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

Pertinent historical, clinical, and laboratory findings were recorded for 37 consecutive patients who presented to the emergency room complaining of shortness of breath and chest pain but without evidence of coronary insufficiency, pneumonia, or musculoskeletal injury. 13 had pulmonary embolism suggested by lung scan with or without pulmonary angiogram, or, in 2 cases, by right heart catheterization. As a group, these patients in whom embolism was judged probable approached fairly closely the profiles of previous studies of patients with documented pulmonary emboli. Nonetheless, they differed very little, and in no clinically useful way short of lung scans and invasive studies, from the remaining 24 patients in whom embolism was judged unlikely. In the population served by this emergency room, which has a high morbidity from chest diseases and putative predisposing conditions to pulmonary embolism, screening patients for high and low probability groups for this diagnosis cannot be done on clinical grounds alone. Six-projection ventilation-perfusion lung scanning may be the only acceptable screening examination, and should be available directly from the emergency room in hospitals with an active emergency service.
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PMID:Accuracy of screening for pulmonary embolism in the emergency room. 45 63

A prospective analysis of 155 patients with pulmonary embolism was undertaken to describe the radiographic characteristics of associated pleural effusions and related abnormalities. Approximately one half of these patients had pleural effusions. Patients with other potential causes of effusion, such as heart failure, pneumonia, or cancer, were eliminated from further analysis. In the remaining 62 patients, radiographic evidence of pulmonary infarction accompanied pleural effusions in one half of the cases. One third of patients with parenchymal consolidation had no evidence of effusion. Atelectasis and other nonspecific radiographic abnormalities occurred in less than one fifth of the cases. Typically, pleural effusions were small and unilateral, appeared soon after symptoms of thromboembolism began, and tended to reach their maximal size very early in the course of the disorder. Pulmonary infarction was associated with larger effusions that cleared more slowly and were more often bloody in appearance on thoracentesis. Chest pain occurred in all but one patient and was a valuable diagnostic clue. Pain and pleural effusions were always ipsilateral and almost always unilateral, but neither correlated well with the presence or time course of infarction. Effusions that were delayed in onset or that enlarged late in the course were associated with recurrent pulmonary embolism or superinfection. These radiographic features may be helpful in the diagnosis and management of pulmonary embolism.
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PMID:Radiographic features of pleural effusions in pulmonary embolism. 65 89

A case report of mesenteric venous thrombosis with small bowel infarction in a 38-year-old woman who had been taking oral contraceptives is reported. The patient was admitted complaining of severe abdominal pain and vomiting for 36 hours. On admission, temperature was 37.5 degrees C and pulse 120/minute. Abdominal rigidity and left-sided abdominal tenderness were present. X-ray of the abdomen showed 2 distended loops of small bowel and 3 fluid levels. Serum amylase was normal. White cell count was 10,000/cu mm. There was a history of abdominal pain and diarrhea over a period of several years. For 6 months she had been taking Ovulen (mestranol .1 mg and ethynodiol diacetate .5 mg) for menstrual irregularity. 2 weeks earlier she had suffered an influenzalike illness with pleuristic chest pain, loin pain, urinary frequency, and dysuria. Chest X-ray and intravenous pylography were then reported as normal. At immediate operation, a 15 cm segment of ileum was found to be infarcted. Semipurulent fluid was present in the abdomen and areas of fibrinous peritonitis were observed. The involved segment of ileum was resected. A small thrombus was extracted from a mesenteric vein. Initial postoperative course was good but 3 days after operation chest pain, dyspnea, and giddiness developed and cardiac arrest followed. Resuscitation was successful. Pulmonary angiography then showed thrombi in all branches of the pulmonary artery. After heparin therapy symptoms improved and the patient left the hospital in 2 weeks, her condition being stabilized with warfarin and dipyridamole (Persantin). The diagnosis was confirmed by histological examination. Early recanalization of a mesenteric vein was noted. Other reported cases have shown an average prodromal phase of 4 or 5 days. The long-term diarrhea was considered as not connected with the present illness but the presumed influenza illness 2 weeks earlier may have been due to a pulmonary embolism. Of reported cases, 5 of 13 have died. Early diagnosis, prompt surgery, and heparin therpay are considered important.
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PMID:Mesenteric venous thrombosis associated with oral contraceptives: a case report. 106 70

Pulmonary embolism is responsible for 50,000 deaths each year. A high diagnostic index of suspicion is necessary if the diagnosis of embolism is to be made prior to death since the classic triad of chest pain, dyspnea, and hemoptysis occurs infrequently. Preventive measures including preoperative anticoagulation will reduce the incidence of trombus formation. Treatment depends on early recognition, rapid anticoagulation, and, in selected cases, partial occlusion of the vena cava.
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PMID:Pulmonary emboli. Prevention, diagnosis, and treatment. 111 49

