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)

During the acute phase of myocardial infarction, two groups of patients are observed. Patients in the first group have no significant complications, and approximately 95 per cent of these patients recover fully without any specific therapy. Patients in the second group may have various complications, some of which are benign, whereas others may lead to a fatal outcome. The complications may be divided into four major types: 1. Cardiac arrhythmias and conduction defects. The tachyarrhythmias and bradyarrhythmias are the most frequently encountered complications in patients with acute myocardial infarction. Tachyarrhythmias include ventricular premature beats, ventricular tachycardia, ventricular fibrillation, supraventricular tachycardia, atrial flutter, and atrial fibrillation. Bradyarrhythmias include sinus and junctional bradycardia and various degrees of heart block. Those patients who are unable to reach a hospital and die suddenly presumably succumb to ventricular fibrillation. 2. Left ventricular failure and cardiogenic shock. In more than 33 per cent of patients with acute myocardial infarction, a third heart sound and pulmonary rales may be heard. If they are present for only 24 hours, the physical findings may indicate an alteration of left ventricular failure. However, if they persist for a few days and disappear after medical therapy, mild left ventricular failure may be present. About 12 per cent of patients have acute pulmonary edema, and 10 per cent of patients develop cardiogenic shock. These two complications carry a high mortality rate (40 per cent and nearly 100 per cent respectively). 3. Rupture of the heart. Cardiac rupture may occur in the free wall, ventricular septum, and papillary muscles. These complications, although less frequently encountered, cause a number of deaths in patients with acute myocardial infarction. 4. Thromboembolism. Under this category are included pulmonary embolism, systemic arterial embolism, and systemic venous thrombosis.
 ...
PMID:The acute phase of myocardial infarction. 110 71

Since July 1982, this noninvasive vascular laboratory has performed 12,856 lower extermity venous duplex examinations. All cases of acute venous thrombosis have been categorized and entered into a computer data base. One thousand four hundred twelve examinations were positive for acute venous thrombosis. This report analyzes the laboratory's entire experience with superficial thrombophlebitis (SVT). One hundred eighty-six patients were diagnosed by duplex scanning to have SVT. Women outnumbered men 99 to 87. They were slightly older (average age 58.4 +/- 16.2 years) compared with the men (53.8 +/- 14.2 years). Men were more likely to have a complicated course of SVT (40% vs 22%; p less than 0.01). Complications included either radiographically documented pulmonary embolism or deep venous involvement. Fifty-seven (31%) patients had at least one complication of SVT. A series of predisposing factors was analyzed and six factors were associated with an increased risk of complications. They are bilateral SVT (p less than 0.01), age greater than 60 years (p less than 0.01), male sex (p less than 0.01), history of deep venous thrombosis (p less than 0.01), bed rest (p less than 0.02), and presence of infection (p less than 0.02). Location of thrombus within the greater saphenous vein (35%) was most likely to be associated with complications. Isolated varicosities (8%) were least likely to be associated with complications. Duplex scanning identifies a significant number of complications of patients with SVT and should be obtained in cases of saphenous vein involvement or in the presence of associated risk factors.
 ...
PMID:Superficial thrombophlebitis diagnosed by duplex scanning. 186 93

Transcatheter direct-current ablation of the atrio-ventricular junction is a recently developed technique in the treatment of medically refractory supraventricular tachycardia. Twenty patients underwent this procedure between July 1987 and May 1989 and were followed-up for a mean period of 8.3 +/- 6 months (range 1-23). Indication for ablation included atrial flutter in 4 patients, atrial fibrillation in 8, atrial tachycardia in 1, atrio-ventricular nodal re-entrant tachycardia in 4, atrioventricular re-entrant tachycardia (concealed pathway) in 2, permanent junctional reciprocating tachycardia in 1. These arrhythmias were resistant to a mean of 3.3 +/- 1.7 antiarrhythmic drugs. A mean of 1.4 +/- 0.59 (range 1-3) electrical shocks, with a mean energy of 285 +/- 135J (range 200-700), were delivered during 1-2 sessions. In all patients a persistent complete atrio-ventricular block was achieved. Immediate complications included transient hypotension in 2 pts, acute pulmonary edema in 1, premature ventricular complexes in 4, non sustained ventricular tachycardia in 4, sustained ventricular tachycardia in 1. Late complications included thrombophlebitis of the right femoral vein in 2 pts; one of them died suddenly as a result of massive pulmonary embolism 10 days after the procedure. Follow-up evaluation reveals chronic complete atrio-ventricular block in all patients. Symptoms related to pre-existing arrhythmia are absent in all pts and none of them is currently taking antiarrhythmic drugs. Two patients with DDD pacing had pacemaker mediated re-entrant tachycardia and 1 patient with VVIR pacing developed a pacemaker syndrome. This experience confirms that transcatheter fulguration of atrio-ventricular junction is an effective technique. However, possible severe complications related to the procedure suggest this approach be restricted to patients with very symptomatic and drug-refractory supraventricular tachyarrhythmias.
 ...
PMID:[Transcatheter fulguration of the atrioventricular junction in supraventricular hyperkinetic arrhythmia. Immediate and long-term results]. 232 75

