| Right bundle branch block as a screening test for pulmonary embolism in chronic spinal cord injury. | |
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MedLine Citation:
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PMID: 19577039 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: To evaluate right bundle branch block (RBBB) on electrocardiograms (ECGs) as a screening tool for the diagnosis of pulmonary embolism (PE) in a chronic spinal cord injury (SCI) population and to determine the prevalence of PE. DESIGN: Retrospective analysis. SETTING: Boston Veterans Affairs Healthcare System. PARTICIPANTS: Consecutive SCI participants (N=112) who were followed at this institution until death between 1999 and 2005 at an average age of 71 years, a duration of paralysis of 31 years, with a tetraplegic level in 62%, and no useful motor function in 84%. INTERVENTION: Not applicable. MAIN OUTCOME MEASURES: PE, as a cause of RBBB, was diagnosed by autopsy, a source of thromboembolism, imaging, or other ECG signs of PE. Chronic obstructive lung disease was diagnosed by pulmonary function tests and myocardial infarction by ECG or echocardiogram. RESULTS: Twenty-nine participants (26%) had RBBB (6 with incomplete RBBB). Evidence that PE caused RBBB was found in 21 (72%), with 4 (3 massive) found by autopsy, 4 by the presence of an embolic source, 3 by imaging, 2 by the intermittent course of RBBB, 1 by abrupt onset of RBBB before death, and 7 by other ECG signs. RBBB represented chronic obstructive lung disease or myocardial infarction in the remaining 8. The onset of RBBB occurred either within months of SCI in 5 (1 before SCI) or years after SCI in 24 (6-50y, median 32y). RBBB was constant in 27 and intermittent in 2. The duration of RBBB ranged from 20 minutes to 31 years, median 4 years. CONCLUSIONS: RBBB may be a useful initial screening test for PE complicating chronic SCI. PE, often recurrent and sometimes fatal, is prevalent in chronic SCI. |
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Authors:
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James H Frisbie; G V R K Sharma |
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Publication Detail:
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Type: Journal Article; Research Support, U.S. Gov't, Non-P.H.S. |
Journal Detail:
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Title: Archives of physical medicine and rehabilitation Volume: 90 ISSN: 1532-821X ISO Abbreviation: Arch Phys Med Rehabil Publication Date: 2009 Jul |
Date Detail:
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Created Date: 2009-07-06 Completed Date: 2009-07-21 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 2985158R Medline TA: Arch Phys Med Rehabil Country: United States |
Other Details:
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Languages: eng Pagination: 1241-4 Citation Subset: AIM; IM |
Affiliation:
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Research Services, Boston Veterans Affairs Healthcare System and Harvard Medical School, Boston, MA, USA. jfrisbie@comcast.net |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Bundle-Branch Block / complications*, physiopathology Chronic Disease Electrocardiography Female Humans Male Pulmonary Embolism / diagnosis*, etiology Retrospective Studies Spinal Cord Injuries / complications* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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