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A rare cause of respiratory insufficiency: case presentation

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Diaconu C., Paraschiv B., Lungu R., Bartoş D.
Open Medicine
|
2014
|
vol. 9
|
issue 1
141-143
EN
We report the case of a 73 year old woman who presented for progressive dyspnea. Her medical history included thyroidectomy 15 years ago, myocardial infarction, recurrent paroxysmal atrial fibrillation and femoral fracture two weeks previously, conservatively treated. Physical examination revealed absent breath sounds in the left hemithorax, up to the apex, and crackles in the right hemithorax. The acid-base balance showed acute hypoxemic respiratory failure. The chest X-Ray revealed left diaphragmatic paralysis. Thoracic CT-scan was performed, which excluded the pulmonary embolism and revealed left diaphragmatic relaxation, ascension of the splenic angle of the colon, stomach and spleen up to the projection of left lung hilum, and right postero-basal alveolar condensation process. Diaphragm dysfunction can be caused by various disorders, including phrenic paralysis. This pathology should be considered in the differential diagnosis of acute respiratory failure.
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Venous thromboembolism in pregnant woman - a challenge for the clinician

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Diaconu C., Bălăceanu A., Bartoş D.
Open Medicine
|
2013
|
vol. 8
|
issue 5
548-552
EN
Deep vein thrombosis and pulmonary embolism are two clinical entities of a single disease called venous thromboembolism. Venous thromboembolism is an important cause of maternal morbidity and mortality. Diagnosis and treatment of venous thromboembolism in pregnant women are much more difficult than in non-pregnant women. Pregnant patients were excluded from all major clinical trials investigating therapeutic combinations for acute thromboembolism. Although, for many years, the standard anticoagulant during pregnancy and postpartum was unfractionated heparin, current guidelines recommend low molecular weight heparin. The advantages of low molecular weight heparin are lower risk of bleeding, predictable pharmacokinetics, lower risk of fracture because of thrombocytopenia and heparin-induced osteoporosis.
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