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

Five cases of peripartum cardiomyopathy are presented. All patients were aged less than 35 years, and four were multiparous. Two cases followed twin deliveries. Pulmonary embolism was diagnosed in four patients. Electrocardiograms showed left ventricular hypertrophy or left bundle branch block. On echocardiography, left ventricular minor axis dimensions were increased (diastolic, 67 +/- 7 mm; systolic, 59 +/- 7 mm) and mean fractional shortening was reduced (13% +/- 5%). All patients had hypokinesis or akinesis of the left ventricular segments and two had right ventricular dilatation. Gallium scanning performed in three patients was negative. Viral serologic testing was negative in all cases. All patients died within 5 years, three within 5 months. Survival duration was closely correlated with left ventricular fractional shortening. Autopsy in three patients confirmed the diagnosis of a dilated cardiomyopathy.
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PMID:Peripartum cardiomyopathy: echocardiographic features in five cases. 372 77

Two cases of pulmonary embolism accompanied by syncope in patients with pre-existing left bundle branch block are reported. Contrary to classical descriptions, the syncopes in these two patients could not be ascribed to cardiovascular collapse, but several arguments (such as the clinical features of the syncope and its coexistence in one case with ECG evidence of complete atrio-ventricular dissociation) were in favour of a paroxysmal disorder of conduction. Right bundle branch block is known to be common in pulmonary embolism and may even be more frequent in patients with left bundle branch block. In such cases, sudden and transient arrest of conduction in the right bundle would complete the left bundle branch block, thus accounting for a paroxysmal atrio-ventricular block.
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PMID:[Paroxysmal atrioventricular block, cause of syncope in pulmonary embolism. 2 cases]. 622 89

A 61 year old man developed acute pulmonary embolism while in hospital. His previous and admission electrocardiograms (ECGs) showed a typical left bundle branch block (LBBB) pattern. Immediately after the onset of acute pulmonary embolism, LBBB disappeared from his body surface ECG with sinus bradycardia, normalisation of QRS duration, prolonged QT interval, and marked T abnormalities to the right precordial leads. Recovery from pulmonary embolism resulted in reappearance of his left bundle branch pattern. Delayed conduction of the previously unaffected right bundle branch resulting in roughly equivalent onset of ventricular activation is the most likely reason. Rate dependent LBBB is also discussed.
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PMID:Transient disappearance of left bundle branch block pattern: an unusual ECG presentation of acute pulmonary embolism. 1235 19

Pulmonary embolism (PE) is life-threatening disease, and sometimes clinical symptoms may be unspecific. We report a case of a previously healthy 70-year-old woman who presented syncope, chest pain, left bundle branch block on ECG and cardiogenic shock requiring vasopressor. Patient underwent cardiac catheterization for suspected acute coronary syndrome, however exam revealed normal arteries. Right side cardiac catheterization demonstrated elevate pulmonary artery pressure (50/37 mmHg) and angiography showed massive bilateral PE. An unsuccessful mechanically fragmentation was attempted, and patient died 6 hours later.
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PMID:Pulmonary arteriography for pulmonary embolism diagnosis: "Old-fashioned", but it is still a valuable diagnostic tool. 1764 36

Pulmonary embolism may result in permanent or transient electrocardiographic abnormalities. New onset left bundle branch block (LBBB) is usually associated with myocardial ischemia. However, nonischemic mechanisms are also known to account for some cases of LBBB. Tachycardia, a common finding in pulmonary embolism, is one such mechanism. This is illustrated by our case, and possible mechanisms for tachycardia-dependent LBBB are discussed. It is important to recognize and interpret the conditions that precipitate it, thereby avoiding inappropriate interventions.
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PMID:Transient left bundle branch block: an unusual electrocardiogram in acute pulmonary embolism. 1932 65

