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Query: UMLS:C0034065 (pulmonary embolism)
 14,979 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This is a case report of an athletic, middle-aged man with a remote history of penetrating right leg trauma who developed a pulmonary embolism, thrombosis of the popliteal vein, a mass in the popliteal fossa, and acute ischemia of the right lower leg. At operation a thrombosed pseudoaneurysm was found arising from a defect in the popliteal vein with extrinsic compression of the popliteal artery. The defect was patched with autogenous vein and the long-term result was excellent. Pseudoaneurysm of the popliteal vein is a previously unreported entity. Popliteal venous aneurysms usually begin with phlebitic or pulmonary thromboembolic manifestations and present a diagnostic challenge. Venous aneurysms in general are uncommon pathologic entities with a diverse etiology; the current etiologic concepts and classification are briefly discussed in the text. A new differential diagnosis for masses in the popliteal fossa is introduced by this report.
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PMID:Popliteal vein pseudoaneurysm: a case report. 649 82

Four drugs that inhibit platelet function have been evaluated for their antithrombotic effects in humans. These are aspirin, dipyridamole, hydroxychloroquine and sulphinpyrazone. Aspirin has been shown to reduce the number of transient ischemic attacks (TIA), stroke and death in patients with multiple TIA. The reduction in TIA was greatest in males who were normotensive and when there was an angiographically demonstrated lesion in the carotid artery that accounted for the symptoms. Aspirin reduced venous thrombosis and non-fatal and fatal pulmonary embolism in patients after surgery for fractured hip and after elective hip replacement. There is evidence that the prophylactic effect of aspirin may be greater in male patients. Aspirin reduced the frequency of arteriovenous shunt thrombosis. Aspirin abolished symptoms in patients with peripheral ischemia associated with thrombocytosis and spontaneous platelet aggregation. There is no conclusive evidence at the present time that aspirin is effective in patients with coronary artery artery disease. Dipyridamole in combination with oral anticoagulants is effective in reducing the frequency of systemic embolism in patients with prosthetic heart valve replacement but is ineffective in patients with transient cerebral ischemic attacks or for the prevention of venous thromboembolism. Hydroxychloroquine was effective in reducing postoperative venous thrombosis in patients undergoing general abdominothoracic surgery but the evidence that it was effective in patients undergoing orthopaedic surgery is inconclusive. Sulphinpyrazone may be effective in reducing the frequency of sudden cardiac deaths in patients in the first year after myocardial infarction when it is started within 25 to 35 days after the infarction. Sulphinpyrazone reduced the incidence of arteriovenous shunt thrombosis in patients undergoing chronic hemodialysis and in combination with anticoagulants, it reduced the frequency of recurrent venous thrombosis. There have been no large scale trials of platelet suppressant drugs in clinical cancer and successful treatment of thromboembolic disorders cannot be used to predict success in the treatment of malignant disease.
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PMID:Antithrombotic effects of drugs which suppress platelet function: their potential in prevention growth of tumour cells. 705 Oct 35

Various neurologic and vascular injuries complicating the technique of tourniquet ischemia for limb surgery are well known. We found no reports of the serious complication of massive pulmonary embolism as a consequence of this technique. This is surprising when one considers the type of patients surgeons deal with in the use of the technique of tourniquet ischemia. These patients are traumatized and immobile, with high potential for development of deep venous thromboembolic disease, and are subjected to extensive extremity manipulation. Such patients are ideal candidates for the development of massive pulmonary embolism. We have encountered and successfully treated a patient with such a complication.
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PMID:Massive pulmonary embolism: a complication of the technique of tourniquet ischemia. 705 71

