54-year old female patient who was diagnosed with dilated cardiomyopathy and suspicious sick sinus syndrome. She complained of chest pain, exertional dyspnea, dizziness and headache. For treatment, we made use of Yugultangami(六鬱湯加味) and Daejobwan(大造丸). Before and after treatment, we measured Heart rate variability(HRV). In result, the clinical symptoms were improved and there was a significant increase in assessmeut by Heart rate variability(HRV). Tills result suggests that Yugultaugami aud Daejowhan have a good effect on cardiac chest pain.

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Surgical Correction of Atrial Septal Defect in Adult (성인 심방중격결손증의 수술교정)

  • 이광선
    • Journal of Chest Surgery
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    • v.28 no.9
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    • pp.811-816
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    • 1995
  • Repairs of atrial septal defect utilizing cardiopulmonary bypass were performed in 50 adults, ranging age from 16 to 53 years, since April 1986 up to October 1994. They occupied 38.8% of all adult congenital heart disease operated in the same period. Preoperatively, 16 patients were functional class II, 12 patients class III and 4 patients class IV[New York Heart Association Classification , respectively. Five patients combined with atrial fibrillation and the remainders revealed regular sinus rhythm. Cardiac catheterizations were performed in 43 out of 50 patients, and revealed a systolic pulmonary arterial pressure in excess of 51 mmHg in 4 patients but none had reversed shunt. 40 patients[80% were repaired with patch closure and remainings were repaired with direct closure. 49 patients were followed up for 2 months up to 102 months[average 55 months . A comparison of the preoperative and postoperative functional class demonstrated a mean decrease of one NYHA functional level[2.5$\pm$0.63 to 1.4$\pm$0.56 . There was no operative mortality. One patient died during the follow-up period and the death was unrelated to heart disease. Operative treatment is indicated for repair of atrial septal defect with left to right shunt in the adult patient and a considerable clinical improvement can be anticipitated with low mortality.

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Annular Constrictive Pericarditis: Simulating Vavular Heart Disease : Case Report (윤상 교약성 심낭염의 외과적 치료 -2예 보고-)

  • 유회성
    • Journal of Chest Surgery
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    • v.13 no.3
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    • pp.280-284
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    • 1980
  • This is report of two cases of annular constrictive pericarditis. Since January 1959 to December 1979 the authors experienced 48 cases of chronic constrictive pericarditis treated surgically at the Department of Thoracic and Cardiovascular Surgery, the National Medical Center in Seoul. These cases simulated valvular heart disease. One case, as mitral stenosis, revealed rumbling apical diastolic murmur [II/VI], atrial fibrillation and right ventricular hypertrophy pattern on E.C.G., the other, as infundibular pulmonic stenosis, presented pressure gradient between right ventricle and main pulmonary artery at infundibular level of 76 mmHg in systole. Both patients underwent operation successfully and one of them was assisted by E.C.C. during pericardiectomy and result was excellent. It is difficult to make the diagnosis of these conditions preoperatively so consideration about these might be important to make the diagnosis accurately.

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Coronary Artery Fistula Associated with Valvular Heart Disease (심장판막증에 동반된 관상동맥루 -1례 보고-)

  • 백완기
    • Journal of Chest Surgery
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    • v.23 no.1
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    • pp.158-161
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    • 1990
  • A congenital coronary artery fistula is an uncommon anomaly which has a direct communication between a coronary artery and the lumen of any one of the four cardiac chambers, or the coronary sinus, or its tributary veins or the superior vena cava. The right coronary artery is involved most frequently, and the abnormal communication in most often is to the right ventricle followed in incidence by drainage into the right atrium and the pulmonary artery. Recently. we experienced a case of congenital coronary artery fistula associated with valvular heart disease. The fistulous communication was noted between the left circumflex artery and the left atrial appendage. Under the cardiopulmonary bypass, the internal obliteration of the left atrial appendage, mitral valve replacement, and aortic valve exploration were accomplished. Postoperative hospital course was uneventful and the patient was discharged without any problems.

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Prognosis Factors of Tricuspid Regurgitation after the Operation for Left-sided Valvular Heart Disease (좌심실 판막질환 수술 후 동반된 삼첨판패쇄부전증의 경과에 영향을 미치는 요인)

