scholarly journals Prediction of Mortality Associated with Cardiac and Radiological Findings in Patients with Pulmonary Embolism

2020 ◽  
Vol 6 (4) ◽  
pp. 84-90
Author(s):  
Sema Avci ◽  
Gokhan Perincek ◽  
Muammer Karakayali
Keyword(s):  
Pulmonary Embolism ◽  
Pulmonary Artery ◽  
Complete Blood Count ◽  
Clinical Signs ◽  
Axis Deviation ◽  
Arterial Blood ◽  
Prediction Of Mortality ◽  
Artery Embolism ◽  
Right Pulmonary Artery ◽  
Pulmonary Artery Embolism

AbstractBackground: In this study, we aimed to compare echocardiography, electrocardiography (ECG) abnormalities, Doppler ultrasonography (USG), and computed tomography pulmonary angiography (CTPA) results in predicting 3-month mortality in patients with acute pulmonary embolism (PE).Methods: This retrospective cohort study included 124 patients (72 females, 52 males) with acute PE. Demographics, symptoms, clinical signs, comorbidities, history of surgery, arterial blood gas, liver-renal functions, complete blood count, echocardiography, ECG, Doppler USG, and CTPA results, as well as 3-month mortality were recorded.Results: pH (z = –2.623; p <0.01), hemoglobin (z = –3.112; p <0.01), and oxygen saturation (z = –2.165; p <0. 01) were significantly higher in survivors. White blood cell (z = –2.703; p <0.01), blood urea nitrogen (z = –3.840; p <0.01), creatinine (z = –3.200; p <0.01), respiratory rate (z = –2.759; p <0.01), and heart rate (z = –2.313; p <0.01) were significantly higher in non-survivors. Nonspecific ST changes (AUC 0.52, 95% CI 0.43–0.61), p pulmonale (AUC 0.52, 95% CI 0.43–0.61), normal axis (AUC 0.61), right axis deviation (AUC 0.56), right ventricle strain pattern (AUC 0.59), and right pulmonary artery embolism (AUC 0.54) on CTPA showed the highest mortality prediction.Conclusions: Nonspecific ST changes, p pulmonale, normal axis and right axis deviation in ECG, RV strain in echocardiography, and right pulmonary artery embolism on CTPA are associated with a higher mortality in patients with PE.

Deep venous thrombosis in the clinical course of pulmonary embolism

2018 ◽  
Vol 34 (7) ◽  
pp. 453-458
Author(s):  
Natalia Stoeva ◽  
Milena Staneva ◽  
Galina Kirova ◽  
Rumiana Bakalova
Keyword(s):  
Pulmonary Embolism ◽  
Mortality Rate ◽  
Pulmonary Artery ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Clinical Presentation ◽  
Clinical Course ◽  
Clinical Signs ◽  
Arterial Blood ◽  
Severe Clinical Presentation

Objectives The aim of the study is to find how concomitant deep venous thrombosis (DVT) changes the clinical course of pulmonary embolism. Methods Three hundred and five patients with pulmonary embolism were examined and grouped into DVT and non-DVT groups. Both groups were compared with regard to demography, predisposing factors, clinical signs, thrombotic burden, and one-month mortality rate. Results The patients with DVT had a more severe clinical presentation: higher heart rate (94.80 ± 18.66 beats per minute versus 87.9 ± 13.90 in the non-DVT group, p = 0.00033), more hemodynamic instability (11.35% versus 3.05% in the non-DVT group, p = 0.005), and less pCO2 in arterial blood gases (30.81 ± 7.94 mmHg versus 32.59 ± 7.35 mmHg in the non-DVT group, p = 0.049). The DVT group had heavier thrombotic burden in pulmonary artery, measured by Mastora score. The one-month mortality rate did not differ statistically between groups. Conclusions Patients with symptomatic pulmonary embolism and concomitant DVT have heavier thrombotic burden in the pulmonary artery and more severe clinical presentation compared to those without DVT, but a similar one-month mortality rate.

scholarly journals On the issue of pulmonary embolism

1898 ◽  
Vol 12 (4) ◽  
pp. 548-549
Author(s):  
A. A. Maksimov
Keyword(s):  
Pulmonary Embolism ◽  
Pulmonary Artery ◽  
Pregnant Women ◽  
Artery Embolism ◽  
Physiological Phenomenon ◽  
Pulmonary Artery Embolism