Two patients abruptly developed congestive heart failure and elevation in serum transaminase levels when given disopyramide phosphate; enzyme abnormalities and hemodynamic status corrected upon withdrawal of the drug. Both patients had underlying ischemic cardiomyopathy. Myocardial infarction, pulmonary embolism, and viral hepatitis were ruled out in both patients. One patient had a liver biopsy documenting central hepatic necrosis with congestion, consistent with hepatic ischemia and not toxic hepatitis. In the other patient, cardiac decompensation and hepatocellular enzyme elevation were reproduced on rechallenge with the drug. Disopyramide should be used with caution in patients with heart failure.
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PMID:Acute cardiac failure and hepatic ischemia induced by disopyramide phosphate. 722 41

Serious side effects of (OCs) oral contraceptives involve blood pressure, the kidneys, and urinary bladder, glucose and lipid metabolism, liver and gall bladder, blood coagulation, and the cardiovascular system. Causes for increased morbidity and mortality resulting from OCs are: venous thrombosis and pulmonary embolism, cerebrovascular ischemia and hemorrhage, as well as myocardial infarctions. Among the pathogenetic mechanisms responsible for vascular complications, a possible atherogenic effect of OCs is frequently discussed which might be mediated by adverse effects on blood pressure, glucose, and lipid metabolism, and by a direct lesion of the vascular wall. We compared past history, atherogenic risk factors, and coronary arteriograms of 9 young females with a history of acute myocardia infarctions on an OC regimen and 21 premenopausal women with advanced coronary atherosclerosis angiographically (of the same age). These observations suggest that myocardial infarctions during OC ingestion may occur in absence of coronary atherosclerosis and of atherogenic risk factors with the possible exception of cigarette smoking. The incidence of serious cardiovascular side effects from OCs is estimated from epidemiologic data, and therapeutic guidelines are derived. (authors' modified)
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PMID:[Cardiovascular side effects resulting from oral contraceptives]. 738 86

An experience of surgical non-thoracic emergencies in patients admitted for chronic lung disease is herein presented. Fifty-four patients out of 10457 admitted in the four Departments of Pneumology of the Binaghi Hospital (Cagliari) between 1-1-1985 and 31-3-1993, were referred to our Department of General Surgery due to non-thoracic surgical emergencies. There was a considerable delay in the referral (only 25% of patients within 12 hours from the onset of symptoms): indeed predominant respiratory symptoms, hypoxia and hypercapnia made these patients no responsive to symptoms of surgical emergency. Surgical emergencies in causal correlation with respiratory disease (intestinal occlusion due to abdominal metastases of lung carcinoma, complicated peptic ulcer) had the worst prognosis (mortality: 52.9%). Those in chance connection, such as acute limb ischemia and preexisting abdominal disease, had a less adverse outcome. Mortality, however, was 37.5%: this datum outlines the role of chronic lung disease in defining operative risk. The authors call attention to three groups of observed patients: 1) three patients were operated on for intestinal occlusion due to unrecognized abdominal neoplasia, that showed itself in the course of hospitalization in the Department of Pneumology for lung metastases; 2) in 3 cases symptoms and signs of acute abdomen were observed without abdominal disease. The cause of acute pseudoabdomen was diaphragmatic pleural or basal pulmonary inflammation; 3) the eight patients with pulmonary embolism were all admitted in the Department of Pneumology with a wrong diagnosis of bronchopneumonia.
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PMID:[Extrathoracic surgical emergencies in hospitalized patients with bronchopulmonary diseases. Analysis of the operative risk]. 780 66

