Pulmonary embolism

Kutty, Kesavan

doi:10.1080/00325481.1990.11704754

Postgraduate Medicine

1990

DOI: 10.1080/00325481.1990.11704754

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Pulmonary embolism

Kesavan Kutty

Abstract: Pulmonary embolism is a common problem in hospitalized patients. Because its initial symptoms may be nonspecific, pulmonary embolism may be difficult to diagnose. A high index of suspicion, together with careful selection of diagnostic tests, is essential. An algorithm for clinical assessment of suspected pulmonary embolism is presented here.

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Cited by 4 publications

References 35 publications

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Noninvasive imaging of the lower extremity for deep venous thrombosis

Richlie

1993

J Gen Intern Med

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Noninvasive imaging for LE DVT has advanced remarkably in the past decade. Currently, IPG and ultrasound techniques (RTU and DS) have been proven to be quick, accurate, relatively inexpensive, and widely available methods for detecting proximal LE DVT and can be used as the initial diagnostic studies in many settings. Color-flow Doppler ultrasound studies may be more accurate than other ultrasound techniques in diagnosing calf DVT and in differentiating acute from chronic LE DVTs, though this bears further review. Many concerns remain regarding noninvasive LE DVT imaging, including: The accuracy of the above studies in nonreferral centers. The need for and optimal frequency of follow-up studies to detect clots that propagate proximally. The optimal noninvasive techniques for imaging in the setting of recurrent DVT and other specialized settings (e.g., high-risk patients).

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Noninvasive imaging of the lower extremity for deep venous thrombosis

Richlie

1993

J Gen Intern Med

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Pulmonary Embolism in Children

Evans

Wilmott

1994

Pediatric Clinics of North America

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A Case of Minimally Differentiated Acute Leukemia (AML—M0) Complicated by Ventricle Thrombosis During Remission-induction

et al. 2001

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Sudden chest pain, dyspnea, and tachypnea occurred in a 21-year-old female who was undergoing induction chemotherapy under a diagnosis of minimally differentiated acute leukemia (M0). The arterial blood gas (ABG) tensions were decreased (PO2 71.6 mm Hg, PCO2 23.7 mm Hg), and an electrocardiogram showed a right-bundle branch block. Coagulation abnormalities (PT 73.1%, APTT 39.4 s, FDP 235mg/dl) were observed 72 h before onset. Echocardiography revealed a large thrombus in a right ventricle. A diagnosis of pulmonary thromboembolism (PTE) was made, and a tissue-type plasminogen activator (monteplase) was administered under percutaneous cardiopulmonary support (PCPS). The complete lysis of thrombus was confirmed by an echocardiogram 8 h later. Symptoms and ABG data were also improved. PTE in adult AML cases is rare, but should be considered as one of the life-threatening complications in AML patients under chemotherapy who develop respiratory difficulties. We suggest a careful monitoring of coagulation abnormalities for the prediction of PTE during chemotherapy for AML, and the use of tissue-type plasminogen activator (t-PA), monteplase, for the treatment of PTE in these cases.

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Pulmonary embolism

Cited by 4 publications

References 35 publications

Noninvasive imaging of the lower extremity for deep venous thrombosis

Noninvasive imaging of the lower extremity for deep venous thrombosis

Pulmonary Embolism in Children

A Case of Minimally Differentiated Acute Leukemia (AML—M0) Complicated by Ventricle Thrombosis During Remission-induction

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