Abstracts. Review of Obstetric and Gynecological literature: Russian.A.A. Maksimov. On the issue of pulmonary embolism . (Journal. Russian. General. Protection. Nar. Health. 1897,. No. 11, p. 647).Schmorl, who discovered pulmonary artery embolism with cells later, identified this phenomenon as the cause of eclampsia in pregnant women. Lubarsch considered embolism as a consequence of all sorts of seizures in pregnant women. Kasyanov, who found embolism in all pregnant women, suggested that this is a physiological phenomenon that occurs during every pregnancy. The author studied the lungs in 40 pregnant rabbits and was convinced that, under normal conditions, the rabbit does not have pulmonary embolism with shorts after.

scholarly journals Clinical importance of the distribution of pulmonary artery embolism in acute pulmonary embolism

2021 ◽  
Vol 49 (4) ◽  
pp. 030006052110047
Author(s):  
Yunqiang Nie ◽  
Li Sun ◽  
Wei Long ◽  
Xin LV ◽  
Cuiyun Li ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Pulmonary Artery ◽  
Right Ventricular ◽  
Mixed Type ◽  
Acute Pulmonary Embolism ◽  
Disease Duration ◽  
Clinical Importance ◽  
Artery Embolism ◽  
Pulmonary Embolisms ◽  
Pulmonary Artery Embolism

Objective To explore the clinical importance of the distribution of pulmonary artery embolism in acute pulmonary embolism (APE). Methods Sixty-four patients with APE were classified into mixed-type and distal-type pulmonary embolism groups. Their right ventricular systolic pressure (RVSP) and disease duration were recorded, and the diameter of their right ventricles was measured by ultrasound. The computed tomography angiographic clot load was determined as a Mastora score. Results Patients with distal-type pulmonary embolisms had significantly lower RVSPs (44.92 ± 17.04 vs 55.69 ± 17.66 mmHg), and significantly smaller right ventricular diameters (21.08 ± 3.06 vs 23.37 ± 3.48 mm) than those with mixed-type pulmonary embolisms. Additionally, disease duration was significantly longer in patients with distal-type pulmonary embolisms (14.33 ± 11.57 vs 8.10 ± 7.10 days), and they had significantly lower Mastora scores (20.91% ± 18.92% vs 43.96% ± 18.30%) than patients with mixed-type pulmonary embolisms. After treatment, RVSPs decreased significantly in patients with both distal-type and mixed-type pulmonary embolisms. Right ventricle diameters also decreased significantly in patients with mixed-type pulmonary embolisms after treatment. Conclusion Patients with mixed-type pulmonary embolisms are significantly more susceptible to pulmonary hypertension, enlarged right ventricular diameters, and shorter durations of disease than those with distal-type pulmonary embolisms. The distribution of pulmonary artery embolism in APE can provide a clinical reference.

scholarly journals Present aspects of thrombolytic therapy of pulmonary artery thromboembolism

2021 ◽  
Vol 99 (1) ◽  
pp. 6-14
Author(s):  
Y. V. Ovchinnikov ◽  
M. V. Zelenov ◽  
V. S. Polovinka ◽  
E. V. Kryukov
Keyword(s):  
Pulmonary Embolism ◽  
High Risk ◽  
Pulmonary Artery ◽  
Thrombolytic Therapy ◽  
Pulmonary Blood Flow ◽  
Pulmonary Thromboembolism ◽  
Comparative Efficiency ◽  
Artery Embolism ◽  
Pulmonary Arterial ◽  
Pulmonary Artery Embolism

The concept of high-risk pulmonary artery embolism determines that verification of the occlusion of the pulmonary arterial bed requires urgent restoration of pulmonary blood flow in such patients. Thrombolytic therapy is currently recognized as the main treatment for pulmonary artery thromboembolism. It can save patients’ lives, prevent the development of chronic post embolic pulmonary hypertension and thromboembolism recurrence. The literature review presents thrombolytic medications used in the treatment of pulmonary thromboembolism, describes indications for thrombolytic therapy, comparative efficiency and safety of various thrombolytics. The main complications of thrombolytic therapy are described and the issues of increasing its safety are raised. Criteria for the success of thrombolysis are early diagnosis, accurate risk stratification, and adequate use of reperfusion agents in patients with high-risk or transitionally high-risk of pulmonary embolism.

