Massive pulmonary embolism without arterial hypoxaemia

Jardin, François; Bardet, J; Sanchez, Adriana Paula; Blanchet, F. Guillaume; Bourdarias, Jean-Pierre; Margairaz, A

doi:10.1007/bf01683065

Cited by 9 publications

(3 citation statements)

References 22 publications

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“…In obstructive shock recalcitrant hypotension is not surprising; in fact, it's expected. 5 Tension pneumothorax is a classic cause of this kind of problem, which is usually seen in the context of penetrating trauma. Our patient's normal chest imaging studies completely eliminate this possibility.…”

Section: Faculty Discussionmentioning

confidence: 99%

“…There are, though, a number of reports of unexpectedly high pO 2 in patients with massive PE and shock. 5,6 This may be due to low cardiac output with increased dwell time of blood in the pulmonic vasculature. Of note, stroke in association with PE is also reported.…”

Section: Faculty Discussionmentioning

confidence: 99%

“…Computed tomograms (CTs) of the head, chest, and abdomen were performed emergently (Figs. [3][4][5]. The head CT was read as normal, the chest CT demonstrated no aortic pathology, and the abdominal CT showed no free fluid or aneurysm.…”

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confidence: 99%

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Clinicopathological Conference: A 73‐year‐old Man with Shock, Stroke, and Cyanotic Extremities

Lafleur

Stokes‐Buzzelli

2002

Academic Emergency Medicine

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A 73-year-old man was brought to the emergency department (ED) after being found unresponsive. The patient was well until two weeks prior to presentation, at which time the family noticed a decrease in activity, poor appetite, and intermittent dyspnea. The patient refused to see a physician for evaluation of these symptoms and continued to work at a family-owned print shop. On the day of presentation, the patient went to work as usual; he had no problems during the day, but late in the afternoon complained of dyspnea. Within minutes he was noted to be dusky and became unresponsive. He was transported to the ED by private vehicle.Past medical history included hypertension and peripheral vascular occlusive disease. Surgical history included carotid endarterectomy and a femoral-femoral bypass. According to family members, the patient took no medications; he did smoke cigarettes, but didn't drink alcohol. The family history and review of systems provided no additional information.On physical examination the patient was unresponsive and tachypneic. There were no signs of trauma; the skin appeared mottled below the umbilicus and over both legs. The patient's rectal temperature was 34ЊC, pulse was 88 beats/min, respiratory rate 30 breaths/min, and blood pressure 89/69 mm Hg.The patient's pupils were 3 mm bilaterally and sluggishly reactive; the conjunctivae were pale. The neck was supple with no jugular venous distention or bruits. The lungs were clear, though respirations were shallow. On cardiac examination the rate was regular, with no murmurs noted. The abdomen was soft, nondistended, and nontender, with normal bowel sounds; bypass tubing was pal-

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Section: Faculty Discussionmentioning

confidence: 99%

Section: Faculty Discussionmentioning

confidence: 99%