Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0034065 (pulmonary embolism)
 14,979 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 21-year-old Italian woman with extensive Klippel-Trenaunay syndrome (KTS) developed recurrent pulmonary embolism in spite of the insertion of a Greenfield filter in the inferior vena cava. Clinical and radiologic diagnostic tests failed to demonstrate the pathway of the emboli. Radionuclide venography and intravenous radionuclide total body arteriography were performed. These radionuclide procedures helped to evaluate the extent of KTS and to detect the route of the emboli. This is the first case of KTS studied with intravenous total body arteriography reported in the literature.
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PMID:Evaluation of Klippel-Trenaunay syndrome with radionuclide total body angiography. A case report. 133 Mar 94

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.
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PMID:Hageman factor deficiency and oral contraceptives. 610 95

The haemodynamic and respiratory changes occurring acutely after pulmonary embolism induced in dogs were documented, and the effect of heparin and isoprenaline on the emboli and on the changes induced were also studied. Heparin led to a greater reduction in embolus weight compared to control animals, but in the short time interval of this study it did not lead to improvement, in the respiratory or haemodynamic parameters. Isoprenaline led to increased pulmonary artery flow and a reversal of changes in lung compliance. It is concluded that both these agents should be instituted as soon as possible following pulmonary embolism.
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PMID:The influence of heparin and isoprenaline on the changes produced by pulmonary embolism. 695 28

Patients with acute pulmonary embolism are at risk for early death or chronic morbidity. Appropriate therapy can dramatically reduce the incidence of both. Oxygen and heparin therapy should be started as soon as the diagnosis is suspected. The condition of a hypotensive patient with right ventricular overload from acute pulmonary embolism usually is made worse by a fluid challenge; hypotension may be relieved by preload reduction or even by gentle diuresis. Norepinephrine (Levophed), isoproterenol hydrochloride (Isuprel), and epinephrine are the pressor agents of choice. Immediate thrombolysis is the standard of care for any patient with significant hypoxemia or hypotension due to proven pulmonary embolism. Beyond this, the potential benefit of using thrombolytic agents should be considered routinely for every patient with proven pulmonary embolism. Surgical embolectomy is useful for unstable pulmonary embolism when there are absolute contraindications to thrombolysis or when thrombolytic therapy fails. Empirical use of thrombolysis may be considered as a last-ditch effort for a critically ill patient when there is a high clinical suspicion of pulmonary embolism. Standard closed-chest cardiopulmonary resuscitation is ineffective when the pulmonary circulation is obstructed by thrombus. Emergency thoracotomy or femorofemoral cardiopulmonary bypass is appropriately used in patients with full cardiac arrest from pulmonary embolism.
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PMID:Acute pulmonary embolism. Aggressive therapy with anticoagulants and thrombolytics. 781 17

Diagnosis is central to medicine. In spite of tremendous diagnostic technological advances, no infallible test exists and in the complex diagnostic process the physician may well get lost. The ultimate feedback on the accuracy of diagnosis is the autopsy. Five patients illustrate that the autopsy may disclose unexpected results. The first patient was a 9-year-old girl who suffered from daily abdominal spasmodic pain but each time recovered. She died suddenly; autopsy revealed intestinal intussusception. A 46-year-old man who was treated for hypertension developed pain in the chest and the lower back, but there were no other signs of myocardial infarction. He died suddenly; autopsy revealed a dissecting aortic aneurysm with rupture in the left pleural cavity. A 21-year-old woman, an excellent swimmer, drowned during a swim in the sea. Autopsy revealed severe widespread coronary disease with multiple myocardial infarction. A 32-year-old Surinam woman developed acute coma and died from cardiorespiratory arrest. At autopsy she had massive pulmonary embolism and generalized lymphadenopathy due to sarcoidosis. The last patient, a 32-year-old woman suffered from fatigue after her fourth child was born. She was admitted with severe dyspnoea and her chest X-ray showed interstitial fibrosis. She died presently and autopsy revealed metastatic colon carcinoma with pulmonary lymphangitis carcinomatosa. Systematic reviews of the results of autopsies show no decline in the percentage of false diagnoses and/or unexpected findings in spite of the enormous growth of the diagnostic armamentarium. Although we may radiologically 'slice' the body in incredible detail or investigate human cells at the molecular level, the autopsy has by no means become obsolete and is an invaluable tool for quality control and teaching.
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PMID:[Truth after death]. 1059 Jul 70

