Floating right heart thrombi can occur in 4-18% of patients with pulmonary embolism. Usually, the diagnosis is done by echocardiography and carries an important prognostic significance as thrombi can embolize at any moment and severe pulmonary embolism is the most frequent way of floating right heart thrombi presentation (mortality rate ...

Pulmonary embolism (PE) is a significant cause of morbidity and mortality after surgical procedures. Early diagnosis and prompt, effective management of this condition present considerable clinical challenges to surgeons. Imaging studies form the mainstay of diagnosis of PE and include plain radiography, ventilation-perfusion scan, venography, echocardiography, catheter pulmonary angiogram, CT ...

Sputum cytology is an important diagnostic tool in pulmonary medicine, but it can yield a false-positive diagnosis of malignancy. We describe such a case, which involved a 70-year-old man who presented with chest pain, hemoptysis, and bilateral pulmonary infiltrates. In the initial evaluation of hemoptysis, multiple sputum samples demonstrated cytological ...

BACKGROUND: Helical computed tomography (CT) has been proposed as a first-line test for the diagnosis of pulmonary embolism. How the test affects the diagnostic evaluation of patients with suspected pulmonary embolism is unknown. METHODS: We examined a cohort of 360 patients evaluated for pulmonary embolism at a teaching hospital in ...

Cardiac troponin I levels were increased in 24 of 147 patients (16%) with documented acute pulmonary embolism and in 20 of 594 patients (3%) without pulmonary embolism (p <0.001). In patients with acute pulmonary embolisms, 8 of 24 (33%) with increased cardiac troponin I levels and 9 of 123 (7%) ...

OBJECTIVE: The purpose of our study was to compare the bronchial arteries of patients with acute pulmonary embolism with those of patients with chronic or recurrent pulmonary embolism. MATERIALS AND METHODS: Twenty-seven patients with acute pulmonary embolism and 14 patients with chronic or recurrent pulmonary embolism were retrospectively identified from ...

BACKGROUND: Helical computed tomography has been introduced for the diagnosis of pulmonary embolism. OBJECTIVE: To determine the clinical safety of withholding anticoagulant treatment in patients with suspicion of pulmonary embolism and negative helical computed tomography study. METHODS: During a 9-month period, we performed a prospective study including 209 consecutive patients ...

Pulmonary embolism (PE) is a common and potentially lethal complication of deep venous thrombosis. Clinical diagnosis is difficult and treatment carries significant potential side effects. High sensitivity and specificity of any diagnostic modality for PE are desirable. Helical CT pulmonary angiography (CTPA) offers this by direct visualization of embolic material ...

An analysis of the accessible literature on the diagnostic applicability of artificial neural networks in coronary artery disease and pulmonary embolism appears to be comparative to the diagnosis of experienced doctors dealing with nuclear medicine. Differences in the employed models of artificial neural networks indicate a constant search for the ...

OBJECTIVE: The purpose of this study was to present the computed tomography (CT) findings of pulmonary artery sarcoma in 7 patients with a focus on the distinguishing features of pulmonary embolic disease. METHODS: For the 9 years from December 1993 to November 2002, we treated 7 patients with pathologically proven ...

Multi-slice computed tomography has become the main method to diagnose and evaluate the intensity of acute pulmonary embolism (PE). The most common cause of PE is thrombosis of veins of the lower limbs and pelvis. The paper presents various aspects of the use of combined pulmonary artery arteriography and indirect ...

Solitary pulmonary microembolism is rarely discussed as a distinct diagnostic entity. The purpose of this investigation was to determine the prevalence and clinical significance of embolism limited to subsegmental branches in a group of patients discharged from hospital on anticoagulants with a diagnosis of pulmonary embolism based on ventilation-perfusion imaging ...

The volume of myocardial tissue that is perfused by an epicardial coronary artery has been shown to be predictably related to the diameter of the epicardial arterial lumen. However, to what extent the intramyocardial microvasculature follows the epicardial rules remains unclear. To explore the relationship between the diameter of coronary ...

