Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0034065 (pulmonary embolism)
 14,979 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Acute pulmonary thromboembolism produces a number of pathophysiologic derangements of pulmonary function. Foremost among these alterations is increased pulmonary vascular resistance. For patients without preexistent cardiopulmonary disease, increased pulmonary vascular resistance is directly related to the degree of vascular obstruction demonstrated on the pulmonary arteriogram. Vasoconstriction, either reflexly or biochemically mediated, may contribute to increased pulmonary vascular resistance. Acute pulmonary thromboembolism also disturbs matching of ventilation and blood flow. Consequently, some lung units are overventilated relative to perfusion (increased dead space), while other lung units are underventilated relative to perfusion (venous admixture). True right-to-left shunting of mixed venous blood can occur through the lungs (intrapulmonary shunt) or across the atrial septum (intracardiac shunt). In addition, abnormalities of pulmonary gas exchange (carbon monoxide transfer), pulmonary compliance and airway resistance, and ventilatory control may accompany pulmonary embolism. Thrombolytic therapy can reverse the hemodynamic derangements of acute pulmonary thromboembolism more rapidly than anticoagulant therapy. Limited data suggest a sustained benefit of thrombolytic treatment on the pathophysiologic alterations of pulmonary vascular resistance and pulmonary gas exchange produced by acute pulmonary emboli.
 ...
PMID:Pulmonary physiology during pulmonary embolism. 155 81

Four years after an HIV infection and without any preceding illness characteristic of AIDS, a 24-year-old woman developed dyspnoea on exertion and peripheral oedema. She had for several years been an intravenous drug addict and contracted hepatitis A and B. There were no symptoms of the HIV infection. Clinical, radiological and echocardiographic examination demonstrated right ventricular failure caused by pulmonary hypertension not due to pulmonary embolism or another known aetiology. The patient died suddenly 9 months after the diagnosis from heart failure. Autopsy established primary pulmonary hypertension with pathognomonic plexogenic pulmonary arterial disease which had led to cor pulmonale with overload myocarditis. Although there had been no clinical signs of renal failure, there was histological evidence of mesangioproliferative glomerulonephritis and non-destructive interstitial nephritis. This case demonstrates that, in addition to the typical AIDS-associated diseases, other rarer syndromes may, in uncertain ways but connected with the HIV infection, decide the prognosis of such patients.
 ...
PMID:[Primary pulmonary hypertension and mesangioproliferative glomerulonephritis in HIV infection]. 158 15

In the submitted case-history the authors describe the clinical case of an adolescent patient who developed phlebothrombosis of the right ileofemoral area one year after a blunt injury in the scrotal and right inguinal area. The symptoms of pulmonary embolism were detected sooner than the symptoms of phlebothrombosis. Two-dimensional echocardiography provided valuable information when the authors monitored the dynamics of changes in acute cor pulmonale and the effect of administered treatment.
 ...
PMID:[Pulmonary embolism as a rare complication of a contusion in the inguinal region]. 163 94

Emergency two-dimensional echocardiography was carried out in 61 patients admitted to an intensive care unit for suspected pulmonary embolism, in order to find out whether signs of acute cor pulmonale (ACP) were present or absent. Pulmonary angiography was subsequently performed to confirm or infirm the diagnosis of pulmonary embolism. Only 7 out of 13 patients with normal echocardiography had no pulmonary embolism. All other patients who showed echocardiographic signs of ACP had pulmonary embolism. Thus, the finding of normal echocardiographic results does not necessarily exclude a diagnosis of pulmonary embolism. Conversely, the presence of echocardiographic signs of ACP in a suggestive context provides a near-certain diagnosis of pulmonary embolism.
 ...
PMID:[Quantitative two-dimensional echocardiography in acute pulmonary embolism]. 183 33

One describes the clinical case of a patient suffering from massive pulmonary embolism under a state of shock who was successfully treated with APSAC 30 units in one single bolus. Thrombolytic agents provoke a rapid destruction of thrombi which lead to a very important and fast hemodynamic improvement. These agents have a great improving action, compared to heparin, in the alterations of pulmonary diffusion provoked by embolism. Most of the times, they also avoid surgery and the appearance of cor pulmonale. APSAC seems to be effective and secure.
 ...
PMID:[Pulmonary embolism. A propos of a case treated with APSAC]. 188 24

