Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
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.
 ...
PMID:Accuracy of screening for pulmonary embolism in the emergency room. 45 63

A 65-year-old man was admitted to our hospital because of shortness of breath on exertion. As the results of examinations including pulmonary angiography, pulmonary perfusion scan and pulmonary ventilation scan, we diagnosed the case as chronic recurrent pulmonary embolism. Although the patient received thrombolytic therapy by a tissue plasminogen activator (t-PA), there was no noticeable improvement. However, oxygen and vasodilator therapy had marked effective on the hemodynamics. In chronic pulmonary embolism, vasodilators are generally not considered to be effective for improvement of hemodynamics. However, if the acute effects of vasodilators were confirmed, we should try to administer them while paying attention to possible adverse effects.
 ...
PMID:[Acute and chronic effects of vasodilators in a case of chronic recurrent pulmonary embolism]. 190 16

Central venous catheter (CVC) vascular erosions are difficult to diagnose, and they cause serious complications. From 1985 to 1987, ten patients receiving the surgical services at the University of Florida suffered CVC vascular erosions. By chest roentgenogram, nine CVC tips were in the superior vena cava (SVC), although three catheter tips abutted the lateral wall of the SVC. One catheter tip was in the right atrium. All patients had sudden onset of symptoms, the most common of which was shortness of breath. Initial diagnosis was respiratory insufficiency in five patients, cardiac failure in three patients, pulmonary embolism in one, and sepsis in one. Four patients required intensive care. Two patients suffered pericardial tamponade, and pleural effusions developed in eight patients. One patient died of cardiac arrest. The average time interval from CVC placement to onset of symptoms was 60.2 hours, and from the onset of symptoms to the time of diagnosis, the interval was 16.7 hours. The mean volume obtained at thoracentesis was 1324 ml and at pericardiocentesis was 250 ml.
 ...
PMID:Central venous catheter vascular erosions. Diagnosis and clinical course. 293 Feb 92

Hageman factor, a coagulation factor (Factor 12) is reported to be deficient in users of OCs (oral contraceptives) in this letter to the editor. A 21-year-old female on OCs for 4 months was admitted with sudden onset of chest pain and shortness of breath; a lung scan confirmed bilateral pulmonary embolism. She underwent a coagulation screen, prior to heparin therapy, which revealed a partial thromboplastin time of 120 seconds. A 15% Hageman factor deficiency was found. It is suggested that before prescribing OCs, physicians should screen patients by partial thromboplastin time, at the least, to determine if Hageman factor is deficient.
 ...
PMID:Hageman factor deficiency and oral contraceptives. 610 95

The clinical diagnosis of pulmonary embolism (PE) remains difficult despite years of investigation. The clinical signs and symptoms of pulmonary embolism are numerous, but they are not diagnostically accurate. Radionuclide ventilation perfusion imaging (VQ) has become an important adjunct in screening patients for suspected PE. This study re-evaluates the predictive capabilities of various clinical signs and symptoms in a population of patients in whom angiography was thought to be necessary because of clinical concern for PE. One hundred one patients with suspected PE were retrospectively identified. Clinical information on them was complete, and laboratory studies, VQ imaging, and pulmonary angiography were performed. Thirty-seven clinical signs, symptoms, and other characteristics were individually compared for patients whose angiographic results were positive or negative for PE. Modifying or interactive effects on PE were then examined with logistic regression analysis. Several clinical conditions, including immobilization and recent surgery, were significantly associated with PE. Shortness of breath and history of smoking were significantly associated with negative results on pulmonary angiography. A "high probability" VQ scan was highly predictive (P < .0001) of positive results on angiography. When interactive factors for PE were examined, lack of shortness of breath and arterial pH < or = 7.45, lack of shortness of breath and respiratory rate > 23, diaphoresis in a nonsmoker and immobilized female, were significantly associated with PE. This study again documents the difficulty in using clinical criteria--including signs, symptoms, and laboratory determinations--to predict PE accurately, even in a population in which PE was of clinical concern irrespective of the VQ scan results.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Clinical signs and symptoms in pulmonary embolism. A reassessment. 798 17