CONTEXT: Experienced clinicians' gestalt is useful in estimating the pretest probability for pulmonary embolism and is complementary to diagnostic testing, such as lung scanning. However, it is unclear whether recently developed clinical prediction rules, using explicit features of clinical examination, are comparable with clinicians' gestalt. If so, clinical prediction rules ...

BACKGROUND: Wheezing is a little known but possible presentation feature of acute pulmonary embolism. PATIENTS AND METHODS: A retrospective review of the records of 154 consecutive patients with acute pulmonary embolism, who survived long enough for diagnostic evaluation. RESULTS: Fourteen patients with acute pulmonary embolism (9.1%) had wheezing at presentation. ...

BACKGROUND: Systemic artery to pulmonary vessel fistulas (SAPVF) occur through pleural adhesions from miscellaneous origin. We report 3 cases of acquired SAPVF that developed late after thoracotomy. METHODS: There was one pleurectomy for pneumothorax, one sleeve main bronchial resection, and one lower-middle bilobectomy. These SAPVF were discovered 4, 18, and ...

BACKGROUND: Pulmonary embolism occurs frequently in hospitalized patients. Thrombolytic therapy, currently used as the major treatment, has often been associated with severe bleeding complications and has thereby been life-threatening. We have developed a novel therapeutic method based on our newly created pulmonary endothelium-specific antibody. METHODS AND RESULTS: We isolated membrane ...

Along with clinical examination and laboratory tests, imaging plays a key role in the diagnosis of pulmonary embolism. Multi-detector row helical computed tomography (CT) is particularly helpful in the diagnosis of acute pulmonary thromboembolism (PTE) owing to its capacity to directly show emboli as intravascular filling defects. Although parenchymal abnormalities ...

The objectives of this study were to determine if diagnostic certainty on angiography correlates with scintigraphic probability for the diagnosis of pulmonary embolism. From a total of 160 consecutive patients who underwent both nuclear imaging and invasive selective pulmonary angiography, we reviewed the xenon-133 ventilation images in 2 posterior oblique ...

OBJECTIVE: The purpose of this article is to describe the imaging findings of acute central pulmonary embolism on computed tomography (CT) densitometry images performed before contrast-enhanced CT pulmonary angiography. METHODS: A retrospective review was conducted of reports from all CT pulmonary angiograms performed at our institution, and cases of acute ...

The use of B-type natriuretic peptide to diagnose congestive heart failure is becoming more frequent and widespread. We report five patients recently seen at our hospital who were diagnosed with pulmonary embolism and noted to have elevated B-type natriuretic peptide levels. We caution that elevations of B-type natriuretic peptide may ...

AIM: The purpose of this study was to determine the feasibility of echocardiogram (ECG)-gated multi-slice CT angiography (MCTA) in patients with clinical suspicion of acute venous thromboembolism (VTE), to investigate the effect of ECG-gating on cardiac motion artefacts, and to determine the diagnostic reader agreement of ECG-gated MCTA in comparison ...

BACKGROUND: the incidence of pulmonary embolism increases with age but the 'classical' presentation of acute pulmonary embolism may not occur in older persons. OBJECTIVES: to compare the clinical presentation of younger and older patients with acute pulmonary embolism. DESIGN: retrospective identification of 60 consecutive cases of spiral computed tomography confirmed ...

Pulmonary embolism after total hip arthroplasty is problematic, and intravenous heparin treatment in the absence of pulmonary embolism carries risk. Algorithms for treating pulmonary embolism often cite clinical index of suspicion as a basis for initiating intravenous heparin, but most information regarding variables to predict pulmonary embolism originate from studies ...

A 68-year-old healthy man was admitted because of liver abscess and aeromonas bacteremia accompanied by pulmonary embolism. Aeromonas sobria was isolated from blood. Coagulation parameters were normal and a lower limb venogram showed no evidence of thrombosis. Septic embolism originating from the liver abscess was considered as the possible cause ...

