Inferior Vena Cava Filter Limb Fracture with Embolization to the Right Ventricle
| Autor: | Bradley S. Jackson, Chad M. Cannon, Jared T. Marx, Mykel Sepula |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
medicine.medical_specialty Vena Cava Filters Heart Ventricles medicine.medical_treatment Embolism Inferior vena cava filter Vena Cava Inferior 030204 cardiovascular system & hematology Chest pain Inferior vena cava 03 medical and health sciences 0302 clinical medicine medicine Humans 030212 general & internal medicine Embolization Cardiac catheterization Computed tomography angiography Venous Thrombosis medicine.diagnostic_test business.industry Sarcoma Limb fracture Foreign Bodies Surgery Radiography Lower Extremity medicine.vein Echocardiography cardiovascular system Emergency Medicine Female Radiology medicine.symptom Tomography X-Ray Computed business Chest radiograph |
| Zdroj: | The Journal of Emergency Medicine. 53:248-251 |
| ISSN: | 0736-4679 |
| Popis: | Background Inferior vena cava (IVC) filter and filter limb embolization is a known phenomenon, with a prevalence of up to 25% for certain filter types. Most commonly, the site of embolization is to the heart. Point-of-care ultrasound is an easily accessible imaging modality that should be utilized when considering IVC filter complications. Case Report A 28-year-old woman with a history of metastatic sarcoma and IVC filter placement for deep venous thrombosis presented to the Emergency Department (ED) for chest pain. Chest radiography was reviewed and originally thought to have no abnormalities. Chest computed tomography angiography was negative for filling defects or foreign bodies. A possible foreign body in the heart was noted by a radiologist's over-read of the original chest radiograph. An echocardiogram done by Cardiology was negative for foreign bodies or other abnormalities. Next, an emergency physician performed a bedside echocardiogram, with focused attention to the right side of the heart. An echogenic foreign body was visualized in the right ventricle. The patient was subsequently taken to the cardiac catheterization laboratory, where fluoroscopic visualization of a limb wire of an IVC filter within the right ventricle was obtained. That foreign body was subsequently removed successfully, along with removal of the broken IVC filter. Why Should an Emergency Physician Be Aware of This? This case report highlights the utility of point-of-care ultrasound in the work-up of a patient with an embolized IVC filter wire. Chest pain patients frequently receive point-of-care echocardiography in the ED, and these ultrasound findings should be recognized and used to guide further treatment and consultation. |
| Databáze: | OpenAIRE |
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