Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0149871 (deep vein thrombosis)
 12,364 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 16 year old teenager with chest pain came to the emergency room at Children's Hospital in Charleston, South Carolina. Her sharp, constant midsternal pain and breathing difficulties began the morning of admission. 1 week before admission, she experienced a similar but less intense pain which resolved spontaneously. She was taking low-dose, triphasic oral contraceptives (OCs) as treatment for severe dysmenorrhea and dysfunctional uterine bleeding. She had no family history of elevated lipids, blood or clotting disorders, and cardiovascular disease. She did not smoke. She was obese (137.3 kg). She had elevated blood pressure (147/33 mm Hg), a high low-density lipoprotein count (140 mg/dL), and a high total cholesterol count (237 mg/dL). Her tender right calf was larger than the left calf. She had decreased perfusion of the entire left lung and right lower lobe. A pulmonary angiogram revealed emboli, and ultrasound of the legs revealed a thrombus behind the right knee. The physicians discontinued the OCs. They administered 2 anticoagulants--intravenous heparin followed by oral sodium warfarin for 6 months. Her respiratory distress ended within several days. Her right calf was no longer tender after 1 week. The physicians discharged her on a low-cholesterol, low-fat diet. They suggested she reduce her weight and exercise more often. She did not experience another venous thrombosis or pulmonary embolus. It appeared that the OCs contributed to her thromboembolism; yet, she did lead a sedentary lifestyle and was considerably overweight. Even though thromboembolism is rare in adolescents with no underlying predisposition for cardiovascular disease and who do not smoke, physicians should watch for sizeable changes in blood pressure, lipids, and cholesterol level as well as symptoms of deep venous thrombosis and cardiovascular disease.
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PMID:Pulmonary embolus in an adolescent on oral contraceptives. 129 Jul 74

There are occasional reports in the literature concerning the incidence of pulmonary embolism in the postburn population, but reports of burned children are especially rare. The clinical diagnosis of pulmonary embolism is particularly difficult in these populations due to the postburn pulmonary complications of pneumonia, bronchopneumonia, respiratory distress syndrome, and changes incurred through inhalation injury. A retrospective review of all patient deaths occurring at this institution during the past 22 years was performed in order to document the incidence of pulmonary embolism in burned children. Of the 6589 patients admitted during this time, 178 patients died (2.7%) and three (1.7%) deaths were attributable to pulmonary embolism. Two other deaths (1.1%) were associated with deep vein thrombosis. The incidence of pulmonary embolism can then be calculated at 46 per 100,000 admissions in this population of burned children. Burned patients always pose an increased risk for the development of pulmonary embolism. These patients are traumatized, require multiple venous and/or arterial cannulations, undergo multiple surgical procedures, are immobile for prolonged periods, prone to infectious processes and fluid and electrolyte imbalances. Despite all these risk factors, the incidence of pulmonary embolism is less than 2 per cent of all deaths in this postburn paediatric population.
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PMID:Pulmonary embolism in burned children. 262 93

Pulmonary embolism following postoperative deep venous thrombosis is a very serious complication with a high mortality rate. Though this disorder has been thought to be rare in Japanese, its occurrence seems to be increasing recently because of changes in eating habits, increase of average age and the frequent practice of venous catheterization. Two cases of the pulmonary embolism following deep venous thrombosis after surgery are reported, and possible causes of the deep venous thrombosis are discussed. Case 1: A 48 year-old obese female was operated on for a posterior fossa dural arteriovenous malformation. On the 4th postoperative day, she developed a pain and swelling in the left leg and low back pain. On the 18th postoperative day, she fell into a state of shock following the sudden onset of a severe back pain and respiratory distress. After diagnosis of the pulmonary embolism, she was immediately treated with urokinase, warfarin and aspirin. Her obesity was considered to be one of the risk factors of the postoperative deep venous thrombosis. Case 2: A 62 year-old female with a ruptured cerebral aneurysm could not get out of bed because of postoperative mental disturbance. A central venous pressure catheter was inserted into the right femoral vein for two weeks postoperatively. One month after surgery, she complained of swelling and a dull pain in the right leg without cardiorespiratory symptoms. Lung perfusion scintigraphy showed asymptomatic pulmonary embolism. She was treated immediately. Both long bed rest and femoral venous catheterization were considered as risk factors possibly leading to deep venous thrombosis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Postoperative pulmonary embolism in neurosurgical practice: report of two cases]. 321 Dec 80

