ArticleThe American journal of case reports2025
Right Ventricular Volume Overload Mimicking Pulmonary Embolism: A Case of Intraoperative Fluid Absorption-Induced Ventricular Interdependence.
Article in The American journal of case reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND Ventricular interdependence - mediated by shared pericardial and septal mechanics - can precipitate biventricular dysfunction during acute right ventricular (RV) volume overload. RV dilation impairs left ventricular (LV) compliance through diastolic constraint, elevating pulmonary pressures and triggering a self-perpetuating cycle of cardiopulmonary compromise. This hemodynamic cascade generates echocardiographic signs indistinguishable from pulmonary embolism (PE). CASE REPORT A 75-year-old woman with hypertension and diabetes developed acute hypoxia, tachycardia (110/min), and tachypnea (35/min) during ureteroscopic lithotripsy, accompanied by a positive fluid balance of 2430 mL from irrigation absorption. Bedside echocardiography revealed RV dilation, McConnell's sign, D-shaped LV, severe tricuspid regurgitation, elevated systolic pulmonary artery pressure (58 mmHg), 60/60 sign, and fused mitral E/A waves - findings highly suggestive of PE. Laboratory tests showed metabolic acidosis (pH 7.32), hypoxemia (PaO₂/FiO₂ 132 mmHg), and markedly elevated NT-proBNP (3892 pg/mL). Pulmonary CT angiography excluded thromboembolism but confirmed bilateral pulmonary edema. The diagnosis of fluid absorption-induced cardiogenic pulmonary edema was established. Aggressive diuresis and respiratory support led to symptom resolution, with normalized RV/LV ratio (34 mm → 23 mm) and NT-proBNP (136 pg/mL) on follow-up. CONCLUSIONS Acute volume overload from intraoperative fluid absorption exacerbates RV failure through ventricular interdependence, producing PE-mimicking echocardiographic signs. This case demonstrates that RV dilation, septal flattening, and pulmonary hypertension - classically associated with PE - can originate from non-thromboembolic etiologies. Clinicians must utilize multimodal imaging (echocardiography + CTPA) to discriminate fluid overload syndrome from PE. Preventive strategies, including real-time intraoperative fluid balance monitoring and renal pelvic pressure control, are critical to mitigate hemodynamic decompensation during endoscopic procedures, thereby avoiding misdiagnosis and optimizing critical care outcomes.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.