Haemoptysis due to pulmonary venous stenosis

Abstract

Haemoptysis is a potentially life-threatening condition with the need for prompt diagnosis. In about 10-20% of all cases the bleeding source remains unexplained with the standard diagnostic approach. The aim of this article is to show the necessity of widening the diagnostic approach to haemoptysis with consideration of pulmonary venous stenosis as a possible cause of even severe haemoptysis and haemoptoe.A review of the literature was performed using the Medline/PubMed database with the terms: ''pulmonary venous stenosis'', ''pulmonary venous infarction'' and ''haemoptysis''. Further references from the case reports were considered.58 case reports and case collections about patients with haemoptysis due to pulmonary venous stenosis were detected. This review gives an overview about the case reports and discusses the underlying pathophysiology and the pros and cons of different imaging techniques for the detection of pulmonary venous stenosis.Several conditions predispose to the obstruction of the mediastinal pulmonary veins. Clinical findings are unspecific and may be misleading. Pulmonary venous stenosis can be detected using several imaging techniques, yet three-dimensional magnetic resonance-angiography and three-dimensional contrastenhanced computed tomography are the most appropriate. Pulmonary venous stenosis should be considered in patients with haemoptysis. @ERSpublications Pulmonary venous stenosis should be considered in haemoptysis and is best diagnosed using CT or MRI venography http://ow.ly/tMPFP

Estenosis de las venas Pulmonares post ablación de fibrilación auricular: presentación clínica similar a una neoplasia pulmonar. Reporte de caso.

“…Dado que suele ser asintomática, su incidencia es difícil de estimar, aunque diversas series la estipulan en un 0.3% a 6%. Cuando están presentes, los síntomas parecen ser consecuencia de la disminución de la perfusión (disnea) y de la estasis venosa (hemoptisis y tos) 4 . El cuadro clínico hace suponer causas más frecuentes, como infecciones o neoplasias.…”

“…El cuadro clínico hace suponer causas más frecuentes, como infecciones o neoplasias. Dado que tanto la circulación bronquial como la pulmonar drenan en las venas pulmonares, por el bloqueo del drenaje pueden aparecer manifestaciones tanto bronquiales (mucosa endobronquial friable, distensión de las venas pleurales e hiliares) como del parénquima pulmonar (edema pulmonar intersticial, hemorragia alveolar) 4 . En el caso clínico presentado, la disminución del volumen pulmonar, el aumento de tejidos peri hiliares, la presencia de septos engrosados y los nódulos hipercaptantes de 5FDG en un paciente fumador, hicieron suponer la presencia una neoplasia primaria de pulmón.…”

Repair of iatrogenic pulmonary vein occlusion with a vascularized atrial flap

“…Iatrogenic pulmonary venous obstruction (PVO) is a rare condition, most commonly reported as a complication following ablation for atrial fibrillation or after complex congenital cardiac surgery . Patients with PVO commonly complain of dyspnea and hemoptysis . In cases of PVO including multiple pulmonary veins, symptoms can be life threatening and require prompt intervention .…”

“…[1][2][3][4][5] Patients with PVO commonly complain of dyspnea and hemoptysis. 1,6 In cases of PVO including multiple pulmonary veins, symptoms can be life threatening and require prompt intervention. 7 Percutaneous revascularization strategies are most commonly applied in the treatment of PVO.…”

Clinical Relevance of Computed Tomography Pulmonary Venography

“…Typical symptoms and signs of pulmonary venous stenosis are shortness of breath, chronic cough, recurrent haemoptysis, pulmonary oedema, recurrent pleural effusions and pulmonary venous hypertension [3][4][5][6][7]. Common radiological findings are thickened interseptal lines, ground-glass opacity, enlarged hilar lymph nodes and pleural effusions.…”