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

The diagnosis of pulmonary embolism was established during a 6-year period in 284 patients hospitalized in medical departments of a general hospital. Of the 183 patients who died, 178 were autopsied. A retrospective study was performed on the autopsy-verified fatal cases to correlate their clinical state to relevant postmortem findings. Two groups made thorough, independent evaluations of data from the medical and pathological records. In 95% of the patients a confirmed fatal pulmonary embolism constituted only a slight modification of life expectancy, because of concomitant complicating, severe, terminal disease. Reflecting this poor clinical state, only 26 patients (15%) had a diagnosis of pulmonary embolism premortally and of these patient, 13 died within 5 hours after onset of symptoms and 10 were treated with antithrombotic drugs. Our results seem to indicate an increase in the incidence of terminal diseases in the population of elderly, hospitalized patients and change the concept of fatal pulmonary embolism into an agonal incident in a terminal-care medical patient.
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PMID:178 fatal cases of pulmonary embolism in a medical department. 724 71

An elderly patient suffered a cardiac arrest while undergoing repair of a pathological femoral fracture. Intraoperative transoesophageal echocardiography demonstrated massive pulmonary embolism. Pulmonary embolectomy was considered inappropriate in view of her underlying terminal disease, so a decision was made to withdraw all further supportive measures. Despite this, the patient's haemodynamics improved spontaneously. The embolic material was presumed to be bone marrow fat. Fat may traverse the pulmonary circulation; hence the clinical consequences (and management implications) of massive intraoperative pulmonary embolism may vary, depending on the composition of the embolic material. As there are no reliable means of determining the composition of embolic material intraoperatively, the clinical suspicion of fat embolism poses a management dilemma. Should these cases be managed surgically or conservatively?
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PMID:Massive intraoperative pulmonary embolism: it may not be as bad as it looks.... 1691 53