Ginghina C. Mic tratat de cardiologie. Romania: Editura Academiei Romane; Greyson CR. The right ventricle and pulmonary circulation: basic concepts. the Romanian Journal of Cardiology and I are looking forward to your comments and suggestions! Kindest regards, Professor Carmen Ginghina Editor in chief. Eduard Apetrei. “CC Iliescu” Department of Cardiology – A short history. Cardiologie, cazuri comentate si Ilustrate, Eduard Apetrei, Carmen Ginghina.

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In other cases, alveolar haemorrhages can be present with a consolidation—like appearance or an oedema —like aspect.

When severe hypoxaemia is associated, a massive PE or a ginghian shunt is present. Additional laboratory tests can be requested in young patients with RVMI or PE in order to establish their coagulation status.

GINGHINA mic tratat de cardiologie.pdf

A paradoxical movement of the interventricular septum can be found secondary to the right ventricle overloading. As a rule, when a characteristic electrocardiogram is present, it is suggestive of PE, but a normal aspect does not exclude ginthina diagnostic.

Myocardial scintigraphy is rarely used at the onset of a myocardial infarction due to difficulties in mobilisation of the patient. Both the sensitivity and the specificity of the chest X—ray are low.

European Journal of Echocardiography. Tissue Doppler imaging is useful in determining myocardial velocities and for ventricular function evaluation. These values must be judged in the diagnosis algorithm and the cardilogie clinical probability assessment should be revised by applying valid scores such as Wells or Geneva. Because of the challenges that the differential diagnosis poses, based on clinical assessment, performing an echocardiogram is very important.


The complexity of the right ventricular structure makes the evaluation of the ejection fraction difficult. Clinical diagnosis alternative diagnosis less likely than pulmonary embolism. In patients with PE one can also encounter normal AST; raised total LDH and raised iso—enzymes 3,4,5 ; raised total bilirubin and especially indirect bilirubin — in the first 2—3 days from the onset.

Journal List J Med Life v. However, this method has a low sensitivity especially in those cases with inferior localisation of the infarction. Elevations of CK—MB following pulmonary embolism. Hipertensiunea pulmonara in practica de cardiologie. Indreptar de diagnostic si tratament in infarctul miocardic acut.

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Diagnosing Pulmonary Embolism Chest. Generally, radiographic changes are present in late stages and they are not helpful in the acute management needed in both situations. Trying to succeed when the right ventricle fails.

The hypoxemia can be corrected by oxygen—therapy. However, this has low specificity when an anterior left ventricular myocardial infarction is not excluded.

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Venous Color Doppler examination: Chest X—ray Cxrdiologie routine chest X—ray has a limited value in the differential diagnosis of the two conditions and the changes are ranging from a normal aspect to specific changes. When oxygen therapy does not correct the hypoxemia in a RVMI, an intra—cardiac right to left shunt should be suspected patent foramen ovale usually being present. X—ray changes suggestive of PE proximal site without pulmonary infarction; associated high risk with following features: Please review our privacy policy.


In RVMI, the typical apex—base gradient is inverted and high flow velocities are found at the apex and in the outflow tract. Low CO2 values can often be present due to hyperventilation associated with a mild degree of respiratory alkalosis.

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In RVMI, the right cardiac chambers are dilated and they present motion abnormalities. This method is particularly useful in RVMI cases. Doppler venous ultrasound, Contrast venography; Impedance pletismography are useful in evaluating patients with clinically suspected PE, as it can show thrombi in the lower limbs venous system or in other territories.

Non—specific changes are usually present and they should not be used for diagnosis.

Magnetic resonance imaging can evaluate both pulmonary artery flows caardiologie well as cardiac flows, but the method is not routinely used remaining at this moment an alternative to CT scan. In some cases beside the intra—arterial filling defects, CT scan can show the presence of a pulmonary infarction, usually a triangular shadow with its tip towards the hilum and the base towards the pleura.

Torbicki A, Perrier A.