Print

Print


Wow, been a while since I've been called wonderful.  Were you being
sarcastic? :)
I would do what you could do and mention the rest of the study was not
able to be completed.  

Marcus D. Stanbro, D.O.
University Medical Group--Vascular Medicine
200 Patewood Dr., Suite A300
Greenville, SC 29615
Office: 864-454-2100

Confidentiality Note: This message is intended for use only by the
individual or entity to which it is addressed and may contain
information that is privileged, confidential, and exempt from disclosure
under applicable law. If the reader of this message is not the intended
recipient or the employee or agent responsible for delivering the
message to the intended recipient, you are hereby notified that any
dissemination, distribution or copying of this communication is strictly
prohibited. If you have received this communication in error, please
contact the sender immediately and destroy the material in its entirety,
whether electronic or hard copy. Thank you.

-----Original Message-----
From: UVM Flownet [mailto:[log in to unmask]] On Behalf Of Nancy
Hohn
Sent: Wednesday, September 26, 2007 10:56 AM
To: [log in to unmask]
Subject: Re: dvt = syncope

For our wonderful physicians:
Would you suggest doing the scan groin to knee with a comment regarding
the inability to rule out a clot in the calf?  Or just not do the exam?
I would do groin to knee.
I remember someone on here once stating they had been told  "in Canada
they can do US through a cast"  :-)

-----Original Message-----
From: UVM Flownet [mailto:[log in to unmask]] On Behalf Of Marcus
Stanbro, DO
Sent: Wednesday, September 26, 2007 9:47 AM
To: [log in to unmask]
Subject: Re: dvt = syncope


Paradoxical embolism always falls under the differential diagnosis for
stroke and arterial embolic phenomenon, BUT is usually thought of more
in the settings of "stroke in the young" or cases in which there is no
other obvious causes.  Most commonly associated with PFO's or atrial
septal defects. PFO's are quite common, but to be associated with a
paradoxical embolism, there needs to be a RT to LT shunt or flow which
can occur acutely/temporarily like with coughing, Valsalva, or anything
that raises the pulmonary artery, RV, RA pressures.  An acute and
massive PE can do that as well.
Path:  Veins to RT heart to LT heart and out to wherever.
Symptoms:  Would totally depend upon where the embolism ends up, so
could present in a myriad of ways.
Treatment:  Acutely, simply anticoagulation (for the presumed DVT). Once
again, depending upon location of embolism, other treatments may apply
such as thrombolysis, etc.  Occasionally the PFO or ASD would need to be
closed, but I have only seen 1 or 2 of these in my career.  Maybe Dr.
Schneider would know more.


Marcus D. Stanbro, D.O.
University Medical Group--Vascular Medicine
200 Patewood Dr., Suite A300
Greenville, SC 29615
Office: 864-454-2100

Confidentiality Note: This message is intended for use only by the
individual or entity to which it is addressed and may contain
information that is privileged, confidential, and exempt from disclosure
under applicable law. If the reader of this message is not the intended
recipient or the employee or agent responsible for delivering the
message to the intended recipient, you are hereby notified that any
dissemination, distribution or copying of this communication is strictly
prohibited. If you have received this communication in error, please
contact the sender immediately and destroy the material in its entirety,
whether electronic or hard copy. Thank you.

-----Original Message-----
From: UVM Flownet [mailto:[log in to unmask]] On Behalf Of
Betty-Sue/Elizabeth
Sent: Wednesday, September 26, 2007 10:26 AM
To: [log in to unmask]
Subject: Re: dvt = syncope

The kid did tell the tech that he had a heart echo 4 years ago but
couldn't 
remember why and the mom volunteered no info and of course we didn't
know 
what questions to ask.  Haven't used the term patent foramen ovale since

school. Thank you Chris. He had no other symptoms of anything.
    Now assuming he had one,PFO...is this still the first test of
choice? 
All I can find on Google tying this together is syncope related to
massive 
PE.
    And of course we don't refuse anything, the fact that he had a cast
on 
his leg would have been a good enough reason and we are far more
educable 
than the docs seem to be. In fact that is why I am asking you learned
folks 
to educate me.
    So feeling slightly embarrassed, could Dr Stanbro please go into 
Paradoxical Embolism a little more in depth (cause, path, symptoms and 
treatment)  thank you very much.  And could Dr Schneider please go into
the 
ACGME.  When we go to our Radiologist and say could you please talk to
the 
ER about 'blank' their response is " I can't tell another Doctor how to
do 
his job"  thank you all very much 

To unsubscribe or search other topics on UVM Flownet link to:
http://list.uvm.edu/archives/uvmflownet.html

To unsubscribe or search other topics on UVM Flownet link to:
http://list.uvm.edu/archives/uvmflownet.html

NOTE: This electronic message and attachment(s), if any, contains
information which is intended solely for the designated recipient(s).
Unauthorized disclosure, copying, distribution, or other use of the
contents of this message or attachment(s), in whole or in part, is
prohibited without the express authorization of the author of this
message.

To unsubscribe or search other topics on UVM Flownet link to:
http://list.uvm.edu/archives/uvmflownet.html

To unsubscribe or search other topics on UVM Flownet link to:
http://list.uvm.edu/archives/uvmflownet.html