Introduction: In the last three years, there has been a significant increase in chest examinations due to COVID-19. In addition to the initial assessment of the lung parenchyma, the use of CT angiography to identify pulmonary thromboembolism (PTE) occupied a prominent place in the assessment of pulmonary vasculature and perfusion. Materials and Methods: From May to October 2022, all Angio-CT exams for PTE research performed by the same professional were acquired with a maximum of 50 mL, using optimized protocols for Philips® Brilliance 64-slice and Siemens® SOMATOM go.Up equipment. 32-slice. In each examination, the patient general condition was analyzed, the venous catheter was tested and the most suitable injection parameters were determined. The ROI location and the number of reference Hounsfield Units varied from patient to patient. Results: The average volume of contrast injected in exams performed using the Philips® equipment was 38.3 ± 3.7 mL and the flow was 3.3 ± 0.5 mL/s, with an average acquisition time of 3. 9 ± 0.6 s. In the Siemens® equipment, the mean volume of injected contrast was 38.3 ± 6 mL, with mean flow and acquisition time of 3.2 ± 0.6 mL/s and 11.1 ± 1.3 s, respectively. Conclusion: For each equipment and patient, it´s imperative to adapt the volume of contrast to be injected to detect PTE. Volumes of less than 50 mL are sufficient to demonstrate small circulation.

Publicações recentes relatam episódios trombóticos em pacientes infectados pelo HIV associados a outras condições que incluem neoplasias e infecções que predispõem para um estado de hipercoagulabilidade. Relata-se o caso de uma paciente de 47 anos portadora do HIV que desenvolveu tromboembolismo pulmonar, tuberculose pulmonar e câncer de mama. Foi tratada com rifampicina, isoniazida, pirazinamida, heparina, femprocumona, zidovudina, lamivudina e efavirenz. Bacilos ácido-álcool-resistentes foram observados no exame de escarro e três meses depois foi isolado o Mycobacterium tuberculosis da biópsia de linfonodo durante um episódio de reconstituição imune. A micobactéria isolada demonstrou sensibilidade a todas as drogas anti-tuberculosas de primeira linha. A infecção pelo HIV, o câncer de mama e a tuberculose pulmonar possuem vários mecanismos que induzem um estado de hipercoagulabilidade e que podem produzir complicações tromboembólicas incluindo o TEP nos pacientes com AIDS. O TEP nesta paciente foi um desafio diagnóstico, considerando todas as outras doenças graves que apresentou simultaneamente.

CONTEXT: Pulmonary thromboembolism is the third most frequent cause of morbidity and mortality among acute cardiovascular diseases. The incidence of pulmonary embolism in necropsies has remained unchanged over the last few decades. Cardiac diseases, neoplasia, trauma, recent surgery and systemic diseases are important predisposing clinical conditions. The relationship between male and female sexes is estimated at 1.24. Various studies have shown an increase in morbidity in spring and autumn. There is great difficulty in precise anatomopathological diagnosis in relation to the localization of the emboli in the pulmonary vessels, although they are preferentially located in the right lung and lower lobes. OBJECTIVE: To study the incidence of lethal and non-lethal pulmonary thromboembolism in relation to epidemiological and anatomical variables. DESIGN: Retrospective study performed via reports on the necropsy findings. SETTING: University hospital providing tertiary-level attendance. SAMPLE: 16,466 consecutive necropsies performed from January 1972 to December 1995. MAIN MEASUREMENTS: Frequency of lethal and non-lethal pulmonary thromboembolism, predisposing diseases, occurrence in relation to the seasons of the year, and location where the embolus is lodged. RESULTS: Pulmonary thromboembolism was found in 4.7% of all the necropsies performed. There was a predominance of lethal cases (68.2%). There was no difference in relation to sex or seasons of the year for the occurrence of this disease. Cardiovascular diseases were more frequently associated with thromboembolic phenomena. With regard to the location where the embolus was lodged, various lung segments showed greater incidence of being bilaterally compromised. CONCLUSION: Over the period of this study, it was observed that there was a reduction in the incidence of pulmonary thromboembolism, which was probably due to the increase in prophylactic measures over the last few decades. Nonetheless, lethal thromboembolism predominated in frequency, probably because of the abrupt onset of a condition of attack across a large area of the lung, lack of clinical suspicions and consequently a lack of early diagnosis, and delay in instituting fibrinolytic therapy in the cases with hemodynamic repercussions or a large number of lung segments affected.

Pulmonary thromboembolism (PTE) corresponds to the occlusion of the pulmonary circulation, having as itsetiology the thrombi that may originate in another part of the body (for example in the venous circulation of the lower limbs). Virchow’s triad describes the 3 main components that lead to the formation of PTE. As a matter of physiological aging, PTE is more frequent in the elderly population. However, there are risk factors that increase the likelihood of this pathology developing in the younger population. This article presents the case of a 26-year- -old patient who, due to dyspnea and pleuritic chest pain, is seen by a general and family medicine practioner, and is later referref and diagnosed with PTE in a hospital setting.

Cardiovascular diseases (CVDs) account for a significant portion of global mortality, emphasizing the need for effective strategies. This study focuses on myocardial infarction, pulmonary thromboembolism, and aortic stenosis, aiming to empower medical practitioners with tools for informed decision making and timely interventions. Drawing from data at Hospital Santa Maria, our approach combines exploratory data analysis (EDA) and predictive machine learning (ML) models, guided by the Cross-Industry Standard Process for Data Mining (CRISP-DM) methodology. EDA reveals intricate patterns and relationships specific to cardiovascular diseases. ML models achieve accuracies above 80%, providing a 13 min window to predict myocardial ischemia incidents and intervene proactively. This paper presents a Proof of Concept for real-time data and predictive capabilities in enhancing medical strategies.