A 21-year-old man who had a history of intravenous drug addiction was admitted with complaints of high fever and a productive cough. Chest CT on admission showed multiple consolidations, and pneumonia was initially diagnosed and treated. Because echocardiography after admission showed vegetation, with no bacteriological findings, attached to the tricuspid valve, right-sided infective endocarditis was diagnosed. After antibiotic therapy was changed, his fever was reduced and the inflammatory findings were eliminated. In the western world, most cases of right-side infective endocarditis are caused by drug addicts, but in Japan, this disease is very rare. Right-side infective endocarditis in drug addicts causes a high rate of pulmonary complications, in particular, septic pulmonary embolism. Many drug addicts suffering from pulmonary complications may consult doctors, but if the latter are not well-informed about this disease, it may not be possible to give an accurate diagnosis or proper treatment.
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PMID:[A case of infective endocarditis accompanied with pulmonary complications in a drug addict]. 1232 40

The tendency for thrombosis to occur if haemolysis persists after splenectomy is especially marked in "hereditary stomatocytosis", in which the red cell membrane "leaks" Na and K. A 21-year-old woman, who was splenectomized in childhood for a congenital haemolytic state, presented with major pulmonary embolism that recurred despite anticoagulation. Tests showed a significant cation leak with a "shallow-slope" abnormality in temperature dependence. Allogeneic bone marrow transplantation caused the thrombophilic state to cease and subsequently anticoagulation was stopped without recurrence of thromboembolism. However, she died 9 months after transplantation: iron overload, intensified by the transfusion demands of the transplant, was a major factor.
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PMID:Allogeneic bone marrow transplantation for severe post-splenectomy thrombophilic state in leaky red cell membrane haemolytic anaemia of the stomatocytosis class. 1267 Mar 41

A 21-year-old male presented with right scrotal discomfort. Right high orchiectomy revealed non-seminoma and he was diagnosed with stage I non-seminoma. Since acute myeloid leukemia (AML) was diagnosed incidentally, no adjuvant therapy was given and he received chemotherapy for AML. One year later, he complained of lumbago and general malaise. Complete remission of AML had been achieved and bone marrow puncture revealed no signs of recurrence. Computed tomography showed retroperitoneal lymph node swelling, inferior vena caval embolus distal to the hepatic vein, and multiple lung nodules. Metastasis of testicular neoplasm was suspected and chemotherapy with Bleomycin, Etoposide, and Cisplatin was started. On the fourth day of chemotherapy, the patient complained of sudden dyspnea and acutely went into shock. Pulmonary embolism was diagnosed and an inferior vena cava filter was placed. Chemotherapy was continued for four courses and the tumor showed complete remission. He has been free of disease for 24 months. In rare cases of testicular cancer with inferior vena caval embolus, the physician should be aware of the possibility of causing pulmonary embolism after chemotherapy.
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PMID:[Testicular cancer with inferior vena caval embolus causing pulmonary embolism following chemotherapy: a case report]. 1523 86

A 21-year-old man, in whom abnormal nodules had been detected in bilateral lung fields with no clinical symptoms for two years, was admitted to the hospital with sudden cardiopulmonary arrest. Acute pulmonary embolism with a large embolus was diagnosed, but the patient died soon after admission. When the examination was compared with X-ray taken 4 days earlier by chance, a large tumor was now detected in the right heart and was suspected to be the cause of this complication after his death. Necropsy found a 3.8 x 3.5 x 1.0 cm myxoid tumor arising in the right atrium and a large fragment of this type of tumor was at the pulmonary trunk. Many old myxoma fragments were noted in the bilateral peripheral branch of the pulmonary artery. It was concluded that the abnormal nodules were old pulmonary fragments and the cause of death was pulmonary embolism of a large fragment originated from the atrial myxoma. An asymptomatic right atrial myxoma is extremely rare but nevertheless possible to unexpected death like this case.
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PMID:Sudden death due to acute pulmonary embolism from asymptomatic right atrial myxoma. 1876 14

Pulmonary embolism (PE) is a fatal disease that is very rare in young people. A 21-year-old man developed PE because of a retroperitoneal tumor. The inferior vena cava (IVC) was obstructed by the tumor, and thrombus existed in the right common iliac vein. Thrombolysis and heparinization improved his symptoms prior to urgent tumor resection. A temporary IVC filter was inserted the day before the operation, but 8 h later fatal massive PE occurred. At autopsy, the retroperitoneal tumor was revealed as a metastatic choriocarcinoma. Prophylactic use of a temporary IVC filter might have paradoxically induced recurrence of massive PE in this case.
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PMID:Recurrence of pulmonary embolism in young man with retroperitoneal tumor despite insertion of temporary IVC filter. 1914 40


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