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.
 ...
PMID:Entanglement of embolised thrombus with an endocardial lead causing pacemaker malfunction and subsequent pulmonary embolism. 356 90

Pulmonary embolism is a major complication after spinal cord injury and difficult to diagnose in any patient. Supraventricular tachycardia (SVT) is an unusual presentation for pulmonary embolism (PE). This article documents the records of a 60-year-old patient who was undergoing comprehensive rehabilitation after traumatic spinal cord injury and multitrauma. His treatment programme was interrupted by a PE with SVT as the only presenting symptom. This article outlines the clinical approach to the diagnosis of pulmonary embolism. A high index of suspicion of PE should always be kept in mind when SVT occurs in a spinal cord injured patient.
 ...
PMID:Supraventricular tachycardia as a presenting sign of pulmonary embolism in paraplegia. Case report and review. 763 Jun 55

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.
 ...
PMID:Pulmonary embolism presenting as supraventricular tachycardia in paraplegia: a case report. 823 64

Syncope is a frequent clinical event. It is mainly caused by a suddenly reduced cerebral blood flow. There are two reasons for sudden cerebral underperfusion: cardiogenic - associated with cardiac disorders and neurocardiogenic - resulting from a sudden fall of arterial blood pressure due to impaired autoregulation of the circulation. Cardiogenic syncopes prevail in cardiac diseases associated with impaired blood flow and cardiac arrhythmias. They develop in aortic stenosis, hypertrophic cardiomyopathy, atrial myxoma, myocardial infarction, pulmonary embolism, cardiac tamponade. Cardiac arrhythmias associated with syncope include ventricular tachycardia, supraventricular tachycardia in the preexcitation syndrome, sinus bradycardia, II degrees and III degrees atrioventricular block, atrial fibrillation with rapid ventricular response. The prognostic value and pathomechanisms loss of consciousness in these disease states have been discussed. Neurocardiogenic syncopes include vasovagal syncope, carotid sinus syndrome, orthostatic hypotension, event-induced syncope. It is frequently difficult to establish the reason for syncope. Physical examination and a history should be taken first followed by noninvasive studies such as standard ECG, exercise testing, carotid sinus compression, Holter monitoring, tilt testing, signal-averaged ECG. Noninvasive diagnosis helps establish the cause of syncope in 53-62% of cases and is indispensable before proceeding to electrophysiological testing. Such testing should be limited to patients with organic heart disease, in whom previous examinations did not reveal the etiology of loss of consciousness.
 ...
PMID:[Syncope as a cardiologic problem]. 892 55

Thrombophlebitis of the superficial veins (SVT) of the leg is usually regarded as a mild and uncomplicated disease. Although this is generally true for acute thrombosis of the branches of the saphenous vein, the natural history of SVT involving the main trunk may not be as benign. The association of SVT with deep venous thrombosis (DVT) has been reported to range from 17 to 40%; the progression of the thrombotic process from the greater saphenous vein into the deep venous system has been reported in 8.6% of the cases. For this reason, even if symptoms of DVT are lacking, it is necessary to use duplex ultrasonography to be certain that DVT does not exist concurrently with SVT. In a recent study we found that saphenous-vein thrombi embolize even when no femoral-vein involvement is evident. Of 21 patients included in the study, findings compatible with a high probability of pulmonary embolism were detected in 7 (33.3%, 95% CI, 14.6 to 57.0), although clinical symptoms were present only in 1. The risk of pulmonary embolism is similarly high in patients with and without thrombosis at the sapheno-femoral junction. These patients presumably would benefit from anticoagulation, but such a benefit remains to be proven. Superficial thrombophlebitis, in the absence of DVT proven by duplex ultrasonography, is generally treated with nonsteroidal anti-inflammatory agents. A prospective randomized study is being carried out at our Institution evaluating therapeutic doses of anticoagulant drugs in SVT. Interim report suggests that, in thrombophlebitis of the thigh, high fixed doses of unfractioned heparin are more effective than low doses for the prevention of early and late venous thromboembolic complications and are not associated with an appreciable bleeding risk.
 ...
PMID:[Superficial thrombophlebitis]. 1125 44

Two patients in the prehospital setting died immediately after receiving adenosine for presumed supraventricular tachycardia. Both patients' cardiac rhythms were atrial fibrillation rather than supraventricular tachycardia, and their unstable conditions resulted from underlying diseases-chronic obstructive pulmonary disease and pulmonary embolism-rather than the tachycardia. Misinterpretation of the cause of tachycardia as well as the electrocardiographic findings may be responsible for adverse outcomes.
 ...
PMID:Two deaths after prehospital use of adenosine. 1148 13

Superficial thrombophlebitis (SVT)is a common disorder with potential morbidity from recurrence and pulmonary embolism (PE), but it has received little attention in the literature. The availability of reliable duplex ultrasonography of the deep and superficial venous systems has made routine determination of the location and incidence of deep vein thrombosis (DVT) in association with SVT practical.
 ...
PMID:Superficial vein thrombophlebitis as a marker of hypercoagulability. 1245 32


1 2 Next >>