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

The natural history of pulmonary embolism is described, together with the physiopathologic alterations and the clinical manifestations of this disease, correlating these with the various patterns of pulmonary perfusion usually found by lung scintigraphy with 99mTc-MAA in patients with thromboembolic lung disease. By using data found in the literature, the operating characteristics (sensitivity, specificity, and accuracy) and the predictive values of the different scintigraphic patterns, were calculated for populations with different prevalences of pulmonary embolism. It is concluded that perfusion lung scintigraphy is a non-invasive, objective and fast procedure, very sensitive to alterations of the regional blood flow, but that is not specific for embolism. In some cases it can replace pulmonary angiography but in others, its results may indicate the performance of invasive procedures.
Arch Inst Cardiol Mex
PMID:[Scintigraphic criteria for the diagnosis of pulmonary embolism]. 293 4

This article describes a method for inhalatory lung scintigraphy (ILS) by the use of radioactive monodisperse aerosols, with particles smaller than 2 microns. We discuss the findings in normal subjects, in patients with pulmonary embolism (PE) or/and obstructive pulmonary disease (OPD), and in individuals with severe pulmonary hypertension. This procedure has several advantages over the use of radioactive gases, such as 133Xe and 81Krm: lower cost, easier to perform, several scintigraphic projections in one study, acquisition of perfusion and inhalatory images in a single session, and inhalatory and perfusion images with identical spatial resolution and similar data density. It is concluded that ILS with radioactive monodisperse aerosols is a useful method for the study of OPD and in conjunction with perfusion lung scintigraphy is helpful in the diagnosis of PE.
Arch Inst Cardiol Mex
PMID:[Pulmonary scintigraphy using the inhalation of monodispersed radioactive aerosols. Preliminary report]. 294 41

When in 1977 the Food and Drug Administration approved streptokinase for the treatment of deep vein thrombosis and pulmonary embolism, a new and exciting field of therapies was opened up for the clinician. In the period since the approval of streptokinase, the number of pharmacologic agents that activate the fibrinolytic system for thrombolysis has increased. Hence, this article reviews the history of this evolving field of therapies.
Cardiol Clin 1987 Feb
PMID:The fibrinolytic system and its pharmacologic activation for thrombolysis. 295 Oct 8

We studied a seventeen year old female patient with clinical manifestations of pulmonary embolism. A Two-Dimensional echocardiography showed the presence of a right intraventricular mass. It was surgically removed and the histopathological study showed it to be a myxoma. The recovery of the patient was uneventful. This is the first case of a right ventricular myxoma diagnosed during life in our hospital. The medical literature describing this unusual location is reviewed.
Arch Inst Cardiol Mex
PMID:[Myxoma of the right ventricle: report of a clinical case and review of the literature]. 295 90

To assess abnormalities of right heart function and their reversal with thrombolysis in pulmonary embolism, serial imaging and Doppler echocardiographic studies were performed before and after a 6 hour intravenous infusion of 80 to 90 mg of recombinant tissue-type plasminogen activator (rt-PA) in seven patients with segmental or lobar acute pulmonary embolism. None of the five men and two women had known prior pulmonary hypertension. Substantial clot lysis and improvement in pulmonary blood flow, as determined by serial pulmonary angiography and perfusion lung scanning, were achieved in all. Coincident with clot lysis, pulmonary artery systolic pressure decreased (from 42 +/- 11 to 26 +/- 7 mm Hg, p less than 0.005), right ventricular diameter decreased (from 3.9 +/- 1.0 to 2.0 +/- 0.5 cm, p less than 0.005) and left ventricular diameter increased (from 3.7 +/- 0.9 to 4.4 +/- 0.6 cm, p less than 0.01). Right ventricular wall movement, initially mildly, moderately or severely hypokinetic in one, two and four patients, respectively, normalized in five and improved to mild hypokinesia in two. Tricuspid regurgitation was present before lytic therapy in six patients. In five, flow velocity in the tricuspid regurgitant jets indicated a peak systolic right ventricular minus right atrial pressure gradient of 25 to 52 mm Hg. Tricuspid regurgitation was detected early after lytic therapy in only two patients. Systolic septal flattening was noted before but not after lysis. These findings confirm that pulmonary emboli may result in appreciable right ventricular dysfunction and dilation, resultant tricuspid regurgitation, abnormal septal position and decreased left ventricular size.(ABSTRACT TRUNCATED AT 250 WORDS)
J Am Coll Cardiol 1987 Nov
PMID:Early reversal of right ventricular dysfunction in patients with acute pulmonary embolism after treatment with intravenous tissue plasminogen activator. 295 13

