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

A family is described in which the mother and three of seven children had atrial myxoma. The mother had biatrial myxoma; surgical treatment resulted in massive intraoperative embolization and death. Surgery was sucessful in two sons with left atrial myxoma and systemic arterial embolization. A third son had calcified right atrial myxoma with destruction of the tricuspid valve and episodes of syncope and pulmonary embolism; surgery including valve replacement, was successful. The mother's father and a brother had died suddenly without a definite diagnosis. The family data are consistent with dominant transmission. The possibility of finding affected relatives should be borne in mind when studying patients with atrial myxoma.
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PMID:Atrial myxoma in a family. 13 7

A review of 132 consecutive cases of acute pulmonary embolism (PE) documented by pulmonary angiography indicated that syncope was the initial or predominant clinical feature in 17 (13%). When massive PE causes syncope in a nonhospitalized patient, the diagnosis of PE is frequently overlooked. Hypotension after PE may resolve spontaneously after a short interval. In this circumstance, the syncopal episode might easily be attributed to another cause. The appropriate diagnosis can be established only if other clues, suggestive of PE, are sought. Both arterial blood gas determinations and pulmonary scintigraphy are helpful in making this diagnosis.
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PMID:Syncope in patients with pulmonary embolism. 57 84

Following episodes of pulmonary embolism, the presence of thrombi in the pulmonary arteries leads to severe respiratory insufficiency and chronic right heart failure. We have operated upon 16 such patients, nine men and seven women from 23 to 68 years of age. All had severe dyspnea, 14 had chronic cor pulmonale, six had mental disturbances with syncope, and four had severe cardiac failure. The presence of clots was demonstrated by pulmonary angiography, and the permeability of the distal arterial bed was ascertained by selective injection of the bronchial arteries. In all cases but two a lateral thoracotomy was used so that the obstructed arterial branches could be approached distally. The inferior vena cava was always ligated to prevent recurrences. There were six operative deaths, three from cardiac failure, one from acute pulmonary edema, one from hemothorax, and one following a pyothorax. Ten patients are surviving after 6 months to 10 years. One is still limited because of significant pleuropulmonary sequelae. Six are enjoying good results with marked improvement in their functional limitations, a significant drop in the pulmonary artery pressure, and radiological permeability of previously obstructed arteries. Three are excellent condition--completely asymptomatic.
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PMID:Surgical correction of chronic postembolic obstructions of the pulmonary arteries. 70 66

In ten patients successful embolectomy after acute massive pulmonary embolism was performed. Clinical symptoms included circulatory arrest and shock as well as collaps, syncope and dyspnoe. Pulmonary angiography regularly showed massive, bilateral emboli. In 9 patients more than one half of the pulmonary artery system was involved (perfusion defect more than 50%). Right heart catheterization demonstrated pulmonary hypertension in all cases. In 8 patients the pulmonary artery mean pressure (PAm) exceeded 30 mm Hg. In 9 patients there were signs of right heart failure (RVEDP more than 11 mm Hg). At recatheterization 6 to 30 (mean 19) days after operation using cardiopulmonary bypass there was a marked improvement of pulmonary angiograms, which were normal in 3 cases. PAm decreased from 34.3 mm Hg to 14.6 mm Hg postoperatively and RVEDP from 14.4 to 5.1 mm Hg (p less than 0.001). These results confirm, that pulmonary embolectomy leads to a good functional results.
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PMID:[Results of embolectomy in massive pulmonary embolism (author's transl)]. 85 22

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

We report 2 patients who developed massive pulmonary embolism with greater than 50% occlusion of the pulmonary arterial circulation. Hypotension, syncope and right sided failure were the clinical manifestations. Immediately after diagnostic pulmonary arteriography, 20,000 U of streptokinase (SK) were delivered in the pulmonary artery next to the thrombotic mass. A continuous infusion of SK, 10,000 U/h was maintained for 24 h in one patient and 72 h in the other. Rapid clinical improvement was observed in the following 24 h. Control angiography showed lysis of the embolus with residual obstructions of segmentary branches. The clinical value of this form of treatment for pulmonary embolism is discussed.
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PMID:[Massive pulmonary thromboembolism treated with selective infusion of streptokinase. Report of 2 cases]. 182 61

