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

In reference to a personal series of 100 partial interruptions of the inferior vena cava (74 clips, 11 Mobin-Uddin umbrellas, 15 Greenfiled's filters), the authors analyze the criteria of choice in various procedures where the mortality, morbidity and sequellae remain low. In light of these results, the current place of surgery in the prevention of pulmonary embolism is discussed, in cases where anticoagulant therapy is contraindicated, inadequate or has failed.
Ann Cardiol Angeiol (Paris) 1988 Jan
PMID:[Current role of partial interruption of the inferior vena cava. Apropos of 100 cases]. 327 69

Pseudo-infarct Q waves occur in a number of conditions, related to physiologic or positional variants, altered ventricular conduction, ventricular enlargement, and non-coronary myocardial damage. Prominent Q waves in asymptomatic individuals may be due to previous "silent" myocardial infarction, normal variants, or some pathologic but non-coronary cause. Differential diagnosis may be aided by echocardiography (normal variants, cardiomyopathies, left or right ventricular enlargement, amyloid deposition, and so on). Failure to recognize pseudo-infarct patterns may result in "electrocardiographogenic disease" if the Q wave is a normal variant, or in missing a critical clue to some important pathology such as hypertrophic cardiomyopathy or pulmonary embolism that has very different therapeutic implications from coronary disease.
Cardiol Clin 1987 Aug
PMID:Normal and noninfarct Q waves. 331 61

Pulmonary embolism is a condition with a potentially high mortality that often goes unrecognized. Prompt diagnosis and treatment effectively reduce the mortality rate. Clinical judgment alone is insufficient for diagnosis; objective testing is needed. Once the diagnosis is made, effective treatment should be instituted. Treatments differ, based on several factors including disease severity, contraindications to treatment and pre-existing diseases. The major thrust of training should be to teach medical care workers how to prevent deep vein thrombosis and its most serious complication, pulmonary embolism.
Cardiol Clin 1987 Nov
PMID:Pulmonary embolism: diagnosis and treatment. 333 18

Myocardial perforations with a central venous catheter are rare in adults (67 cases published since 1968). These accidents are fatal in more than two-thirds of the cases owing to confusion caused by misleading symptoms which suggest pulmonary embolism. The perforation is generally localized in the right atrium (29 cases), less frequently in the right ventricle (18 cases). The superior vena cava is rarely affected (3 cases). The site of the perforation was not found in the other published cases. Clinical symptoms are signs of tamponade with disorders of cardiac rhythm. An enlargement of the cardiac shadow and an abnormal position of the catheter, buckled or openly intrapericardial, make the diagnosis radiologically. Echocardiography provides some information, but this is often too late for practical application. The diagnosis is made with right catheterization when it shows an equalization of the diastolic pressures. This allows the patient to be watched closely following the pericardial tap, after which a surgical approach may be indicated and performed. Prevention of these iatrogenic accidents must be systematic and strictly controlled for.
Clin Cardiol 1988 Feb
PMID:Iatrogenic cardiac tamponade after central venous catheter. 334 9

Chronic pulmonary embolism is a rare disease which can occur at first with pulmonary hypertension. In these cases it may be difficult to distinguish between primary pulmonary hypertension. We examined nine patients with Chronic Pulmonary Embolism (CPE) (three females and six males, mean age 45 +/- 13 years, range 21-67 years) and ten patients with Primary Pulmonary Hypertension (PPH) (seven females and three males, mean age 35 +/- 13 years, range 10-56 years) who came to our attention during the years 1973-1986 (mean follow up 3 years). All patients had an electrocardiogram, chest x-ray, echocardiogram, cardiac catheterization with pulmonary angiography; seven patients with CPE and eight with PPH had perfusion lung scans. Progressive dyspnoea was the main feature in all the patients; four out of nine with CPE and none of the ones with PPH had a previous history of thrombophlebitis. In all the patients the electrocardiogram, chest x-ray and echocardiogram showed signs of pulmonary hypertension, so that a clear distinction between the two groups was not possible. Cardiac catheterization showed pulmonary pressure values higher in patients with PPH as compared to the ones with CPE (systolic pressure 96 mmHg vs 70 mmHg, diastolic pressure 49 mmHg vs 31 mmHg, mean pressure 65 mmHg vs 45 mmHg). Pulmonary angiography in more than half of the patients with CPE showed a "cut off" of two or more lobar branches of the pulmonary arteries. In the patients with PPH pulmonary angiography showed a dilatation of the main pulmonary artery and a diffuse bilateral hypoperfusion. Perfusion lung scan in all the cases of CPE showed zonal perfusion defects, while in all cases of PPH, with the exception of one, it was largely normal. Venograms in the districts of the inferior vena cava demonstrated thrombosis in two out of six patients with CPE. Negative venograms were found in the five patients with PPH who had this investigation performed. One patient with CPE had a surgical embolectomy, the other eight had anticoagulant oral treatment. During the follow-up period three patients with CPE and five with PPH died within five years and within fifteen months respectively, of the diagnosis.(ABSTRACT TRUNCATED AT 400 WORDS)
G Ital Cardiol 1988 Jan
PMID:[Differences in patients with chronic pulmonary embolism and primary pulmonary hypertension]. 338 46