The classic electrocardiographic abnormalities observed in massive or submassive thromboembolism in the absence of preexistent cardiac or pulmonary disease are: S1Q3T3 pattern, right axis deviation, "pulmonary" P wave, ST segment depression or elevation, subepicardic ischemia and transient right bundle branch block. Left axis deviation due to pulmonary embolism was first described in 1949; this same finding and the presence of low voltage of the frontal plane owed to pulmonary embolism has been reported occasionally in the last decades, but it has had little diffusion. We report on a patient with no prior cardiac or pulmonary disease who suffered massive pulmonary thromboembolism. Electrocardiographically left axis deviation and low voltage of the horizontal plane attributed to pulmonary thromboembolism was observed. The mechanisms that originate this electrocardiographic changes in pulmonary embolism are unknown. Since the electrocardiogram is aspecific method for the diagnosis of this disorder, and the presence of the mentioned changes originate a greater difficulty in the diagnosis; we consider is important to publish it.
Arch Inst Cardiol Mex
PMID:[Massive pulmonary thromboembolism with left axis deviation and low voltage]. 296 Feb 86

Five cases of neoplastic pulmonary embolism are reported in whom the clinical presentation was consistent with acute cor pulmonale. Perfusory lung scintigraphy was negative in all the cases. Four patients died within 7 days, one after 30 days from starting of symptoms. At autopsy in all the cases neoplastic diffuse embolization of pulmonary arteries was seen with or without thrombosis. In two cases lymphatic carcinosis was also evident. In the literature the majority of cases are reported to have a subacute clinical course as compared to the acute clinical evolution of our series. We suggest to keep in mind the diagnostic hypothesis of vascular pulmonary carcinosis in the cases of acute cor pulmonale with negative perfusory lung scintigraphy.
G Ital Cardiol 1986 Jun
PMID:[Pulmonary carcinomatosis: a rare cause of acute cor pulmonale]. 301 14

Recombinant human tissue-type plasminogen activator (rt-PA), a relatively clot-specific fibrinolytic agent, represents a novel and promising approach to thrombolytic therapy of pulmonary embolism. Therefore, the efficacy and safety of peripheral intravenous rt-PA therapy were assessed in 47 patients with angiographically documented pulmonary embolism. The drug regimen was 50 mg over 2 hours followed by repeat angiography and, if necessary, an additional 40 mg over 4 hours. By 6 hours, 44 of the 47 patients had angiographic evidence of clot lysis that was slight (n = 5), moderate (n = 12) or marked (n = 27). Among the 34 patients with pulmonary hypertension before treatment (mean pulmonary artery pressure exceeding 17 mm Hg), the pressure decreased from 43/17 (mean 27) to 31/13 (mean 19) mm Hg (p less than 0.0001). Fibrinogen decreased 33% from baseline at 2 hours and 42% from baseline at 6 hours. There were two major complications that required surgical control of bleeding: hemorrhage from a pelvic tumor and mediastinal tamponade in a patient 8 days after coronary artery bypass surgery. The initial results demonstrate that, among selected patients, peripheral intravenous rt-PA can rapidly and, for the most part, safely lyse pulmonary embolism within 6 hours.
J Am Coll Cardiol 1987 Nov
PMID:Thrombolytic therapy of acute pulmonary embolism: current status and future potential. 311 62

Pulmonary embolism remains a frequent and often fatal disorder. For the majority of patients, anticoagulation with heparin followed by warfarin represents the primary mode of treatment. Thrombolytic therapy is recommended for the patient with massive pulmonary embolism that has produced hypotension. Embolectomy is reserved for the patient with post embolic systemic hypotension who has an absolute contraindication to thrombolysis or who deteriorates despite thrombolytic therapy. Following successful embolectomy the surgeon must treat the complications of the surgery and prevent recurrence. Complications include cerebral infarction, pulmonary infarction and endobronchial hemorrhage, right ventricular failure, local or systemic bleeding and venous stasis. A case of successful pulmonary embolectomy with a complicated postoperative course is presented and the pathophysiology and treatment of the complications are discussed.
Can J Cardiol 1988 Oct
PMID:Ongoing role of pulmonary embolectomy. 322 60

Seven hundred fifty four consecutive cases of pulmonary embolism, diagnosed between 1969 and 1982 at S. Chiara Hospital in Pisa, were examined in order to assess the causes and the rate of the early mortality. Full documentation was not obtained in 47 cases (6.2%) and they were excluded from the study; 81 (11.4%) of the remaining 707 died within 30 days of diagnosis, and in 56.8% of them pulmonary embolism was the primary cause of death. The survival rate was 90.6% in patients with apparently primary pulmonary embolism, 89.8% in post surgical cases, 81.5% in cardiac patients and 75% in patients affected by neoplasm. Twenty five per cent of patients were not treated during the acute phase, because the diagnosis was made more than one month after the onset of symptoms or because the fear of bleeding precluded anticoagulant treatment. The incidence of fatal haemorrhage during treatment was 0.5% overall, and 0.4% in surgical patients. Mortality was 9.2% in patients who received treatment, versus 25.2% in untreated patients. Sixteen fatal recurrent embolisms occurred after the end of treatment: 11 were observed in patients not treated with oral anticoagulants. Routine autoptic examinations, performed in 44.4% of the cases, often demonstrated both recent and organized emboli, especially in cardiac patients. Recurrence of pulmonary embolism may account for both the severity of clinical patterns and the high mortality rate in the early phase of treatment.
G Ital Cardiol 1988 Jul
PMID:[Short-term prognosis of pulmonary embolism]. 323 57


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