Primary hepatocellular carcinoma can be revealed by recurrent pulmonary embolism as observed in this case of a 63-year-old woman initially hospitalized for abdominal pain and shortness of breath. The clinical diagnosis was confirmed by laboratory findings, a ventilation perfusion scan and pulmonary angiography which demonstrated peripheral basal artery cut-off and slow filling with delayed washout. The patient was treated with heparin then with nicoumarol and responded well. One month after discharge the patient again complained of shortness of breath and was readmitted. Anticoagulation was adequate as evidenced by a prothrombin time of 1.39 INR and the physical examination and laboratory tests again suggested pulmonary emboli, confirmed by a ventilation perfusion scan. Computed tomography of the chest and abdomen revealed multiple hypodense masses filling half of the liver volume and needle biopsy led to the diagnosis of hepatocellular carcinoma. Hypercoagulability in malignancy is well-known although cases of migratory thrombophlebitis are extremely rare. Pulmonary embolism has not been described as a presenting feature of hepatocellular carcinoma. In this case, there was no evidence of hepatic dysfunction and the pulmonary embolism occurred despite adequate anticoagulation. Clinicians should include occult carcinoma among the possible causes of recurrent pulmonary embolism and when searching for malignancy can include hepatocellular carcinoma among the causes of hypercoagulation.
 ...
PMID:Pulmonary embolism as the presenting feature of hepatocellular carcinoma. 802 23

We report the use of centrally administered tissue-type plasminogen activator for three patients who presented with massive pulmonary embolism to the emergency department. In all patients, rapid improvement of pulmonary arterial pressures ensued by the end of the drug infusion, while the presenting symptoms of chest pain and shortness of breath subsided.
 ...
PMID:Treatment of massive pulmonary embolism with centrally administered tissue-type plasminogen activator. 833 42

A 50-year-old man was admitted to our hospital because of shortness of breath and an oppressive feeling in his chest on exertion. As a result of examinations including pulmonary-angiography, pulmonary perfusion scan and phlebogram, we diagnosed the case as chronic recurrent pulmonary embolism due to deep vein thrombosis. Later on, the patient showed an abnormal reaction on treadmill exercise test, and revealed redistribution at the anteroseptal and the inferior wall on thallium exercise test. We performed coronary angiography and diagnosed the case as angina pectoris (seg. 1 was total occlusion, segs. 2 and 3 were filled with bridge collateral, seg. 7 was 75% stenotic lesion). We evaluated the acute effect of vasodilators on pulmonary and systemic hemodynamics. The effect was beneficial in that it improved the hemodynamics. On account of this we thought a reversible condition was presented, and we administered these drugs to this patient.
 ...
PMID:[A case of chronic recurrent pulmonary embolism complicated with effort angina pectoris]. 846 32

Massive pulmonary embolism is defined as an anatomic obstruction of 50% or more of the pulmonary artery. A reduction of at least 50% of the cross-sectional area of the pulmonary artery causes significant hemodynamic instability and marked hypoxia exhibiting syncope, apprehension, hypotension, diaphoresis, chest pain, altered mental status, and shortness of breath. A patient, who had no definite clinical signs and symptoms, was demonstrated to have massive pulmonary embolism by extensive mismatched ventilation-perfusion defects scintigraphically and confirmed as thromboemboli in the main pulmonary arteries on a standard CT of the thorax. The lack of clinical manifestations of massive pulmonary embolism might be related to the insidious onset and progressive formation of thromboembolism. The patient gradually adapted to and/or compensated for hemodynamic changes.
 ...
PMID:Massive pulmonary embolism without symptoms demonstrated by radionuclide imaging with thromboemboli in both main pulmonary arteries. 874 82

We present a case report of primary hepatocellular carcinoma with tumor thrombus extending into the right atrium complicated by pulmonary embolism. A 49-year-old man was admitted to our hospital for searching a cause of thrombus in the right atrium. The patient complained of shortness of breath and oedema of the lower extremities. He had a history of hepatitis B. Abdominal sonography and computed tomography revealed a tumor of the liver. A needle biopsy confirmed the diagnosis of hepatocellular carcinoma. Magnetic resonance showed a tumor thrombus also in the inferior vena cava. The diagnosis of pulmonary embolism was confirmed by pulmonary perfusion scintigraphy. This case stresses that clinicians should include hepatocellular carcinoma among the possible causes of intracardiac thrombus and pulmonary embolism.
 ...
PMID:[A case of primary hepatocellular carcinoma with tumor thrombus in the right atrium and massive pulmonary embolism]. 875 55


1 2 3 4 5 6 7 8 9 10 Next >>