Pulmonary embolism remains a challenging diagnostic problem. We developed a simple diagnostic strategy based on combination of assessment of the pretest probability with perfusion lung scan results to reduce the need for pulmonary angiography. We studied 390 consecutive patients (78% in-patients) with suspected pulmonary embolism. The pretest probability was rated ...

BACKGROUND: Helical computed tomography (CT) techniques for the diagnosis of pulmonary embolism have been refined over the past decade. Helical CT is widely used in the diagnosis of pulmonary embolism despite the lack of well-designed trials supporting this approach. Although helical CT correlates well with pulmonary angiography in detecting central ...

We propose an emergency department (ED) pulmonary embolism rule-out protocol based on pretest probability assessment coupled with either a negative D -dimer assay result or a negative D -dimer assay result plus a normal alveolar dead-space measurement. We examine the safety, efficiency, and feasibility of such a protocol, paying special ...

PURPOSE: To identify right-sided chest lead electrocardiographic abnormalities in acute pulmonary embolism. PATIENTS AND METHODS: Analysis of electrocardiographic changes in 100 African American patients suspected of having pulmonary embolism was made at Howard University Hospital during 2001-02 (60% women, 40% men, median age 50 years). Standard 12-lead EKGs were obtained ...

RATIONALE AND OBJECTIVES: The authors explored the possibility that patients with suspected pulmonary embolism are at high risk for coronary artery disease. To this purpose, they compared the presence of coronary artery calcification on computed tomography (CT) in patients suspected of pulmonary embolism with age- and gender-matched controls. MATERIALS AND ...

Pulmonary arterial involvement is a rare but life-threatening complication of Behçet's disease (BD). A 28-year old male, presented with hemoptysis, fever, dyspnea, weight loss and recurrent oral ulcers was diagnosed with Behçet's disease with multiple bilateral pulmonary arterial aneurysms confirmed following a CT and MRI. scan Besides pulmonary involvement, ocular ...

OBJECTIVE: To evaluate the diagnostic performance of transthoracic sonography of the lung in view of an acute suspicion of pulmonary embolism. METHODS: The diagnosis of pulmonary embolism was made within 48 hours of admission with the use of a validated strategy that combined a lung scan, lower limb sonography, helical ...

BACKGROUND: Pulmonary embolism is a common clinical disorder that is associated with high morbidity and mortality if untreated. It is important to confirm or rule out the diagnosis in patients with clinical suspicion of the disease. PURPOSE: To evaluate various diagnostic strategies for excluding pulmonary embolism. DATA SOURCES: MEDLINE (1966 ...

AIMS: To test the hypothesis that Qr in V(1)is a predictor of pulmonary embolism, right ventricular strain, and adverse clinical outcome. METHODS AND RESULTS: ECG's from 151 patients with suspected pulmonary embolism were blindly interpreted by two observers. Echocardiography, troponin I, and pro-brain natriuretic peptide levels were obtained in 75 ...

PURPOSE: To assess the clinical outcomes of patients who were suspected of having acute pulmonary embolism and underwent spiral computed tomographic pulmonary angiography (CTPA) for diagnosis. METHODS: We evaluated the clinical outcomes of 62 patients with suspected pulmonary embolism; 82 CTPA scans were performed in a 15-month period. Clinical outcomes ...

OBJECTIVE: Our purpose was to describe the imaging findings of central pulmonary embolism on unenhanced multidetector CT (MDCT) of the chest. CONCLUSION: Unenhanced MDCT of the chest is often performed for the evaluation of nonspecific chest symptoms. Awareness of the rare finding of a high-attenuation centrally located pulmonary embolism on ...

Percutaneous catheter-based thrombolysis is commonly used in association with angioplasty to treat thrombosed hemodialysis arteriovenous grafts. Although major complications of these percutaneous procedures are relatively uncommon, they can result in several potentially serious complications, including pulmonary embolism, cerebral embolism, arterial embolism, bleeding with perigraft hematoma or hemorrhage, and vein rupture. ...