  • Jin, Ung;Kim, Hwan-Wook;Lee, Jong-Ho;Kweon, Jong-Bum;Jo, Min-Seop;Yoon, Jeong-Seob;Moon, Seok-Whan;Sim, Sung-Bo;Park, Kuhn;Kim, Chi-Kyung;Cho, Keon-Hyun;Wang, Young-Pil;Lee, Sun-He;Kwack, Moon-Sub
    • Journal of Chest Surgery
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    • v.36 no.3
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    • pp.150-156
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    • 2003
  • Tricuspid regurgitation has been considered as a secondary lesion when it is combined with left valvular heart diseases. However, there have been some reports which show that tricuspid regurgitation keeps going and results in congestive heart failure even after a successful operation for left valvular heart disease. So far, there are no definite operation indications and predictive factors for the tricuspid re-gurgitation which is resulted from the left sided valvular heart disease. We designed this study to evaluate the effects of pulmonary artery pressure and left ventricular ejection fraction on the prognosis of tricuspid regurgitation, and to make an operation indication for the patients with secondary tricuspid regurgitation. Material and Method: We reviewed the medical records of patients who underwent surgery for the left sided valvular heart disease with tricuspid regurgitation and were followed for more than 1 year with echocardiograms. There was a total of 114 cases. We compared the grades of tricuspid regurgitations and pulmonary artery pressures and left ventricular ejection fractions on the basis of echocardiograms which were checked preoperatively and on the last follow up. Result: There were 43 cases of tricuspid an-nuloplasty. In these patients, the grades of tricuspid regurgitations were improved in 42 cases (97.7%). But in 71 cases without annuloplasty, 29 cases (41%) were improved, 32 cases (45%) had no change, and 29 cases (14%) were aggravated. This finding shows significant differences in the prognoses of tricuspid regur-gitations between the two groups (p<0.05). There was no difference in pulmonary artery pressures and ejection fractions between the patients who showed progression of tricuspid regurgitations and those who didn't (p > 0.05). The improvements of tricuspid regurgitations are not statistically related to the changes of pulmonary artery pressures or left ventricular ejection fractions. Conclusion: This study shows that it is impossible to predict the prognoses of tricuspid regurgitations with preoperative pulmonary artery pressures or left ventricular ejection fractions. Also, the excellent results of tricuspid annuloplasty is proven in controlling the secondary tricuspid regurgitations. Therefore, when tricuspid regurgitation is detected preoperatively, the procedures to correct the tricuspid regurgitation at the time of the operation for the left-sided valvular heart disease must be considered positively, regardless of the grades of tricuspid regurgitations, to prevent sig-nificant tricuspid regurgitation that may develop later.

A Case of Bronchus-Associated Lymphoid Tissue(BALT) Lymphoma Treated with Lobectomy (폐엽절제를 통한 BALT 림프종 치료 1 예)

  • Choi, Won Sub;Cho, Jae Hyun;Hwang, Young Il;Jang, Seung Hun;Kim, Dong-Gyu;Jun, Sun-Young;Min, Kwangseon;Lee, In Jae;Lee, Jae Woong;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.5
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    • pp.427-431
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    • 2007
  • The bronchus-asociated lymphoid tissue(BALT) lymphoma is a low-grade primary malignant lymphoma that originates from bronchus associated lymphoid tissue. A 67-year-old woman was admitted for evaluation of cough, sputum, rhinorrhea which had persisted for one month. Physical examination showed decreased breathing sound on the left upper lung field. High resolution chest computed tomography demonstrated consolidation which showed air-bronchogram and surrounding ground glass opacity in left upper lobe. These findings implicated inactive tuberculosis, organizing pneumonia, or bronchiolo-alveolar carcinoma. The histologic findings from percutaneous needle aspiration biopsy revealed aggregated atypical small lymphoid cells with lymphoepithelial lesions. With immunohistochemical staining, the atypical lymphoid cells reacted positively with CD 20 antibody and negatively with CD 3 antibody. Thus, we could diagnosed her as a patient with BALT lymphoma. After left upper lobectomy, she has been well without recurrence of the disease for 14 months. In this country of Republic of Korea, it was the 1st case of BALT lymphoma surgically treated when histological diagnosis had been done. Based on this case, we wanted to demonstrate the importance of early histological diagnosis and treatment of BALT lymphoma.

Pulmonary artery sarcoma manifesting as a main pulmonary artery stenosis diagnosed by 18F-FDG PET/CT (18F-FDG PET/CT를 통해 진단된 주폐동맥 협착 소견의 폐동맥 육종)

  • Lee, Hoonhee;Park, Han-bit;Cho, Yun Kyung;Ahn, Jung-Min;Lee, Sang Min;Lee, Jae Seung;Kim, Dae-Hee
    • Journal of Yeungnam Medical Science
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    • v.34 no.2
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    • pp.279-284
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    • 2017
  • Pulmonary artery sarcoma (PAS) is a rare and fatal disease that often mimics chronic thromboembolic pulmonary hypertension (CTEPH); therefore, diagnosis of PAS is often delayed. Herein, a healthy 74-year-old man was presented with a 4-month history of dyspnea. Chest computed tomography showed wall thickening and stenosis in the main pulmonary artery as well as in both proximal pulmonary arteries. In order to differentiate between unusual CTEPH, vasculitis, and PAS, we performed right heart catheterization and pulmonary angiography. The mean pulmonary arterial pressure was 21 mmHg, and there was severe pulmonary artery stenosis. Thrombi on the pulmonary arterial wall lesions were observed in intravascular ultrasound and optical coherence tomography. Furthermore, the patient had a history of deep vein thrombosis. Therefore, we diagnosed unusual CTEPH. After 6 months of rivaroxaban anticoagulation therapy, a chest X-ray revealed a left lower lobe lung mass, and a positron emission tomography later showed hypermetabolic lesions in the main pulmonary artery wall, in both pulmonary arteries walls, in the lung parenchyma, and in the bones. A biopsy of the right proximal humerus lesion revealed undifferentiated intimal sarcoma. Pulmonary sarcoma is rare, but should be considered when differentially diagnosing main pulmonary artery wall thickening and stenosis. A positron emission tomography may aid in this diagnosis.