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Results for “PULMONARY EMBOLISM AND THROMBOSIS”

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At least 19 recordsLinked to original sources
PubMed1992

[Arterial embolism, venous thrombosis, pulmonary embolism: a suggestive triad].

The aim of this study is to present a relatively rare case of paradoxical arterial embolism, found in a patient who was sent to us for serious pulmonary embolism. Taking into account that the foramen ovale, despite being functionally competent, remains anatomically patent in 30% of the adult population, we cannot neglect the possibility of a paradoxical embolism, in the presence of a sudden embolic limb ischemia unless heart pathology or aortic lesions can be held responsible. Furthermore it must not be forgotten that deep venous thrombosis in the lower limbs or in the pelvic plexus may go unobserved on a purely clinical evaluation.

Axillary Artery↗
PubMed2002

Comparison of outcomes after hospitalization for deep venous thrombosis or pulmonary embolism.

Venous thrombosis and pulmonary embolism are commonly viewed as different manifestations of a single disease process, venous thromboembolism. Recent evidence suggests that there may be important differences between patients who manifest these two conditions. Using linked hospital discharge records we analyzed 71,250 patients hospitalized with a principal diagnosis of venous thrombosis alone or pulmonary embolism and analyzed predictors of rehospitalization within 6 months for venous thrombosis or pulmonary embolism. There were 51233 patients diagnosed with venous thrombosis alone and 21,625 diagnosed with pulmonary embolism. Comparing patients initially diagnosed with venous thrombosis alone to patients with pulmonary embolism, the relative risk of being rehospitalized with venous thrombosis within 6 months for venous thrombosis was 2.7. Conversely, when patients with pulmonary embolism were compared to patients with venous thrombosis alone, the relative risk of rehospitalization within 6 months with a diagnosis of pulmonary embolism was 4.2. In multivariate models the strongest predictor of recurrent thromboembolism manifest as pulmonary embolism was an initial diagnosis of pulmonary embolism and the strongest predictor of recurrence as venous thrombosis was an initial diagnosis of venous thrombosis. We conclude that the initial clinical manifestation of thromboembolism strongly predicts the manifestation of a recurrence. Venous thrombosis and pulmonary embolism appear to be distinct, albeit overlapping, clinical entities with different natural histories.

Aged↗
PubMed1996

Deep vein thrombosis, pulmonary embolism, and the white clot syndrome.

Thromboembolic events such as deep vein thrombosis (DVT) and pulmonary embolism (PE) are very uncommon in the pediatric age group; even more rare is the white clot syndrome. We present the case of a 13-year-old girl who presented with no known risk factors for thromboembolic disease or cardiopulmonary complaints, yet was found to have extensive lower extremity DVT and PE. This patient also suffered the rare but potentially devastating complication of heparin therapy referred to as the white clot syndrome, resulting in amputation of the lower extremity. Greater awareness of both thromboembolic disease in children and the white clot syndrome may lessen the morbidity and mortality associated with these entities.

Adolescent↗
PubMed1990

Diagnosis of venous thrombosis and pulmonary embolism.

Venous thrombosis and pulmonary embolism are closely related disorders. As many as 70 to 80% of patients with pulmonary embolism have associated proximal deep venous thrombosis. The clinical diagnosis alone of both venous thrombosis and pulmonary embolism is inaccurate because of the insensitivity and nonspecificity of findings, a problem that also occurs with a variety of other disorders. Invasive, objective tests are still the reference standard, but they are not always easy to perform, they cannot be used for a considerable number of very ill patients, and they create some patient discomfort. There is an increasing trend toward using noninvasive methods, either alone or in combination. These methods entail less risk, can be performed more quickly and conveniently, and are usually more cost-effective. Practical approaches to diagnosing venous thrombosis and pulmonary embolism in the clinical setting are discussed.

Algorithms↗
PubMed1985

Deep venous thrombosis, pulmonary embolism and acute surgery in thrombophlebitis of the long saphenous vein.

