Uterine fibroids have been described as an associate to acute venous
thromboembolism (VTE), with case reports showing an association between large
uterine fibroids, acute deep venous thrombosis (DVT), and acute pulmonary
embolism (PE). However, there is little known about the association or causation
between uterine fibroids, chronic thromboembolic disease (CTED), and chronic
thromboembolic pulmonary hypertension (CTEPH). We report on six women with
uterine fibroids and CTEPH, as well as one woman with CTED, all of whom
presented with exertional dyspnea, lower extremity swelling, and in the cases of
CTEPH, clinical, echocardiographic, and hemodynamic evidence of pulmonary
hypertension and right heart failure. Compression of the pelvic veins by
fibroids was directly observed with invasive venography or contrast-enhanced
computed tomography in five cases. All seven women underwent pulmonary
thromboendarterectomy (PTE) followed by marked improvement in functional,
clinical, and hemodynamic status.
To curb transmission of SARS-CoV-2 and preserve hospital resources, elective procedures were postponed in the United States, affecting patients previously scheduled for electrophysiology (EP) procedures. We aimed to understand patients’ perceptions related to procedural postponements during the first wave of the SARS-CoV-2 pandemic. We performed a telephone survey between May 1-15 2020, of consecutive patients who experienced procedural postponement from March-April. Of 112 patients, 20% may have been lost to follow up and 12% lost interest in having their procedures done. The level of anxiety related to postponement was moderate to high in more than two thirds of patients.
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