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

Acute coronary syndrome, with an estimated prevalence of 300 000 cases annually in France, is one of the principal diagnostic and therapeutic emergencies in atheroma. In cases of atypical chest pain, with or without signs of severity, coronary, aortic and pulmonary CT should allow emergency specialists to rule out rapidly diagnoses of coronary disease, pulmonary embolism, aortic dissection or other chest conditions. Should acute coronary syndrome develop after immediate therapeutic management, a cardiac MRI will provide the cardiologist with the additional data necessary to assess the patient's prognosis--especially by assessing myocardial viability--and decide on subsequent management. In cases of acute coronary syndrome with normal coronary angiography, cardiac MRI can distinguish myocardial infarction from myocarditis or from Tako Tsubo syndrome.
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PMID:[Cardiac CT and MRI in acute coronary syndrome]. 1831 1

Acute coronary syndrome most commonly begins with atherosclerotic plaque rupture and intracoronary thrombus formation. Therefore, the primary goal of treatment for acute coronary syndrome is the achievement of early and complete reperfusion. The diagnosis of acute myocardial infarction (AMI) is made from typical symptoms, characteristic rises in serum enzyme levels, and changes in the electrocardiographic pattern. Although rapid developments in technology in the field of serum biomarkers have redefined the diagnosis of AMI, the electrocardiogram still remains significant in the diagnosis of AMI. Moreover, the identification of high-risk subgroups based on the admission electrocardiogram is essential to estimate the severity of AMI. Pulmonary embolism is an another thromboembolic disorder leading to mortality worldwide. The relationship between deep vein thrombosis and pulmonary embolism has been emphasized. The early detection of free-floating deep venous thrombosis by venous ultrasonography of the lower extremities is critical to prevent pulmonary embolism. For the detection of atherosclerosis, the identification of myocardial necrosis and thrombi by imaging tests is important. This paper reports the clinical usefulness of various noninvasive diagnostic approaches in cardiovascular disease.
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PMID:[Clinical significance of physiological function testing in cardiovascular disease]. 2007 24

A variety of diseases cause chest pain. Some entities such as acute coronary syndrome, aortic dissection, and pulmonary embolism are Life-threatening and immediate medical interventions may be required. Acute coronary syndrome is a disease due to disruption of plaque in coronary arteries. The echocardiography can be utilized to diagnose these situation by detecting wall motion abnormalities. Aortic dissection occurs when a tear in the inner wall of the aorta causes blood to flow between the layers of the wall and force the layers apart. The diagnosis can be made by pointing out the intimal flap by echocardiographic examination. A pulmonary embolism is a sudden blockage in a lung artery, which usually caused by a blood clot in a deep vein thrombosis. The echocardiography can prove the existence of pulmonary hypertension and right ventricular over loading. When one performs echocardiography in patients with chest pain in the emergency room, it is important to observe patient's condition, physical findings, and the electrocardiogram. The life-threatening diseases such as acute coronary syndrome, aortic dissection and pulmonary embolism should be considered in the first. If these lethal diseases are ruled out, every possibility including diseases other than cardiovascular disease must be considered. In the emergency echocardiography, incomplete knowledge and skills may lead misdiagnosis and patient's life is threatened. Thus, expert sonographer should perform the examination. The most important issue is to save the patients not to complete the echocardiographic study in this situation.
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PMID:[Management of the patient presenting chest pain]. 2233 12

Focus assessed transthoracic echocardiography and focused cardiac ultrasound are point-of-care echo protocols for the evaluation of cardiac disease in the emergency room; however, these protocols may not adequately assess aortic dissection, pulmonary embolism, and acute coronary syndrome in patients with killer chest pain. Here, I present an echocardiography protocol focused on screening for these critical cardiovascular diseases. This protocol (termed EASY screening) consists of the assessment of effusion in the pericardial space, aortic abnormalities, the size and shape of the ventricles and asynergy of the left ventricle. Aortic dissection is suggested by positive findings for effusion and/or abnormal aortic findings. Pulmonary embolism is suggested by a dilated right ventricle and a D-shaped left ventricle in the short-axis view. Acute coronary syndrome is suggested by asynergy of left ventricular wall motion. EASY screening may facilitate the assessment of aortic dissection, pulmonary embolism and acute coronary syndrome in patients presenting to the emergency room with killer chest pain.
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PMID:Point-of-care echocardiography for aortic dissection, pulmonary embolism and acute coronary syndrome in patients with killer chest pain: EASY screening focused on the assessment of effusion, aorta, ventricular size and shape and ventricular asynergy. 2649 52

Acute coronary syndrome (ACS), pulmonary embolism and acute aortic syndrome are the most common causes of life threatening chest pain. The triple rule-out CT (TRO CT) has emerged as a technology that can simultaneously visualize the coronary arteries, aorta and pulmonary arteries as well as other intrathoracic structures. It has been proposed as a one-stop imaging modality in patients who present to the emergency department with low to intermediate risk of ACS in whom pulmonary embolism and/or acute aortic syndrome are also considered. This review focuses on the TRO CT imaging technique, image quality, radiation dose, diagnostic accuracy, yield, efficiency and cost through a series of frequently asked questions.
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PMID:Triple rule-out cardiac computed tomography: is it finally a reality? 2795 91