Approximately 1 percent of primary care office visits are for chest pain, and 1.5 percent of these patients will have unstable angina or acute myocardial infarction. The initial goal in patients presenting with chest pain is to determine if the patient needs to be referred for further testing to rule in or out acute coronary syndrome and myocardial infarction. The physician should consider patient characteristics and risk factors to help determine initial risk. Twelve-lead electrocardiography is typically the test of choice when looking for ST segment changes, new-onset left bundle branch block, presence of Q waves, and new-onset T wave inversions. For persons in whom the suspicion for ischemia is lower, other diagnoses to consider include chest wall pain/costochondritis (localized pain reproducible by palpation), gastroesophageal reflux disease (burning retrosternal pain, acid regurgitation, and a sour or bitter taste in the mouth), and panic disorder/anxiety state. Other less common but important diagnostic considerations include pneumonia (fever, egophony, and dullness to percussion), heart failure, pulmonary embolism (consider using the Wells criteria), acute pericarditis, and acute thoracic aortic dissection (acute chest or back pain with a pulse differential in the upper extremities). Persons with a higher likelihood of acute coronary syndrome should be referred to the emergency department or hospital.
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PMID:Outpatient diagnosis of acute chest pain in adults. 2341 61

The differential diagnosis of ST-segment elevation includes four major processes: ST-segment elevation myocardial infarction (STEMI); early repolarization; pericarditis; and ST elevation secondary to an abnormality of the QRS complex (left bundle branch block, left ventricular hypertrophy, or preexcitation). Other processes that may be associated with ST elevation include hyperkalemia, pulmonary embolism, and Brugada syndrome. The clinical setting and specific electrocardiographic criteria often allow identification of the cause. This article reviews ST-T and QRS configurations specific to each diagnosis.
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PMID:ST-segment elevation: Differential diagnosis, caveats. 2608 96

Isolated left ventricular non-compaction is a rare disease classified as a primary genetic cardiomyopathy and is characterized by heart failure, systemic embolism and ventricular arrhythmias. The diagnosis is established by Doppler echocardiography. We report the case of an asymptomatic young adult, with no history of heart disease, who underwent preoperative assessment for low-risk orthopedic surgery. The electrocardiogram showed left bundle branch block, which prompted further investigation with Doppler echocardiography, cardiac computed tomography angiography and cardiac magnetic resonance imaging. A diagnosis of isolated left ventricular non-compaction and pulmonary embolism was made. Some aspects of preoperative assessment in low-risk surgical patients are discussed.
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PMID:Two potentially fatal surprises in the preoperative assessment of an asymptomatic young adult. 2711 95

Episodic (transient/ intermittent) left bundle branch block (LBBB) has been associated with different conditions such as bradycardia, tachycardia, anesthesia, acute pulmonary embolism, changes in intrathoracic pressure, chest trauma, cardiac interventional procedures, mad honey poisoning, and in other clinical settings. Of note, exclusion of an acute coronary syndrome in the setting of episodic LBBB is of great importance. Moreover, episodic LBBB is sometimes symptomatic and may be associated with left ventricular systolic and/or diastolic dysfunction or conduction disturbances leading to syncope. This review article provides a comprehensive overview of the conditions associated with episodic LBBB and discusses the clinical impact of this phenomenon.
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PMID:Episodic Left Bundle Branch Block-A Comprehensive Review of the Literature. 2729 5

A rapid diagnosis of ST-segment elevation myocardial infarction (STEMI) is mandatory for optimal treatment of an acute coronary syndrome. However, a small number of patients with suspected STEMI are afflicted with other medical conditions. These medical conditions are rare, but important clinical entities that should be considered when evaluating a STEMI alert. These conditions include coronary vasospasm, Takotsubo cardiomyopathy, coronary arteritis/aneurysm, myopericarditis, Brugada syndrome, left bundle branch block, early repolarization, aortic dissection, infective endocarditis with root abscess, subarachnoid hemorrhage, ventricular aneurysm after transmural myocardial infarction, and hemodynamically significant pulmonary embolism with right ventricular strain. Herein, we present several STEMI mimickers.
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PMID:ST-segment Elevation: Myocardial Infarction or Simulacrum? 2814 16


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