A case of pulmonary embolism in a fracture of both lower extremities

1903 ◽  
Vol 3 (3-4) ◽  
pp. 155-155
Author(s):  
N. N. Smirnov
Keyword(s):  
Pulmonary Embolism ◽  
Pulmonary Artery ◽  
Venous Thrombosis ◽  
Clinical Picture ◽  
Statistical Data ◽  
Lower Extremities ◽  
Lower Leg ◽  
Unexpected Death ◽  
Artery Embolism ◽  
Pulmonary Artery Embolism

In the case observed by the author, the patient had an unexpected death (within 1/2 hour with the onset of cardiac paralysis) in the period of recovery 3 weeks after the fracture of the shin bones (2-sided). Autopsy revealed thrombosis of the vein of the lower leg and embolism of the pulmonary artery, -Embolism on the basis of venous thrombosis, according to statistical data, is rather rare. In total, there are currently 37 cases of proven embolism and 15 cases. 70% of this number should be attributed to after fractures. Depending on the size of the embolus and the place of the drift, it causes a clinical picture of varying severity and outcome.

scholarly journals A visualized pulmonary arterial thrombus by using a new  echocardiographic view in an intermediate-risk a cute pulmonary embolism  patient: a case report

2019 ◽  
Author(s):  
Guanyu Mu ◽  
Feixue Li ◽  
Xiaolin Chen ◽  
Bo Zhao ◽  
Guangping Li ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Pulmonary Embolism ◽  
Pulmonary Artery ◽  
Acute Pulmonary Embolism ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Pulmonary Angiography ◽  
Normal Blood ◽  
Intermediate Risk ◽  
Normal Blood Pressure

Abstract BackgroundAcute pulmonary embolism (APE) is a life-threatening disease with nonspecific clinical signs and symptoms. Rapid and accurate diagnosis is crucial for the clinical management of patients with acute pulmonary embolism. A new recommended echocardiography view may be of further help in the diagnosis, evaluate the change of the thrombosis and treatment effect.Case presentationWe report a case of a 74-year-old man with a 12-day history of decreased exercise capacity and dyspnoea. The patient was diagnosed intermediate-risk APE as several pulmonary emboli in pulmonary artery were seen in multidetector computed tomographic pulmonary angiography with normal blood pressure and echocardiographic right ventricular overload. And we found a pulmonary artery clot in the right pulmonary artery through transthoracic echocardiography. After 11-days anticoagulation, the patient underwent a reassessment, showed decrease in RV diameter and pulmonary artery thrombus. ConclusionThis case highlights the significant role that echocardiography played in a patient who presented pulmonary embolism with a stable hemodynamic situation and normal blood pressure. The new echocardiographic view could provide correct diagnoses by identifying the clot size and location visually. Knowledge of the echocardiography results of APE would aid the diagnosis.

scholarly journals P701 Usefulness of echocardiography in diagnosis and monitoring in patient with pulmonary embolism during pregnancy, a case report

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
K Starzyk ◽  
P Dybich ◽  
K Ciuraszkiewicz ◽  
W Rokita ◽  
B Wozakowska-Kaplon
Keyword(s):  
Pulmonary Embolism ◽  
Pulmonary Artery ◽  
Troponin T ◽  
Pulmonary Arteries ◽  
Pulmonary Trunk ◽  
Clinical State ◽  
Main Trunk ◽  
Right Pulmonary Artery ◽  
Low Incidence ◽  
The Right

Abstract Pulmonary embolism is one of the leading causes of maternal mortality despite a low incidence of during pregnancy. We present 32-year-old woman, in the 35 week of first pregnancy, admitted to the Intensive Care Unit with dyspnea, tachycardia, cyanosis. Echocardiography confirmed the presence of embolic material in the main trunk of pulmonary artery, spreading to the right pulmonary artery. D-dimer and troponin T level were elevated, BNP remained within the normal range. The risk in PESI scale was assumed as intermediate high. LMWH therapy was initiated, the patient was constantly monitored. Venous thrombotic disease in lower extremities was excluded by ultrasonography. The treatment was carried out under obstetric supervision. The clinical state gradually improved, the patient was hemodynamically stable. Serial echocardiographic testing, revealed gradual regression of changes in the pulmonary trunk. Normalization of troponins and lowering of BNP levels were observed. The pregnancy was terminated in 39 week, by cesarean section (obstetric indications). The LMWH was continued few days after delivery, as the patient started lactation. She decided to terminate lactation in a first week after delivery so the therapy was switched into rivaroxaban for at least 3 months. Echocardiography after 3 month confirmed lack of changes in pulmonary trunk, the risk of pulmonary hypertension was low. Echocardiography can be a method of choice for confirming and monitoring pulmonary embolism during pregnancy, in a situation of high or intermediate clinical risk and good visualization of changes in pulmonary arteries Abstract P701 Figure. Embolism of pulmonary trunk and RPA

Sarcoma of the pulmonary artery mimicking pulmonary artery embolism

2019 ◽  
Vol 40 (33) ◽  
pp. 2824-2824
Author(s):  
Srdjan Kostic ◽  
Stefan Guth ◽  
Georg Bachmann ◽  
Christian W Hamm ◽  
Roland Klingenberg
Keyword(s):  
Pulmonary Artery ◽  
Artery Embolism ◽  
Pulmonary Artery Embolism
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