A patient presented in the coronary care unit with acute chest pain and in shock. The electrocardiographic features suggested an acute high lateral myocardial infarction. Certain features were, however, paradoxical, and suggested reversed arm electrodes. A repeat electrocardiogram reflected the classic features of acute pulmonary embolism. It is evident that the "mirror image' of the classic S1Q3T3 presentation of acute pulmonary embolism mimics an acute high lateral infarction.
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PMID:A pitfall in electrocardiographic diagnosis. Acute pulmonary embolus versus actue high lateral infarction. 114 62

The autopsy findings and clinical features in 60 patients with fatal pulmonary embolism (PE) in University College Hospital, Ibadan, between 1985 and 1989 are analysed in the current study. Pulmonary embolism occurred in 3,8 pc of all autopsied patients during this period. There was a male to female ratio 1,4 to one and average age was 47 years. Malignant neoplasms, infections and cardiac failure were the leading predisposing factors to PE identified. The ante-mortem clinical features consisted largely of non-specific respiratory symptoms of dyspnoea, cough, chest pain and haemoptysis. Of these patients, 15,6 pc were diagnosed ante-mortem as having PE. Pulmonary infarction occurred in 13,3 pc of the cases and was commoner in females and in patients with underlying cardiac diseases. This study emphasises the need for a high clinical index of suspicion to improve the antemortem diagnosis of this potentially fatal condition and to advocate a greater use of prophylactic anti-coagulant therapy in high risk patients.
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PMID:Pulmonary embolism in Ibadan, Nigeria: five years autopsy report. 130 38

A 24-year-old man was sent to the emergency unit and evaluated with the symptom of acute right-sided chest pain. Myocardial infarction and pulmonary embolism were excluded. A creatine kinase (CK) serum concentration of 17,034 U/l (normally up to 270) was found. The patient gave a history of excessive body-building exercises on the previous day. During the follow-up period symptoms resolved within several days, and CK values gradually diminished. A review of current literature on rhabdomyolysis in patients with body-building is presented.
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PMID:[Rhabdomyolysis in body building. Report of a case and literature review]. 141 Sep 85

In recent years, case reports of the pulmonary thromboembolism which had been comparatively less in our country, have been gradually increasing. However, this disease is more often reported in the chronic stage, and case reports of severe cases in the acute stage are still less. The case reported here was admitted to our hospital by emergency ambulation with severe chest pain. On the second day after the admission, respiratory standstill developed suddenly following recurrent chest pain, which necessitated cardiopulmonary resuscitation. The patient was intubated and the IABP was instituted because of hemodynamic instability. An emergent cardiac catheterization under the mechanical ventilation and the IABP supported displayed massive shadow defect on the pulmonary arteriogram, which was indicating acute pulmonary embolism. The pulmonary pressure was 58/18 mmHg despite of the shock state (the aortic pressure: 60/28 mmHg). Subsequently, a pulmonary thrombectomy was carried out under the emergency cardiopulmonary bypass. The cardiac catheterization performed two weeks after the operation. Revealed that the pulmonary pressure returned to the almost normal volume (38/18 mmHg) in association with the aortic pressure of 113/72 mmHg. The venogram of lower extremities revealed thrombi in the deep veins, suggesting the cause of the thromboembolism in the pulmonary arteries. The Bird's nest filter was inserted for the prevention of recurrence of pulmonary embolism. This patient is doing well 10 months postoperatively.
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PMID:[A case report of pulmonary embolectomy for acute pulmonary embolism]. 147 99

Hypoplastic pulmonary artery is an unusual congenital malformation. We describe a case of hypoplastic pulmonary artery diagnosed during the third trimester of pregnancy. The clinical and radiologic features mimicked pulmonary embolism, including hemoptysis, chest pain, pleural effusion, mild hypoxemia, and a suggestive ventilation-perfusion scan. Accurate differentiation of this entity from pulmonary embolism is necessary to obviate the need for prolonged anticoagulation.
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PMID:Hypoplastic pulmonary artery: an unusual entity mimicking pulmonary embolism during pregnancy. 149 14

The literature on isolated right ventricular infarction is reviewed and local experience is reported. Chronic lung disease is an important risk factor. Chest pain and breathlessness are common. Syncope and sudden collapse can also occur. Rhythm disorders include sinus bradycardia, atrial fibrillation and ventricular tachycardia or fibrillation. Atrioventricular block is rare. Hypotension and a right-sided fourth heart sound are common. Cautious use of slow-release nitroglycerin is not hazardous in the absence of hypotension. High doses of steroids and anticoagulants can be helpful. The prognosis is usually good, although sudden collapse can occur due to ventricular fibrillation, rupture of the right ventricular free wall or massive pulmonary embolism.
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PMID:Isolated right ventricular infarction. 151 57


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