The performance of a systematic sonocardiography in all our patients hospitalized since January 1985 for pulmonary embolism, has enabled to discover five cases of floating thrombus of the right atrium. Three patients presented an abnormal auscultation, with one of them presenting a tricuspid wedge syndrome. On the sonogram, the aspect of the thrombus, "coil or ball-shaped", floating in the atrial cavity, sometimes prolapsed through the tricuspid valve, associated with the signs of a pulmonary heart, enables to rule out other right intraatrial masses. Pulmonary angiography seems contra-indicated because of the risk of embolus of this thrombus, the migration of which may be fatal. Embolectomy, under extra-corporeal circulation (heart-lung pump) with examination of the right cavities appears to be the treatment of choice.
Ann Cardiol Angeiol (Paris) 1988 May
PMID:[Floating thrombus of the right atrium in acute pulmonary embolism. Clinical, echocardiographic aspects and therapeutic sequelae]. 340 95

A right atrial thromboembolus was detected by two-dimensional echocardiography in a 78-year-old woman with no signs of pulmonary embolism. Anticoagulant therapy was given. The thromboembolus gradually disappeared within four months, and repeat lung perfusion scintigrams during this time did not show any signs of pulmonary embolization.
Acta Cardiol 1986
PMID:Spontaneous disappearance of right atrial thromboembolus without pulmonary embolism. 349 98

Between 1972 and 1985, 674 coronary bypass patients greater than or equal to 70 years (70% male, mean age 73 years) were among 10,622 patients with both catheterization and operative data entered into the Milwaukee Cardiovascular Data Registry. These greater than or equal to 70 years patients were analyzed regarding the operative morbidity, the 30-day operative mortality and the operative mortality's relation to coronary artery disease and ventricular wall motion abnormalities. The operative mortality was not different for the 174 patients operated upon before and the 500 patients after 1980. A mean of 3.4 grafts were placed during surgery. The complications encountered included a 7.1% perioperative infarction rate, a 4.2% incidence of cerebrovascular accident, a 3.6% incidence of reoperation for bleeding, a 2.4% incidence of renal failure, and a 2.1% incidence of pulmonary embolism. The overall operative mortality was 7.4%. The extent of coronary artery disease was distributed among patients such that 8.4% had single-, 28.0% had double-, and 63.6% had triple-vessel disease. The operative mortality as related to the extent of coronary artery disease was 5.2% for single-, 8.9% for double-, and 7.0% for triple-vessel disease. The operative mortality was 6.7% with no and 7.9% with left ventricular wall motion abnormalities. The operative mortality was 1.9% with 1 segmental wall motion abnormality, and increased to 13.3% (p less than 0.05) with 4-6 segmental wall motion abnormalities.(ABSTRACT TRUNCATED AT 250 WORDS)
Clin Cardiol 1987 Jul
PMID:Coronary artery bypass surgery in patients over age 70 years: report from the Milwaukee Cardiovascular Data Registry. 349 1

The authors describe the case of a 61-year-old woman affected with pulmonary embolism, in whom the presence of masses in both atria has been detected by two-dimensional echocardiography. The event of a systemic embolism and the dissolution of both masses after an anticoagulant therapy, has induced the authors to diagnose a biatrial thromboembolism propagating from the venous system and passage of thromboembolic material through a patent foramen ovale. These findings are, therefore, in differential diagnosis compared with other biatrial intracavitary masses.
G Ital Cardiol 1987 Dec
PMID:[Pulmonary and systemic embolism in a case of biatrial thrombosis. Role of two-dimensional echocardiography]. 350 17

Venous thrombi are intravascular deposits composed predominantly of fibrin and red blood cells with a variable platelet and leukocyte component. They frequently arise in large venous sinuses in the calf, in valve cusp pockets either in the deep veins of the calf or thigh or in venous segments that have been exposed to direct trauma. Venous thrombosis can be produced experimentally by a combination of stasis and systemic hypercoagulability or by stasis and endothelial damage. Thrombosis is augmented if the fibrinolytic mechanism is inhibited or defective. A number of clinical conditions and laboratory abnormalities are associated with and predispose to venous thrombosis and, in many of these, it is possible to identify one or more of the thrombogenic factors discussed. Venous thromboembolism (venous thrombosis and pulmonary embolism) is a serious and potentially fatal disorder that usually complicates the course of sick hospitalized patients, but occasionally affects ambulant and otherwise healthy individuals. Screening studies with iodine-125 fibrinogen leg scanning, impedance plethysmography and perfusion lung scanning have shown that the majority of venous thrombi and pulmonary emboli that occur in hospitalized patients are small and asymptomatic, and it is likely that most are clinically insignificant. In bedridden patients, most thrombi commence in the calf and are asymptomatic. When a calf vein thrombus extends into the proximal venous segment, the risk of clinically significant pulmonary embolism increases. Less is known about the incidence and clinical significance in a nonhospital population; although asymptomatic disease occurs, its frequency is unknown. In contrast to the patients with asymptomatic venous thrombosis, symptomatic patients with venous thrombosis usually have large occulsive thrombi localized in their proximal veins.
J Am Coll Cardiol 1986 Dec
PMID:Epidemiology and pathogenesis of venous thrombosis. 353 63


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