Twenty-eight consecutive cases of acute superficial thrombophlebitis of the long saphenous vein above the knee were reviewed concerning presence of asymptomatic deep venous thrombosis and pulmonary embolism and early clinical results after surgical treatment. Contrast phlebography of the ipsilateral leg revealed asymptomatic involvement of major deep veins of the thigh or calf in 4 of 21 examined patients. Perfusion lung scanning and chest radiography demonstrated typical segmental perfusion defects consistent with pulmonary embolism in two of ten examined patients. High ligation and stripping of the phlebitic veins gave prompt cure in 19 patients, though in two who were simultaneously treated with anticoagulants there was troublesome bleeding. Simple high ligation was performed in nine patients without complications, but four of them had protracted phlebitic pain. The results indicated that preoperative phlebography and lung scanning are helpful in detecting associated asymptomatic disorders and for planning therapy in patients with clinically isolated, superficial thrombophlebitis of the long saphenous vein. The treatment of choice is acute high ligation with removal of all phlebitic veins. If anticoagulation is indicated because of concomitant deep venous thrombosis or pulmonary embolism, the initial procedure should preferably be limited to high ligation.

Adult↗
PubMed1989

[Oral contraceptives: undesirable effects in internal medicine].

Eight instructive clinical case reports on younger women demonstrate the actual problem of severe adverse reactions (ADR) associated with oral contraceptives. Complications consisted of cerebral arterial thrombosis, peripheral arterial thrombosis, cerebral embolism, pelvic vein thrombosis, pulmonary embolism, thrombosis of the sinus sagittalis, recurrent pancreatitis and focal nodular hyperplasia of the liver. Contraindications of hormonal contraception (i.e. heavy smoking) were not always taken seriously by the prescribing physician. The data bank of the Medicines Commission of the German Medical Association contributed 648 cases to draw an ADR frequency profile, according to age, doses, duration of prescription and deaths. 25 deaths in close connection to oral contraception intake were reported, mostly caused by arterial or venous thromboembolism. Deaths predominantly were reported in women less than or equal to 30 years old, mostly following exposition to low-dose-preparations and after relatively short duration of intake (less than or equal to 3 years). These non-representative observations call for strict consideration of contraindications and use of low-dose-preparations, even in younger women.

Adult↗
PubMed1994

[Paradoxical cerebral embolism during fibrinolysis therapy in deep vein thrombosis and pulmonary embolism].

A 37-year-old woman with increasing dyspnoea over several months suddenly developed severe ortho- and tachypnoea as well as cyanosis of the lips and acrocyanosis. Pulmonary angiography revealed massive bilateral pulmonary emboli with a systolic pulmonary artery pressure of 75 mm Hg. Phlebography demonstrated a thrombotic occlusion of the deep veins of the left leg extending to the distal femoral vein. Thrombolysis treatment was started via an indwelling pulmonary artery catheter (500,000 IU urokinase and 10,000 IU heparin as bolus, then 1 mill. IU urokinase and 1,000 IU heparin per hour). After two hours an incomplete left-sided paresis occurred (involving ocular and facial muscles, dysarthria, left arm and left leg) and the thrombolytic infusion was stopped. But cerebral computed tomography (CT) did not demonstrate any intracerebral haemorrhage. The heparin infusion was restarted (partial thromboplastin time between 70 and 90 s). CT examinations during the next few days showed the development of an ischaemic infarction in the distribution of the right medial cerebral artery. Angiography demonstrated occlusion of the right internal carotid artery. The diagnosis of a paradoxical embolus was supported by easy cardiac catheter passage through a patent foramen ovale. Subsequent pulmonary angiography demonstrated a thrombus-free pulmonary arterial circulation with a normal pulmonary arterial pressure. There was gradual and extensive regression of the incomplete hemiparesis.

Adult↗
PubMed1997

The treatment of deep vein thrombosis and pulmonary embolism.

Deep vein thrombosis and pulmonary embolism can be considered as one clinical entity, termed venous thromboembolism, because of their comparable pathogenesis, treatment and prognosis. In this clinical spectrum of venous thromboembolism a gradient in severity of the disease can be recognized. Therapeutic strategies should be adapted to the extent of the thrombotic disease, varying from surgical or thrombolytic therapy in life-threatening disease to a watchful waiting diagnostic follow-up approach in minimal disease. In patients with established venous thromboembolism (low molecular weight) (LMWH), heparin should be initiated. An overview will be given of the safety and efficacy of the different therapeutic modalities such as thrombectomy, thrombolytic therapy, a watchful waiting diagnostic approach and unfractionated heparin. Furthermore, clinical studies comparing LMWH with unfractionated heparin in the initial treatment of venous thromboembolism will be reviewed.

Anticoagulants↗