The overall incidence of clinically important (moderate to severe) OHSS ranges from 1% to 10% of IVF cycles, but only a small proportion (0.5% to 2%) of the cases are severe. In extreme but rare cases, secondary complications such as deep vein thrombosis, respiratory distress and acute hepato-renal failure may occur. The main risk factors are the presence of polycystic ovaries, high ovarian response to superovulation therapy, the use of hCG to trigger the ovulatory process or for luteal phase support, and the endogenous production of hCG by an early pregnancy. The pathogenesis of OHSS is unknown, although the predominant biochemical mediator is thought to be the renin-angiotensin system. Ovarian stimulation should always be carefully monitored to identify those women at risk. In IVF cycles, the hCG injection should be withheld if the risk is judged to be too great. Some women will benefit from a policy of proceeding to collect oocytes, but electively cryopreserving any resulting embryos, thus allowing the ovarian stimulation cycle not to be wasted. The administration of albumin at the time of oocyte collection will reduce the chance of severe OHSS occurring. If a decision is made to proceed with oocyte recovery and embryo transfer, it may be advisable to give 5000 IU of hCG, rather than 10,000 IU, as the ovulatory trigger. Progesterone, and not hCG, should be given in the luteal phase. Women developing mild or moderate OHSS should be kept under outpatient surveillance to detect the minority that may progress to severe OHSS. Those with severe OHSS should be hospitalised for fluid and electrolyte management. Paracentesis under ultrasound guidance is recommended where there are tense ascites, but further surgical intervention should rarely be undertaken and only when there is good clinical evidence of ovarian torsion or haemorrhage.
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PMID:Diagnosis, prevention and management of ovarian hyperstimulation syndrome. 862 33

A sixty-seven-year-old man suffered from acute anterior spinal artery syndrome at the level of T-10. Transverse myelopathy developed by the eighth day. Computed tomography of the brain on the thirteenth day demonstrated hemorrhagic infarction in the left occipital lobe and fresh ischemic infarction in the right cerebellar hemisphere. Respiratory distress was the cause of death on the fifteenth day. Autopsy study showed severe ischemic necrosis of the spinal cord below T-10, and multiple infarcted lesions in the brain, lung, kidney, and heart. Saddle thromboembolism of the bilateral trunk of the pulmonary artery was the major cause of his death. Deep venous thrombosis in the pelvis was disclosed to be the primary source of multiple paradoxical embolisms through the patent foramen ovale.
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PMID:Massive spinal cord infarction with multiple paradoxical embolism: a case report. 844 36

Consider intensive care for any patient with an intracerebral hemorrhage (ICH) and coma, cardiac ischemia, rhythm disturbances, severe respiratory distress, labile hypertension, or progressive neurologic deficits. Begin treatment with diuretics and prophylaxis of deep venous thrombosis; some patients may also require fluid restriction, hyperventilation, antiepileptic drugs, intracerebral drainage, or surgical evacuation. Common causes of ICH include hypertension; vascular malformations; hemorrhagic infarction; and administration of sympathomimetics, anticoagulants, or fibrinolytics. To predict outcome, consider both the clinical features and radiologic findings at presentation.
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PMID:Treating intracerebral hemorrhage effectively in the ICU. The key steps: provide supportive care and determine the cause. 1015 48

