Diagnosing pulmonary thromboembolism.

Windebank, W J

doi:10.1136/bmj.294.6584.1369

Cited by 17 publications

(8 citation statements)

References 15 publications

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“…No patient had a lung angiogram which is the definitive test for the diagnosis of PE (Windebank, 1987). On follow-up no patient had complications associated with PE.…”

Section: Discussionmentioning

confidence: 98%

Pulmonary embolism in patients attending the accident and emergency department with pleuritic chest pain.

Thomas

Reichl

1991

Emergency Medicine Journal

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SUMMARYA series of 92 patients presenting to an accident and emergency department with pleuritic chest pain is described. Only one of the patients had a diagnosis of pulmonary embolus. All the patients were followed up over a period of 3 months. During this time none of them suffered from mortality or morbidity which could be related to pulmonary embolism. No evidence was obtained during this study that a more aggressive approach to such patients is required in order to achieve the diagnosis.

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“…No patient had a lung angiogram which is the definitive test for the diagnosis of PE (Windebank, 1987). On follow-up no patient had complications associated with PE.…”

Section: Discussionmentioning

confidence: 98%

Pulmonary embolism in patients attending the accident and emergency department with pleuritic chest pain.

Thomas

Reichl

1991

Emergency Medicine Journal

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“…As only grossly abnormal scans confirm the diagnosis of PE (Sharma & McIntyre, 1984) and scans between the two extremes are far less specific (McNeil et al, 1974), many authors feel that isotope scans are not useful for the positive diagnosis of PE. Pulmonary arteriography is the most accurate investigation for the diagnosis of pulmonary embolism (Windebank, 1987). As this investigation is invasive, carries a certain degree of morbidity and cannot be performed on an outpatient basis, it is not applicable in the A&E setting.…”

Section: Discussionmentioning

confidence: 99%

“…Isotope perfusion scans are much more widely available. Although this type of scan is less specific than the V/Q scan, a normal result will again exclude the diagnosis of PE (Windebank, 1987). Therefore, this type of scan can be used as a screening procedure in the way the authors used the V/Q scans.…”

Section: Discussionmentioning

confidence: 99%

Use of isotope scanning as an aid to the diagnosis of pulmonary embolism in the accident and emergency department.

Reichl

Bentley²,

Sleet³

1988

Emergency Medicine Journal

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“…However, pulmonary thromboemboli may be difficult to be differentiated from the other problems as it can produce similar clinical and investigational profiles. The hypoxia resulting from emboli may cause reflex bronchospasm typical of asthma or of an exacerbation of chronic obstructive airway disease [5] . Airway may be rendered atelectasis and susceptible to secondary infection, causing edema [4] .…”

Section: Early Diagnosismentioning

confidence: 99%

Pulmonary thromboembolism following thoracotomy for lung cancer

Liu

Wang

et al. 2006

Chin. J. Cancer Res.

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Objective:To investigate the clinical features of pulmonary thromboembolism in patients with primary lung cancer in relation to thoracotomy, and to shed light on prevention, diagnosis and treatment of this fatal disease after lung resection. Methods: A total of 1245 cases with primary lung cancer received thoracotomy in the past 13 years were retrospectively reviewed. Clinical data of a total of 14 patients (1.1%) suffering from pulmonary thromboembolism and requiring cardiao-pulmonary resuscitation were collected and analyzed. Results: The diagnosis was established primarily by clinical findings in 9 cases (64.3%), including further confirmation of one case during operation, by pulmonary ventilation-perfusion scan in 2, by spiral CT angiography in 1, by pulmonary angiography in 1, and by autopsy in 1 case. Even using prompt resuscitation, 8 patients (57.1%) died within 48 h (mean 4 h) after the onset of the symptoms. Six cases eventually recovered. Of the 6 salvaged patients, they all received anticoagulation therapy with heparin intravenously and warfarin orally, including 3 cases of additional thrombolytic therapy with urokinase. Two cases with massive pulmonary emboli received emergency surgery, including one pulmonary embolectomy, and one bilobectomy after right upper lobectomy, with satisfactory results. Conclusion: Massive pulmonary embolism is an infrequent but fatal early postoperative complication after lung resection. The diagnosis should be based mainly on clinical findings in order to initiate the appropriate therapy immediately. The direct diagnostic techniques including radionuclide pulmonary scan, spiral CT angiography, and pulmonary angiography could be based on a careful evaluation of the expected benefits and risks of the various available treatments.

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Diagnosing pulmonary thromboembolism.

Cited by 17 publications

References 15 publications

Pulmonary embolism in patients attending the accident and emergency department with pleuritic chest pain.

Pulmonary embolism in patients attending the accident and emergency department with pleuritic chest pain.

Use of isotope scanning as an aid to the diagnosis of pulmonary embolism in the accident and emergency department.

Pulmonary thromboembolism following thoracotomy for lung cancer

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