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

The results of ventilation-perfusion (V-Q) imaging and pulmonary angiography were retrospectively analyzed in 146 patients with suspected pulmonary embolism (PE) to define the frequency of PE associated with various scintigraphic patterns. When the radionuclide images demonstrated at least two moderate-sized or one large area of V-Q mismatch, the probability of PE was 92%. However, only one of three patients with a single moderate-sized V-Q mismatch had PE, while small V-Q mismatches were not associated with PE in any of 19 patients. Matched V-Q abnormalities in lung regions that were radiographically normal were infrequently due to PE (4.8%). When a perfusion defect was substantially smaller than a corresponding radiographic abnormality, the frequency of PE was low (7.7%). Conversely, when a perfusion defect was substantially larger than the corresponding radiographic abnormality, there was a high probability of PE (87%). Matched perfusion and radiographic abnormalities indicated an intermediate probability of PE (27%). Patients with suspected pulmonary embolism may be classified into groups with low, intermediate, or high probability of pulmonary embolism on the basis of size and number of perfusion defects and a careful comparison of perfusion defects with ventilatory and radiographic findings.
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PMID:Ventilation-perfusion studies in suspected pulmonary embolism. 11 91

Following the findings of a primary sarcoma of the pulmonary artery and its angiographic demonstration, a search was made of the literature for this rare condition. Angiography is usually performed because a pulmonary embolism is suspected. It is best to inject contrast medium into the right atrium or ventricle. If an unusually large defect is demonstrated in the pulmonary artery, a primary malignant neoplasm should be considered in the differential diagnosis, particularly if the mass projects into the outflow tract of the right ventricle.
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PMID:[The angiographic demonstration of a primary sarcoma of the pulmonary artery]. 12 57

Electrocardiograms of 90 patients with arteriographically documented acute submassive or massive pulmonary embolism and no associated cardiac or pulmonary disease were studied. Patients were derived from the Urokinase-Pulmonary Embolism Trial National Cooperative Study. In massive embolism, the electrocardiogram was normal in 6 per cent (3 of 50) of patients. With submassive embolism, 23 per cent of patients (9 of 40) had a normal electrocardiogram. Since one or more of the traditional manifestations of acute cor pulmonale (S1Q3T3, right bundle branch block, P pulmonale, or right axis deviation) occurred in only 26 per cent of patients, one could not rely exclusively upon these electrocardiographic abnormalities for the diagnosis of pulmonary embolism. The most common electrocardiographic abnormalities were nonspecific T wave changes which occurred in 42 per cent of patients and nonspecific abnormalities (elevation or depression) of the RST segment which occurred in 41 per cent of patients. Left axis deviation occurring in 7 per cent of the patients was as frequent as right axis deviation. Low voltage QRS complexes, previously undescribed in pulmonary embolism, occurred in 6 per cent of patients. None of the patients had atrial flutter or atrial fibrillation, which appears to occur more typically in patients with pulmonary embolism who have preexistent cardiac disease. All of the varieties of electrocardiographic abnormalities disappeared in some of the patients by 2 wk. Inversion of the T wave was the most persistent abnormality. Larger defects on the lung scan or pulmonary arteriogram occurred in patients with various abnormalities on the electrocardiogram than in patients with normal electrocardiograms. The pulmonary arterial mean pressure and/or right ventricular end-diastolic pressure was significantly higher in patients with several varieties of abnormal electrocardiograms, although the partial pressure of oxygen in arterial blood, in general, did not differ from that in patients with normal electrocardiograms. These hemodynamic correlations, made for the first time in patients, suggest that acute ventricular dilatation, possibly in combination with hypoxemia, is a causative factor of the electrocardiographic changes in acute massive or submassive pulmonary embolism.
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PMID:The electrocardiogram in acute pulmonary embolism. 12 74

Pulmonary microembolism of microaggregates associated with massive blood transfusion may be a cause of post-traumatic pulmonary embolism. The purpose of this study was to investigate in the dog the influence on certain physiologic parameters of transfusion of blood containing platelet: white blood cell: fibrin (PWF) aggregates and to evaluate the effects of using blood transfusion filters of varying pore sizes during such transfusions. Exchange transfusions of approximately twice blood volume were performed in three groups of animals. Screen filtration pressure measurements verified the presence of large numbers of PWF aggregates in the transfusions. When no transfusion filters or standard commercially available blood transfusion filters of pore size 170 mu were used, experimental animals developed pulmonary hypertension, a decrease in total body 92 consumption, and metabolic acidosis. Interposition of Dacron wool (Swank) blood transfusion filters prevented these changes.
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PMID:Pulmonary microembolism associated with massive transfusion: I. Physiologic effects and comparison in vivo of standard and dacron wool (swank) blood transfusion filters in its prevention. 12 40