We report the case of a 13-year-old male presenting with recurrent symptoms of respiratory distress after a trauma of the lower limb. Pulmonary symptoms had been misinterpreted for several weeks and only marked symptoms of deep venous (DVT) and caval vein thrombosis later prompted the correct diagnosis of DVT and embolic events and subsequently a successful thrombolytic therapy. The case reported here shows a diagnostic pitfall of pulmonary embolism in an adolescent. It emphasizes the need to consider the possibility of thromboembolic events also in young children and adolescents presenting with atypical pulmonary symptoms and suffering from pulmonary diseases not responding to antibiotic therapy. In addition, although the homozygous PT A20210A gene mutation is a rare defect and its relevance as a risk factor on its own remains to be elucidated, this case suggests that a complete thrombophilia laboratory workup should be performed in young patients with a first symptomatic thromboembolic onset.
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PMID:Recurrent pulmonary embolism in a 13-year-old male homozygous for the prothrombin G20210A mutation combined with protein S deficiency and increased lipoprotein (a). 1186 7

We describe here the first case of Salmonella paratyphi A bacteremia associated with deep vein thrombosis in a 10-year-old patient. In spite of aggressive antibiotic therapy and supportive care, the patient died of progressive respiratory distress and septic shock. Awareness of unusual clinical presentation of Salmonella infection in important. A review of the previously reported cases of Salmonella associated venous thrombosis worldwide is also presented.
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PMID:Venous thrombosis associated with Salmonella: report of a case and review of literature. 1451 51

The risk of venous thromboembolism (VTE) in medical patients has been substantially underestimated and prophylaxis is used far less than it is in surgical patients, reflecting the scarcity of evidence supporting antithrombotic therapy in nonsurgical settings. Reports of the frequency of deep venous thrombosis (DVT) in general medical patients in the absence of prophylaxis vary from 10 to 26%, depending on the methods used for diagnosis of DVT and the patient population studied. The risk in specific groups may be higher and may exceed that reported in low- or moderate-risk surgical patients. Data from several studies show that DVT developed in approximately 55% of patients with stroke, 24% of patients with myocardial infarction, and, in general medical populations, congestive heart failure, respiratory distress and/or underlying chest infections appeared to increase the risk of VTE. The frequency of VTE in patients with congestive heart failure has been reported to be as high as 40%. In a study among patients in a medical intensive care unit, it was found that 33% had VTE, of which 48% were proximal leg thromboses. Many other medical conditions increase the risk of thromboembolic events. These include malignant disease, which is commonly associated with a hypercoagulable state; inflammatory conditions such as systemic lupus erythematosus and inflammatory bowel disease; coma; and nephrotic syndrome. Accurate risk assessment and prompt implementation of appropriate prophylaxis, selected on the basis of evidence from well-designed, controlled clinical trials, may reduce future morbidity and mortality due to VTE in medical patients.
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PMID:Venous thromboembolism in medical patients--the scope of the problem. 1473 Apr 74

A 78-year-old woman with unstable angina underwent coronary bypass surgery with complete cardiac revascularization and no immediate postoperative complications. Six days after surgery, during hospitalization for cardiac rehabilitation, the patient developed severe respiratory distress and pulmonary embolism was diagnosed. Color duplex ultrasound revealed the presence of concomitant upper extremity deep vein thrombosis (UEDVT), ipsilateral to the site of placement of a central venous line, in the absence of lower extremity deep vein thrombosis. We describe this case and provide preliminary data from a prospective observational study evaluating the prevalence of catheter-related UEDVT and symptomatic pulmonary embolism (55 and 1.4% respectively) in a series of 71 consecutive coronary bypass surgery patients admitted to a cardiac rehabilitation facility. Catheter-related UEDVT and pulmonary embolism may complicate coronary bypass surgery and should be taken into consideration when managing patients after surgery.
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PMID:Upper extremity deep vein thrombosis and pulmonary embolism after coronary bypass surgery: a case report and preliminary results from a prospective study evaluating patients during cardiac rehabilitation. 1511 10


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