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Query: UMLS:C0034063 (pulmonary edema)
 10,665 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 59-year-old white male accidentally ingested a mouthful of a plant growth chemical, Cycocel, containing 11.8% of the active ingredient (2-chloroethyl)trimethylammonium chloride (chlormequat). He was seen by a family physician and then transferred to a hospital where he died as a result of ventricular fibrillation, which progressed to asystole. Postingestion symptoms were typical of cholinergic crisis and included salivation, diaphoresis, bradycardia, visual disturbances, and seizure. Autopsy findings showed marked pulmonary edema, coronary atherosclerosis, atheromata of aorta, and localized adenocarcinoma of the prostate. Toxicological analyses of biological samples showed the presence of chlormequat in the stomach contents and urine.
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PMID:Sudden death following accidental ingestion of chlormequat. 239 50

Sixteen patients (age 13-53 years) with accidental deep hypothermia have been rewarmed in our clinic during the last 10 years, 14 by femoro-femoral cardiopulmonary bypass (CPB) of whom 11 had a cardiopulmonary arrest (asystole in 5 and ventricular fibrillation in 6). On admission, the latter were clinically dead showing wide non-reactive pupils and being supported by ventilation and external heart massage. In the survivors, the mean length of cold exposure was 4.4 h (2-5.5 h) and mean arrest interval until initiation of CPB was 2.5 h (1.4-3.7 h). Rectal temperature on admission ranged from 17.5 degrees C to 26 degrees C (mean 22.5 degrees C). The causes for hypothermia were fall into a crevasse (5), avalanche (1), drowning (2) and cold exposure (3) including 2 suicide attempts. Results are summarized in the following table: [table: see text] Eight of the 11 patients with deep hypothermia and cardiac arrest were rewarmed and resuscitated successfully with CPB. Three patients, including 2 cases of asphyxia (avalanche and drowning), could not be weaned from CPB despite adequate rewarming. The other drowned patient (53 years) died on the 3rd postoperative day (POD) from ARDS. The main complication was pulmonary edema (57%) and transient neurological deficits. All survivors became conscious during the first POD and resumed, their professional activity. We conclude that patients with accidental deep hypothermia and even prolonged cardiopulmonary arrest should be rewarmed and resuscitated rapidly by cardiopulmonary bypass. These measures are very promising particularly if the cause of accident and the circumstances suggest that cardiopulmonary arrest was induced by hypothermia alone without other asphyxiating mechanisms.
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PMID:Accidental deep hypothermia with cardiopulmonary arrest: extracorporeal blood rewarming in 11 patients. 239 32

During the four most common ergometric exercise tests--bicycle ergometry seated and lying, step exercise testing and treadmill ergometry--such life-threatening complications as ventricular fibrillation, pulmonary edema or myocardial infarction occur to a varying degree. As a typical complication of bicycle ergometry with the patient lying, pulmonary edema, which can be explained by an increase in the venous return in the supine patient, has been observed in 1:29,000 cases. Ventricular fibrillation is particularly common in treadmill ergometry, possibly as a consequence of CNS-derived stimuli provoking arrhythmias due to this type of ergometry which may cause anxiety in some patients. Myocardial infarction, and also death--usually as a result of acute infarction--are also seen much more commonly in treadmill exercise testing (1:2,800 and 1:20,000, respectively) than in bicycle ergometry with the patient seated or supine. The step exercise test is associated with an infarction rate of 1:43,000, and a mortality rate of 1:128,000, and is thus a comparatively safe form of exercise testing. Maximum loading of the patient and the mode of the exercise test (test protocol) appear to have no influence on the complication rate. A careful prior examination including history-taking, the presence of a physician and a standby defibrillator are a must.
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PMID:[Life-threatening complications of ergometry]. 268 Aug 38

Sixty-four patients with cardiac contusion documented by electrocardiographic changes and creatine kinase MB fraction assay following blunt chest injury were reviewed to assess the impact of cardiac contusion on subsequent management. Fifty-eight patients had elevated creatine kinase MB levels; 35 patients had electrocardiographic abnormalities, including ST-segment and T-wave changes (25), premature ventricular contraction (ten), right bundle-branch block (nine), atrioventricular block (three), atrial fibrillation (three), and premature atrial contraction (two). Thirty patients underwent general anesthesia. There were only four perioperative complications: ventricular ectopy, ventricular fibrillation, nodal rhythm, and pulmonary edema. There were no deaths attributable to cardiac contusion. In summary, patients with blunt trauma who have sustained a cardiac contusion can undergo elective operation with a low incidence of complication. In the emergency setting, however, hemodynamic monitoring for early detection of arrhythmias is indicated.
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PMID:Cardiac contusion. The effect on operative management of the patient with trauma injuries. 232 24

A 52-year-old apparently healthy, normotensive woman who presented for elective cholecystectomy experienced intra-operative hypertension and tachycardia, which were controlled by propranolol. Oesophageal temperature increased, there was a metabolic and respiratory acidosis with hypoxaemia, and malignant hyperthermia was diagnosed. Severe cardiogenic pulmonary oedema ensued, and was treated with intravenous glyceryl trinitrate. Ventricular fibrillation caused cardiac arrest, and this was treated successfully. Postoperatively a phaeochromocytoma was discovered, and removed at a subsequent operation. The case illustrates the similarities in presentation of malignant hyperthermia and phaeochromocytoma, and the possibility that misdiagnosis may exacerbate the crisis.
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PMID:Phaeochromocytoma--a presentation mimicking malignant hyperthermia. 323 80