Pulmonary embolism associated with the act of defecation has not been previously well described. Recently, we reported our experience with four patients who presented to us over a 12-month period with syncope, near syncope, or sudden death following the act of defecation. In all four cases, acute pulmonary embolism was shown to be the etiology of the defecation-associated events. A retrospective chart review of all patients with the diagnosis of pulmonary embolism at our institution over a three-year period yielded five additional patients with the diagnosis of defecation-associated pulmonary embolism. These nine patients accounted for 6.8 percent of all patients with a discharge diagnosis of pulmonary embolism seen at our institution during the three-year study period. Six of the nine patients died from their defecation-associated pulmonary embolism. These six deaths accounted for 25 percent of all deaths from pulmonary embolism seen at our institution during the study period. Based on our experience, we suggest that the act of defecation may trigger the development of acute pulmonary embolism in some patients with deep vein thrombosis.
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PMID:Acute pulmonary embolism triggered by the act of defecation. 198 98

Right heart thrombosis (RHT) was found by 2D-echocardiography in 8 cases. Clinical suspicion of RHT could be documented in only 3 patients, while in the other 5 cases syncope, low output syndrome, essential pulmonary hypertension, cerebral embolism or congestive heart failure was the clinical diagnosis on first presentation. Out of the 4 cases of mobile RHT of extracardiac origin 1 patient had an emergency operation, 2 patients died shortly after the 2D-echo diagnosis before treatment could have been started and 1 patient improved on anticoagulant treatment. RHT of intracardiac origin was due to a central line or a ventriculoatrial shunt in 3 cases and no source could be found in 1 patient. Complete recovery was achieved in 2 cases by medical, in one case by surgical management and in 1 patient medical and surgical treatment resulted in clinical improvement. In conclusion authors 1. consider 2D echocardiography necessary in the clinical setting of acute or chronic pulmonary embolism or "primary" pulmonary hypertension and 2. they recommend emergency operation in case of mobile large RHT detected by 2D-echocardiography.
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PMID:[Diagnosis and treatment of thromboembolic diseases of the right heart]. 221 28

The records of 6 patients undergoing pulmonary embolectomy for massive pulmonary embolism (MPE) at Kurume University Hospital during 17 years were reviewed to determine the management of surgery. The patients consisted of 2 men and 4 women. The patients' ages ranged from 29 to 68 years (mean age, 49.3 years). The records showed that one patient died of brain death after operation and the others survived. All the patients complained of chest pain, anterior chest discomfort and dyspnea. Sudden syncope was observed in 2 patients. Artificial mechanical ventilation was performed preoperatively on 3 patients. Right ventricular load was demonstrated on electrocardiograms and ultrasonograms. Pulmonary angiograms were attempted on two patients and one of them had cardiac arrest during this examination. MPE was suspected by perfusion defect of 50% to 80% of pulmonary vasculature demonstrated on lung perfusion scintigram in 4 patients. Open pulmonary embolectomy with cardiopulmonary bypass (CPB) was performed on all patients using crystalloid cardioplegia and topical cooling. Intraoperative pulmonary angiograms were performed in 4 patients to prevent residual thromboemboli. Since most thromboemboli originate below the level of the vena cava, acute double ligation of the vena cava just below the renal vein was performed to control recurrent embolism. Oral anticoagulant, warfarin, was administered for 3 months after embolectomy as prophylaxis against postoperative recurrent embolism. It is our opinion that an aggressive attitude toward pulmonary embolectomy on CPB is necessary to save lives of MPE patients. This surgical procedure is very easy and safe.
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PMID:[Surgical treatment of massive pulmonary embolism--the time of the operation and its effectiveness]. 237 90

Two patients suddenly died of massive pulmonary embolism 3 weeks after hip surgery. In retrospect, several episodes of syncope starting during the first postoperative week were recognized as premonitory signs of the fatal outcome.
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PMID:Syncope as a premonitory sign of fatal pulmonary embolism. Two case reports. 335 26


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