History and physical examination in acute pulmonary embolism in patients without preexisting cardiac or pulmonary disease

Stein, Paul D.; Willis, Park W.; DeMets, David L.; Bell, William R.; Blackmon, John R.; Genton, Edward; Messer, Joseph V.; Sasahara, Arthur A.; Sautter, Richard D.; Wenger, Manette K.; Walton, Joseph A.; Hildner, Frank J.; Fowler, Noble O.

doi:10.1016/0002-9149(81)90388-x

Cited by 150 publications

(52 citation statements)

References 13 publications

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“…13 Patients with circulatory collapse had the most severe pulmonary embolism based on the angiographic score, but the score was not statistically significantly higher than in patients with uncomplicated dyspnea. 13 The absence of dyspnea did not exclude pulmonary embolism, even in patients with circulatory collapse. 11…”

Section: Discussionmentioning

confidence: 98%

Clinical Characteristics of Patients with Acute Pulmonary Embolism: Data from PIOPED II

Stein

Beemath

Matta

et al. 2007

The American Journal of Medicine

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418

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BACKGROUND-Selection of patients for diagnostic tests for acute pulmonary embolism requires recognition of the possibility of pulmonary embolism based on the clinical characteristics. Patients in the Prospective Investigation of Pulmonary Embolism Diagnosis II (PIOPED II) had a broad spectrum of severity, which permits an evaluation of the subtle characteristics of mild pulmonary embolism as well as the characteristics of severe pulmonary embolism.

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Section: Discussionmentioning

confidence: 98%

Clinical Characteristics of Patients with Acute Pulmonary Embolism: Data from PIOPED II

Stein

Beemath

Matta

et al. 2007

The American Journal of Medicine

Self Cite

418

230

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“…5 Typically, patients with proven pulmonary embolism present with dyspnea or acute chest pain and less frequently with cough, hemoptysis, or fainting. 6,7 These findings often occur in association with well-defined risk factors, such as lower limb surgery or immobility (TABLE 1 [8][9][10] ). Frequent findings on examination include tachycardia, tachypnea, and an accentuated pulmonary component of the second heart sound (S 2 ).…”

Section: Introductionmentioning

confidence: 99%

“…Similarly, electrocardiography is nonspecific and may show T-wave inversion across precordial leads, the S 1 Q 3 /S 1 Q 3 T 3 pattern, or a right bundle-branch block. 6,7 Thus, although the above findings are seen in patients with objectively diagnosed pulmonary embolism, they also are common in patients without pulmonary embolism and lack specificity when considered individually. On the other hand, pulmonary embolism is uncommon in the absence of acute or worsening breathlessness or chest pain.…”

Section: Introductionmentioning

confidence: 99%

“…On the other hand, pulmonary embolism is uncommon in the absence of acute or worsening breathlessness or chest pain. 6,7 Because anticoagulant therapy reduces mortality from pulmonary embolism, the threshold for considering the diagnosis should be low. 3 We believe that pulmonary embolism at least should be considered whenever a patient presents with any of the above symptoms or symptom complexes, particularly in the presence of known risk factors or when there is no clear alternative.…”

Section: Introductionmentioning

confidence: 99%

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Does This Patient Have Pulmonary Embolism?

Chunilal

Eikelboom²,

Attia³

et al. 2003

JAMA

158

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“…Emboli larger than 7.5 mm in diameter are commonly fatal. 75 IVC filters are often used when anticoagulation therapy is contraindicated, has resulted in complications, or has failed to protect from embolic events.…”

Section: Inferior Vena Cava Filtersmentioning

confidence: 99%

Invasive Approaches to Treatment of Venous Thromboembolism

Augustinos

Ouriel

2004

Circulation

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Abstract-Deep vein thrombosis (DVT) occurs in one-quarter of a million individuals annually in the United States and results in significant disability from pulmonary embolism and chronic venous insufficiency, especially when the proximal iliofemoral is involved. Treatment has centered on early institution of adequate anticoagulation to prevent thrombus propagation and embolism, but anticoagulation alone does not always restore venous patency and many patients are left with venous outflow obstruction and valvular incompetence-the anatomic underpinnings of the postthrombotic syndrome. Various strategies have been used to restore patency of thrombosed veins, including open surgical thrombectomy, pharmacological thrombolysis, and percutaneous mechanical thrombectomy. Each modality has benefits and shortcomings. Surgical thrombectomy had previously been abandoned secondary to poor long-term results.More recently, with improved techniques and better patient selection, surgical thrombectomy has regained a therapeutic role in treating acute DVT in young patients with short segment occlusions. The advent of percutaneous techniques has allowed thrombolysis, percutaneous mechanical thrombectomy, and stenting to be used in conjunction with each other-allowing for better resolution of venous clot burden than when an individual modality is used alone. Practitioners who treat patients with DVT should be familiar with all the options available to restore venous patency, preserve valvular function, and thereby minimize the risk of late postthrombotic complications.

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History and physical examination in acute pulmonary embolism in patients without preexisting cardiac or pulmonary disease

Cited by 150 publications

References 13 publications

Clinical Characteristics of Patients with Acute Pulmonary Embolism: Data from PIOPED II

Clinical Characteristics of Patients with Acute Pulmonary Embolism: Data from PIOPED II

Does This Patient Have Pulmonary Embolism?

Invasive Approaches to Treatment of Venous Thromboembolism

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