Cross-sectional Echocardiographic Characterization of Atelectatic Lung Segments: Case continue
Clinical Follow-up
Several months following discharge from the hospital, the patient was again admitted with progressive dyspnea, orthopnea, and pedal edema. An echocardiogram (Fig 1С) obtained at the time of this hospital admission revealed recurrence of the left pleural effusion with reappearance of the atelectatic lung segment along the lateral aspect of the left ventricle.
Case 2
A 73-year-old man with a history of diabetes, hypertension, and a previous myocardial infarction was admitted to the hospital for evaluation of left-sided numbness, weakness, and slurred speech. Examination of the lungs was notable for dullness to percussion
Hospital Course
A two-dimensional echocardiogram, obtained to exclude an intracardiac source of embolization, showed mild left ventricular dysfunction with a large echo-dense mass adherent to the lateral aspect of the left ventricle. Before a therapeutic thoracentesis could be performed, the patient underwent a sudden cardiopulmonary arrest and subsequently died. At autopsy the patient was noted to have atelectasis and consolidation of the left lower lobe of the lung; examination of the heart showed evidence of focal fibrosis of the apical and posterolateral walls consistent with a previous myocardial infarction. There was no evidence of an intrathoracic tumor.
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Case 3
A 58-year-old woman with no previous medical problems was admitted to the hospital for evaluation of postmenopausal bleeding and a right lower quadrant mass. At the time of admission, findings from the cardiac and pulmonary examinations were within normal limits; examination of the abdomen revealed a 15 X 15-cm nontender mass in the right lower quadrant. The admitting chest roentgeno¬gram and electrocardiogram were normal.
Hospital Course
On the second hospital day the patient underwent an exploratory laparotomy with a total abdominal hysterectomy and bilateral salpingo-oophorectomy. Although she tolerated the procedure well, her postoperative course was complicated by oliguria, congestive heart failure, and a new left pleural effusion with atelectasis of the left lower lobe of the lung. An echocardiogram was obtained to evaluate left ventricular (unction, which showed normal global left ventricular function and the presence of a large echo-dense mass adherent to the lateral aspect of the heart at the midventricular and apical levels. The patient was given furosemide and underwent diuresis with subsequent resolution of the pleural effusion and left lower lobe atelectasis. viagra plus