Primary leiomyosarcoma of the pulmonary artery is a rare malignancy arising from the multipotential mesenchymal cell of the intima of the pulmonary artery. Due to its rarity and nonspecific clinical symptoms, the correct diagnosis and proper management are often delayed. Furthermore, it is frequently misdiagnosed as pulmonary embolism, mediastinal mass, ...

PURPOSE: To compare the frequency of well-visualized pulmonary arteries according to anatomic level by using different collimation with single- and multi-detector row computed tomography (CT) in patients suspected of having acute pulmonary embolism. MATERIALS AND METHODS: Sixty patients were examined with one of three techniques (20 patients each). Group 1 ...

BACKGROUND: Despite effective treatment with anticoagulants, 2% to 7% of patients with pulmonary embolism will die as a result of their disease. METHODS AND RESULTS: We examined in 110 consecutive patients with pulmonary embolism whether plasma brain natriuretic peptide (BNP), a novel marker of (right) ventricular dysfunction, is a predictor ...

We undertook genetic and biochemical assays in patients with arterial (n = 146) and venous (n = 199) thromboembolism and survivors of pulmonary embolism (n = 58) to study causation and gene-life style interactions. In the clinical material from North Western Russia, factor V Leiden was found to be a ...

We report a case of pulmonary tumor embolism involving multiple emboli from an unusual site, an adenocarcinoma of the prostate. A 78-year-old Japanese man was diagnosed with stage IV (1997 version of the TNM classification) moderately differentiated adenocarcinoma of the prostate in December 1997. He underwent bilateral orchiectomy and hormonal ...

BACKGROUND: Computed tomography pulmonary -angiography (CTPA) plays an increasingly important role in the diagnosis of pulmonary embolism (PE). Although accurate in the detection of large PE, its accuracy in other patient groups is yet to be defined. AIM: To compare CTPA with pulmonary angiography as a second-line investigation in patients ...

Recent advances in the management of patients with suspected pulmonary embolism have improved diagnostic accuracy and made management algorithms safer and more accessible. Ongoing clinical trials are evaluating whether these diagnostic processes can be made even simpler and less expensive. It is now possible to identify low-risk patients with suspected ...

PURPOSE: To develop a structured model to predict the clinical probability of pulmonary embolism. METHODS: We studied 1,100 consecutive patients with suspected pulmonary embolism in whom a definite diagnosis had been established. We used logistic regression analysis to estimate the probability of pulmonary embolism based on patients' clinical characteristics; the ...

The objective was to evaluate the helical CT (HCT) criteria that could indicate severe pulmonary embolism (PE). In a retrospective study, 81 patients (mean age 62 years) with clinical suspicion of PE explored by HCT were studied. The patients were separated into three different groups according to clinical severity and ...

(1) The reference treatment for preventing pulmonary embolism and vein thrombosis during surgery for hip fracture and hip or knee replacement is a low-molecular-weight heparin (LMWH), administered subcutaneously. (2) Fondaparinux, a heparin-derived anticoagulant, is also licensed for these indications, and administered subcutaneously. (3) Four trials versus enoxaparin, an LMWH, showed ...

This evaluation of the use of enzyme-linked immunosorbent assay (ELISA) D-dimer test in routine clinical practice supports other evidence that the assay has a high sensitivity to exclude pulmonary embolism in patient populations in which there is clinical suspicion. Nevertheless, the assay incorrectly excluded the diagnosis of pulmonary embolism in ...

PURPOSE: To investigate if abnormal early contrast enhancement of the aorta and decreased attenuation of pulmonary arteries at deep-inspiration spiral computed tomographic (CT) angiography might be caused by a patent foramen ovale (PFO). MATERIALS AND METHODS: Two hundred forty-four spiral CT angiographic images of the pulmonary arteries obtained during deep ...

Because of differences in presentation, clinical course, diagnostic testing, treatments, prognosis, followup requirements and prevention strategies between ODTS, hypersensitivity pneumonitis, oxides of nitrogen and other pulmonary exposure-related illnesses, it is important for poison centers and clinicians to obtain appropriate elements of history, physical examination, and laboratory data that will allow ...