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

Primary pulmonary hypertension is a progressive disease. Most affected patients are young and middle-aged women. Etiology is unknown, although a familial and genetic factor is present in up to 6% of cases. Endothelial dysfunction and abnormalities in calcium channels of smooth muscle fibers are the present pathogenetics theories. Diagnostic tests try to exclude secondary causes of pulmonary hypertension and to evaluate its severity. Acute vasodilatory test is vital in the selection of treatment. Oral anticoagulation is indicated in all patients. Lung transplant is performed when medical treatment is unsuccessful. Atrial septostomy is an alternative and palliative treatment for selected cases. Chronic thromboembolic pulmonary hypertension is a special form of secondary pulmonary hypertension, clinically undistinguishable from primary primary hypertension, is of mandatory diagnosis because it can be cured with thromboembolectomy. Pulmonary embolism is common in hospitalised patients. The mortality rate for pulmonary embolism continues to be high: up to 30% in untreated patients. The accurate detection of pulmonary embolism remains difficult, as pulmonary embolism can accompany as well as mimic other cardiopulmonary illnesses. Non-invasive diagnostic tests have poor specificity and sensitivity. The D-dimer level and the spiral CT angiography have also been employed as new alternatives and important tools for precise diagnosis of suspected pulmonary embolism. The standard therapy of pulmonary embolism is intravenous heparin for 5 to 10 days in conjunction with oral anticoagulants posteriorly for 3 to 6 months. The incidence of deep venous thrombosis, pulmonary embolism and death due to pulmonary embolism, can be reduced significantly and shown clear benefits only by adoption of a prophylactic strategy with low-molecular-weight-heparins or dextrans in patients at risk.
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PMID:[Clinical practice guidelines of the Spanish Society of Cardiology for pulmonary thromboembolism and hypertension]. 1153 93

Reports regarding the question of whether oral contraceptive (OC) use enhances the risk of cancer or one of several serious cardiovascular disorders, i.e., thromboembolic disease, stroke, and myocardial infarction are reviewed. In 1974 the Royal College of General Practitioners (RCGP) issued an interim report of a large prospective study involving 46,000 women. The study found a 5-fold increase in the risk of deep venous thrombosis among women taking OCs. Laboratory studies have tried to establish a direct causal relationship between OC use and altered hemostatis. In review of these studies, Bingel and Benoit reported an increased incidence of thromboembolism in OC users with blood group A. Other hemostatic alterations in OC users were also noted. Other investigators have examined the effect of OCs on antithrombin 3. In 1 study, the inhibitory activity of antithrombin 3 on factor X was significantly reduced among 57 women using the combined OCs, but there was no substantial difference in the quantity of antithrombin 3 in these women as compared with 48 women in the control group. In 1 retrospective case control study of 60 surgical patients with complications of pulmonary embolism or venous thrombosis, the risk of postoperative thromboembolism was 6.7 times greater in OC users than in 97 well matched surgical controls. The RCGP study showed that the risk of cerebrovascular disease in women using OCs was 4 times greater than in nonusers. This finding was substantiated by the Boston-based Collaborative Group for the Study of Stroke in Young Women, which observed a 2-fold increase in risk for all types of stroke among OC users. Several studies have demonstrated that serum lipids are higher in women who use OCs than in those who do not, with estrogen being implicated as the cause of the elevation. Other studies have attempted to link serum lipid elevations to myocardial infarction, but the association is unclear. Both epidemiological and laboratory studies have implicated OCs in the genesis of essential hypertension. Several studies have examined mortality trends associated with OC use. In 1 analysis of data from 21 countries, women between 15 and 44 years of age were found to have a 3-fold to 5-fold increase in cardiovascular mortality that was associated with OC use. The principle evidence that suggested a possible link between OCs and breast carcinoma derived from experiments in laboratory animals. There is no conclusive evidence that OCs cause breast cancer in humans. The association between OC use and endometrial cancer is also inconclusive at this time. A marked increase in the incidence of hepatic adenomas among OC users has also been noted recently. The following other effects associated with OC use are reviewed briefly: glucose tolerance tests; birth defects; gallbladder disease; postpill amenorrhea; laboratory tests; and drug activity. Absolute and relative contraindications for OC use are listed.
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PMID:Oral contraceptive risks: a realistic appraisal. 1227 76

MicroRNAs (miRNAs) are a novel class of small, non-coding, single-stranded RNAs that negatively regulate gene expression via translational inhibition or mRNA degradation followed by protein synthesis repression. Many miRNAs are expressed in a tissue- and/or cell-specific manner and their expression patterns are reflective of underlying patho-physiologic processes. miRNAs can be detected in serum or in plasma in a remarkably stable form, making them attractive biomarkers for human diseases. This review describes the progress of identifying circulating miRNAs as novel biomarkers for diverse cardiovascular diseases, including acute myocardial infarction, heart failure, coronary artery disease, diabetes, stroke, essential hypertension, and acute pulmonary embolism. In addition, the origin and function and the different strategies to identify circulating miRNAs as novel biomarkers for cardiovascular diseases are also discussed. Rarely has an opportunity arisen to advance such new biology for the diagnosis of cardiac diseases.
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PMID:Circulating microRNAs: novel biomarkers for cardiovascular diseases. 2215 51

Pheochromocytoma during pregnancy is extremely rare. Its clinical manifestation includes hypertension with various clinical presentations, possibly resembling those of pregnancy-induced hypertension. The real challenge for clinicians is differentiating pheochromocytoma from other causes of hypertension (preeclampsia, gestational hypertension, and pre-existing or essential hypertension), from other cause of pulmonary edema (preeclampsia, peripartum cardiomyopathy, stress or Takotsubo cardiomyopathy, pre-existing cardiac disease [mitral stenosis], and high doses betamimetics), and from other causes of cardiovascular collapse (pulmonary embolism, and amniotic fluid embolism). Although, several cases of pheochromocytoma during pregnancy have been published, fetal and maternal mortalities due to undiagnosed cases are still reported. We report a case of a patient whose delivery by cesarean section was complicated by severe hemodynamic instability resulting in a cardiac arrest. Later on, pheochromocytoma was suspected based on computed tomography (CT) scan findings. Diagnosis was confirmed with special biochemical investigations that showed markedly elevated catecholamines in urine and metanephrines in serum, and later by histopathology of the excised left adrenal mass. This case illustrates the difficulty of diagnosing pheochromocytoma in pregnancy and raises the awareness to when this rare disease should be suspected.
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PMID:Cardiorespiratory crisis at the end of pregnancy: a case of pheochromocytoma. 2418 Jan 71