In an autoperfused heart-lung preservation the lungs usually deteriorate earlier than the heart. This study examines the effect of prostaglandin E1 on the lungs in a newly designed autoperfusion model for heart-lung preservation. This model provided constant preload and afterload with stable hemodynamic parameters so that precise changes of lung function could be measured. Lung function was evaluated by the changes of arterial blood gas, pulmonary vascular resistance, pulmonary compliance, and serial biopsies. Eighteen mongrel dogs were divided into two groups. Seven control dogs received no prostaglandin E1. The study group consisted of seven dogs that received continuous infusion of prostaglandin E1 (1, 10, and 40 ng/kg/min) through the pulmonary artery. Attempts to infuse larger concentrations of prostaglandin E1 at 10 to 40 ng/kg/min resulted in ventricular fibrillation in four animals not included in the analysis. In the control group lung function showed good viability up to 5 hours; however, the lungs deteriorated, and lung edema occurred in all experiments after 9 hours. A lower dosage of prostaglandin E1 (1 ng/kg/min) infusion was effective in seven dogs, which prevented lung deterioration, and five of the seven lungs were well preserved for 10 hours with stable arterial oxygen tension, pulmonary vascular resistance, and pulmonary compliance. Ventricular fibrillation occurred at dosages of 10 to 40 ng/kg/min of prostaglandin E1 in four dogs. These dogs therefore were excluded from the analysis. In conclusion, prostaglandin E1 appears to have a beneficial effect on autoperfused heart-lung preparation.
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PMID:Beneficial effects of prostaglandin E1 on autoperfused heart-lung preservation. 336 48

A 67 year old woman with a permanent pacemaker was admitted with pulmonary oedema and mitral valve incompetence two months after a myocardial infarction. Echocardiograms showed good left ventricular function and a large coil of apparent thrombus in the right atrium prolapsing into the right ventricle. Intermittent loss of pacemaker sensing and capture was noticed on admission and probably caused the supraventricular tachycardia and ventricular fibrillation that occurred before an exploratory bypass operation. At operation rupture of the papillary muscle was found and the mitral valve was replaced. A large piece of thrombus was retrieved from the right pulmonary artery. The right heart contained no clot and the pacemaker wire was not displaced. It is envisaged that the strand of venous thrombus was caught in the permanent pacing wire at the tricuspid valve level resulting in an unusual case of pacemaker malfunction. The eventual poor outcome was almost certainly influenced by the arrhythmias and pulmonary embolism caused by the clot and might have been avoided by early operation.
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PMID:Entanglement of embolised thrombus with an endocardial lead causing pacemaker malfunction and subsequent pulmonary embolism. 356 90

Methods of clinico-instrumental investigation and biochemical monitoring (CPK and its membranous fraction) were employed for examination of 432 patients with acute myocardial infarction (AMI). Among them there were patients with an uncomplicated course of disease (19.4%), recurrences (13.7%) and AMI spreading (9%). Lung edema, a cardiogenic shock, ventricular fibrillation and complicated cardiac rhythm disorders were not detected on the 1st day of disease. Clinico-anamnestic data provided no opportunity for defining factors promoting AMI recurrences whereas AMI spreading frequently developed in patients with repeated AMI, suffering from essential hypertension, obesity and heart failure. Higher diastolic pressure in the pulmonary artery, an increase in the cardiac volume, a decrease in the ejection fraction and left ventricular stroke work--changes which were most pronounced in AMI spreading, were noted in patients with AMI lingering forms. Signs of disseminated intravascular blood coagulation were noted in the venous and arterial blood of patients with lingering AMI forms. A high blood enzyme level was shown to be accompanied by a low level of antibodies to LDH and CPK.
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PMID:[Clinico-pathogenetic variants of protracted forms of acute myocardial infarct]. 361 39

A 27-year old female was discovered at 4 a.m. lying in a wet field, the ambient temperature being of 4 degrees C. Her rectal temperature had fallen to 19 degrees C. She was comatose and failed to respond to noxious stimuli. Her pupils were dilated and fixed. Her respiratory rate was reduced to three to four breaths per min. Her blood pressure was not measurable and neither femoral or carotid pulse could be detected. The heart was in sinus rhythm with a rate of 40 b X min-1. During her transfer to hospital, she was ventilated with oxygen, a tidal volume of 300 ml and a rate of 10 b X min-1. On arrival in the emergency room, a short period of ventricular fibrillation preceded cardiac arrest. Cardiac massage and sodium bicarbonate infusion were continued during the transfer of the patient to the operating theatre. A femoro-femoral cardiopulmonary bypass was started with a bloodless priming, 3 mg X kg-1 heparin and a flow of 3,000 to 3,500 ml X min-1. Mean arterial pressure was maintained between 65 and 85 mmHg; cardiac massage was discontinued during the bypass. Within 50 min, ventricular fibrillation appeared, rectal temperature had increased to 33 degrees C. Electrical defibrillation (300 J) was successful. Cardiopulmonary bypass was stopped after 63 min. The postoperative course was uneventful, apart from transient pulmonary oedema. At the time of discharge, a week later, no loss of intellect or change in behaviour could be perceived.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Accidental deep hypothermia and circulatory arrest. Treatment with extracorporeal circulation]. 361 58

Massive dilatation of the cecum developed in an elderly man following admission for an acute episode of upper gastrointestinal hemorrhage complicated by myocardial infarction, ventricular fibrillation, and pulmonary edema. A diagnosis of pseudo-obstruction was made. After an unsuccessful attempt at colonoscopy, percutaneous cecostomy was performed under computed tomographic guidance, using trocar technique. The cecal distention resolved and did not recur. Percutaneous cecostomy is an alternative to colonoscopy and to surgical cecostomy in the treatment of massive cecal distention.
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PMID:Percutaneous cecostomy for decompression of the massively distended cecum. 394 54


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