Between 1968 and 1988, 96 consecutive patients with acute massive pulmonary embolism underwent pulmonary embolectomy under cardiopulmonary bypass. The operative mortality rate was 37.5%. We analyzed 12 clinical and hemodynamic variables by univariate and multivariate analyses to assess the predictive factors of postoperative outcome. Multivariate analysis disclosed that cardiac arrest and associated cardiopulmonary disease were independent predictors of operative death. Long-term follow-up (range, 2 to 144 months; mean, 56 months) information was available for 55 of the 60 discharged patients: 6 had died, and 5 complained of persistent mild or severe exertional dyspnea (New York Heart Association class II). These results help assess the preoperative risk in patients undergoing pulmonary embolectomy. They also show that, in the few patients who do not benefit from optimal medical therapy, pulmonary embolectomy remains an acceptable procedure in view of the long-term results.
 ...
PMID:Pulmonary embolectomy: a 20-year experience at one center. 198 28

To determine the relationships between perfusion scan defect and angiographic severity (Miller index) in acute pulmonary embolism, we analysed examinations obtained before and after thrombolytic therapy in 34 consecutive patients free from underlying cardiopulmonary disease. The overall agreement between the two techniques was excellent (r = 0.82; mean absolute difference = 2.8%), although when embolic involvement was extensive (greater than 50% angiographic obstruction), the perfusion scan moderately underestimated (4%) the defect seen angiographically. These findings suggest that the pulmonary lung scan is a reliable method of assessing the initial pulmonary vascular obstruction as well as of quantifying any changes induced by or associated with the treatment.
 ...
PMID:Comparison of perfusion lung scanning and angiography in the estimation of vascular obstruction in acute pulmonary embolism. 212 70

From animal experiments (n = 10), the authors describe a new technique of pulmonary arterial angioscopy. A balloon-fitted catheter is introduced into the trunk of one of the pulmonary arteries. A small caliber angioscope with an end capable of being propped up is then pushed within the lumen of the catheter. Intraluminal visualization of the pulmonary artery and its branches cannot begin until after the balloon is inflated to arrest blood flow and the visualization chamber is cleared by sterile carbon dioxide. The quality of the image obtained is similar to that of bronchial endoscopy, making is possible to examine at length the walls of the proximal and distal pulmonary arteries up to a caliber of 2.5 mm, and to detect blood clots. Pulmonary angioscopy is tolerated to the same extent as right heart catheterization. Potential applications of this technique are diagnosis of chronic cor pulmonale and treatment of pulmonary embolism.
 ...
PMID:[A new technique of pulmonary arterial angioscopy: capnoangioscopy. An experimental study]. 214 83

The bronchial pulmonary system can be effected by obstructive diseases with and without emphysema. The onset of these affections may be an airway allergy. In case of other mechanisms, fibrotic processes can be observed accompanied by a lung compliance decrease. Lung circulation itself is rarely affected by the development of Cor pulmonale in a state after pulmonary embolism and after the so-called primary pulmonary high pressure. These disorders can be diagnosed properly without or scarcely straining the patient by spirometry which requires the patient's cooperation, however, and by body plethysmography which does not depend on cooperation, lung compliance measurements, arterial blood gases and inhalative provocation tests. If applied by experience staff, these reliable basic methods supply qualitative and quantitative information for the assessment of working capability that scarcely can be obtained on another organ.
 ...
PMID:[Diagnostic parameters for the evaluation of work capacity: the bronchopulmonary system]. 227 71

Since hypoxemia is not known to be a sensitive indicator of acute pulmonary embolism, we performed a retrospective study to determine whether an increased P(A-a)O2 gradient or hypocapnia improved the sensitivity of blood gas analysis in acute embolism. The study group consisted of 78 patients with angiographically documented emboli who had blood gas samples obtained while breathing room air. None had a prior history of cardiopulmonary disease. Hypoxemia was present in 59 patients (76 percent), hypoxemia or hypocapnia in 73 patients (93 percent), an increased P(A-a)O2 gradient in 74 patients (95 percent), and an increased P(A-a)O2 gradient or hypocapnia in 77 patients (98 percent). Only one patient with acute embolism showed a normal P(A-a)O2 gradient and normal PaCO2 breathing room air. These results suggest that a normal P(A-a)O2 gradient and a normal PaCO2 obtained in a patient during room air breathing can be used as evidence against the presence of pulmonary emboli.
 ...
PMID:Improved use of arterial blood gas analysis in suspected pulmonary embolism. 279 99


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>