Ischemia/reperfusion mechanisms contribute to lung injury after transplantation, pulmonary embolism, and resolution of atelectasis. Alveolar tissue becomes hypoxic and deprived of substrate only when both ventilation and perfusion are interrupted, a situation modeled in vivo by complete, unilateral lung collapse. Because previously hypoxic mitochondria may be an important intracellular source of superoxide and hydrogen peroxide (H2O2) during reperfusion and re-oxygenation, the authors, in this study, investigated whether mitochondrial H2O2 release changed as a result of lung hypoxia/hypoperfusion resulting from collapse. Mitochondria were isolated from hypoxic (previously collapsed) right or contralateral left rabbits' lungs and from control rabbits' lungs. Mitochondrial H2O2 release, a marker of superoxide production, was measured fluorometrically after incubation with or without 1 mmol/L cyanide and 0.1 mmol/L nicotinamide adenine dinucleotide. Mitochondrial recovery was determined by assaying succinate dehydrogenase activity in mitochondrial preparations and lung homogenates. Lung succinate dehydrogenase activity and mitochondrial recovery were comparable among groups. Calculated lung mitochondrial content did not change (control subjects: left 7.9 +/- 0.5, right 13.8 +/- 1.7; hypoxic: left 10.3 +/- 1.3, right 10.5 +/- 2.4, all mg mitochondrial protein/lung). Mitochondria released hydrogen peroxide at approximately 5.6 nmol/h/mg pro in buffer alone and 14.8 nmol/h/mg pro in buffer with cyanide and nicotinamide adenine dinucleotide. However, lung collapse and resulting hypoxia caused no change in mitochondrial number or capacity to release H2O2 in vitro. Based on these findings, it is suggested that other sources of reactive oxygen metabolites, including xanthine oxidase and activated neutrophils, contribute to the oxidant injury observed in this model.
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PMID:Hydrogen peroxide release by mitochondria from normal and hypoxic lungs. 794 83

This article reviews the most immediate postoperative complications after abdominal aortic aneurysm surgery. Acute limb ischemia, thromboembolism and pulmonary embolism, postoperative bleeding, and compartment syndrome are described with the associated nursing implications. Prosthetic graft problems are discussed and suggestions for prevention are offered.
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PMID:Abdominal aortic aneurysm surgery, Part II: Major complications and nursing implications. 796 Aug 61

Supraventricular tachycardia as a presenting sign of pulmonary embolism is unusual. A 31-year-old man with incomplete T11 paraplegia on the basis of spinal cord ischemia developed supraventricular tachycardia 37 days after surgery to repair an aortic tear. Subsequent work-up revealed evidence of multiple submassive pulmonary emboli, despite thromboembolism prophylaxis. Clinicians should maintain a high index of suspicion for thromboembolic events when faced with cardiac rhythm disturbances in high-risk patients.
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PMID:Pulmonary embolism presenting as supraventricular tachycardia in paraplegia: a case report. 823 64

Extremity tourniquets are widely used to achieve bloodless dissection in the surgical field. Excision of venous stasis ulcers (VSU) is aided by tourniquet use because of large dilated veins associated with venous stasis disease. We present 3 patients with hypotensive shock occurring 10 to 15 minutes after tourniquet release after excision of venous stasis ulcers. All patients had long histories of venous stasis changes and two-thirds had prior histories of deep vein thromboses and pulmonary embolism. Mean tourniquet inflation time was 34 minutes and there were electrocardiographic changes in two-third of the patients. All patients responded rapidly to standard resuscitation measures and in all 3 postoperative testing for pulmonary embolus and myocardial infarction was negative. Wound cultures revealed no organisms in 1 patient, mixed Gram-positive cocci in another, and greater than 10(5) Serratia marcescens in the third patient. Although small decreases in blood pressure and blood pH, and increases in blood lactate, PcO2, and creatinine phosphokinase, are normally associated with the use of extremity tourniquets, hypotensive shock has not been reported. The combined effect of tourniquet ischemia and venous stasis changes may cause hypotensive shock by (1) an endotoxic bolus upon tourniquet release, (2) pulmonary microembolization of platelet, fibrin, and leukocyte aggregates causing vasoactive substance release, and (3) synergistic effects of platelet-activating factor, a known mediator of endotoxic shock. The untoward events noted in these patients may be prevented by (1) proximal to distal dissection of the ulcer with initial ligation of large veins, (2) pretreatment with steroids and/or platelet-activating factor antagonists, and/or (3) slow release of the tourniquet.
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PMID:Tourniquet-related hypotension in venous stasis ulcer excision. 836 87


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