From September 1962 to May 1972 145 patients with acute or subacute deep vein thrombosis confirmed by phlebography were treated with streptokinase. During the same period 42 patients considered unfit for thrombolytic therapy were treated with herapin and oral anticoagulants. The results, assessed by repeat phlebography, in 93 of the patients treated with streptokinase were compared with those in 42 patients treated with heparin. The age, sex, and severity of occlusion were roughly similar in both groups. Streptokinase treatment was successful in 42 per cent, partially successful in 25 per cent, and unsuccessful in 32 per cent of the 93 patients compared with none, 10 per cent, and 88 percent respectively in the 42 patients treated with heparin. Streptokinase was more effective when the thrombus was in proximal rather than calf veins. Thrombi of more than six days old were readily lysed. Plasma fibrinogen levels were below 0-8 g/1 (80 mg/100 ml) in nearly all patients successfully treated. The incidence of pulmonary embolism was no greater with streptokinase than with heparin treatment. Only prolonged follow-up would show whether thrombolytic treatment would be effective in preventing late complications of deep vein thrombosis such as chronic venous insufficiency.
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PMID:Treatment of deep vein thrombosis with streptokinase. 12 6

Venous thrombosis is often asymptomatic in patients in whom major pulmonary embolism develops. When used expectantly, iodine 125-labeled fibrinogen scanning is a very sensitive method for detecting subclinical leg vein thrombi. Fibrinogen scanning is less useful for the diagnosis of established venous thrombosis, but is valuable for detecting extension of venographically diagnosed calf vein thrombosis. The technique is safe if fibrinogen is obtained from carefully screened donors. The limitations of the method include its inability to distinguish between superficial and deep venous thrombi, and its sensitivity to fibrin in hematoma and inflammatory exudates. Though the results agree closely with those of phlebography, scanning seems less reliable for detecting femoral vein than calf vein thrombi and is insensitive to thrombi above the inguinal ligament. Screening for these major thrombi may be improved by combining fibrinogen scanning with impedance plethysmography or ultrasonic examination.
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PMID:125-I-labeled fibrinogen scanning. Use in the diagnosis of venous thrombosis. 12 51

The infarction of the right ventricle as a spatial and temporal mosaic-infarct and the lesions following it were investigated. Its frequency and its connections with the infarction of the left ventricle, coronary sclerosis and hypertrophy of the right ventricle as cor mitrale and cor pulmonale were reported, treated on 11 073 post-mortem examinations of adults separated in males and females. Three groups were divided: 1. isolated lesions of the right ventricle 2. separated lesions--spatially and/or temporally of the right and left ventricle 3. lesions overlapping from the left on the right ventricle. The infarct of the right ventricle respectively cicatrices were observed in 1.2%. The coronary sclerosis was detected in all cases, and specially the hypertrophy of the right ventricle as cor pulmonale or cor mitrale were important for the pathogenesis of right-cardiac infarcts. The pulmonary embolism was more frequent in isolated infarcts of the right ventricle.
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PMID:[The infarction of the right ventricle and the connections with coronary sclerosis and chronic cor pulmonale (author's transl)]. 13 80

A family is described in which the mother and three of seven children had atrial myxoma. The mother had biatrial myxoma; surgical treatment resulted in massive intraoperative embolization and death. Surgery was sucessful in two sons with left atrial myxoma and systemic arterial embolization. A third son had calcified right atrial myxoma with destruction of the tricuspid valve and episodes of syncope and pulmonary embolism; surgery including valve replacement, was successful. The mother's father and a brother had died suddenly without a definite diagnosis. The family data are consistent with dominant transmission. The possibility of finding affected relatives should be borne in mind when studying patients with atrial myxoma.
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PMID:Atrial myxoma in a family. 13 7

Twenty-seven cases of ruptured chordae tendineae have been discovered during surgery for mitral regurgitation (9,3 %) : the highest incidence of ruptured chordae tendineae has been found among pure mitral insufficiency (36 %). In thirteen cases, the rupture was isolated, without any other valvular lesion. The syndrome described as characteristic of rupture was present in one third of our patients : isolated cases do not differ clinically from the others but for a more frequent acute evolution. In pure or predominant mitral regurgitation, surgery seems needed when clinical aggravation, acute or progressive, cannot be explained by arrhythmia, anaemia, pulmonary embolism, hyperthyroidism.
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PMID:[Rupture of the mitral chordae tendinae]. 13 12

The relationship between factor VIII (AHF) procoagulant activity and factor VIII-related antigen were examined in patients with disseminated intravascular coagulation (DIC), pulmonary embolism (PE), and coronary artery disease with or without myocardial infarction (MI). It was found that 13 of 13 patients with DIC, 17 of 17 patients with PE, and 10 of 12 patients with MI possessed a significantly elevated factor VIII-related antigen to factor VIII activity ratio (VIII-ratio). The VIII-ratio returned to normal in each of 2 patients with DIC and 1 paitent with PE after treatment with heparin, heparin and alpha-amino-caproic acid, and heparin and coumadin respectively. In contrast, the VIII-ratio was slightly elevated only in 1 of 15 patients with coronary artery insufficiency without MI. In in vitro studies, after treatment of plasma with thrombin or plasmin, factor VIII activity was lost, whereas the amount of factor VIII-related antigen remained the same or was even increased when measured by agarose quantitative immunoelectrophoresis. These observations have led us to conclude that an elevated VIII-ratio is a very sensitive indicator of intravascular coagulation.
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PMID:In vivo and in vitro effects of thrombin and plasmin on human factor VIII (AHF). 13 71


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