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Pulmonary Emboli ECG

Benjamin W Hatten, L Keith French, B Zane Horowitz, Robert G Hendrickson
STUDY OBJECTIVE: In cases of high-concentration peroxide ingestion reported to US poison centers, we describe medical outcomes, examine the role of hyperbaric oxygen, and review the use of endoscopy. METHODS: The study was a retrospective analysis of a structured database, the National Poison Data System. The chart for each poison center case of a high-concentration (>10%) peroxide ingestion was obtained and abstracted in a standardized fashion; 1,054 cases were initially considered and 294 cases met inclusion criteria...
June 2017: Annals of Emergency Medicine
David Luke Glancy
Failure to recognize ECG features consistent with acute cor pulmonale in a man with new onset syncope and dyspnea resulted in death from undiagnosed pulmonary emboli.
August 1, 2016: American Journal of Cardiology
Yung-Kun Hsieh, Fu-Yuan Siao, Chun-Chieh Chiu, Hsu-Heng Yen, Yao-Li Chen
Prolonged cardiac arrest with pulseless electrical activity (PEA) results in death if its aetiology cannot be corrected immediately. We describe the case of a 75-year-old man with chest pain and his electrocardiogram (ECG) revealing ST-segment elevation in leads II, III, and aVf. Inferior wall myocardial infarction was subsequently diagnosed. Before performing emergency coronary angiography, however, a sudden cardiac arrest with PEA developed and the patient was placed on advanced cardiac life support. Oxygenation support for the extracorporeal membrane was initiated approximately 65min after prolonged cardiopulmonary resuscitation...
July 2016: Heart, Lung & Circulation
Jinghua Zhang, Guizhi Liu, Suifeng Wang, Weiguo Du, Peisheng Lv, Hua Guo, Qian Sun, Yining Liu, Xinxin Qi
OBJECTIVE: Pulmonary embolism (PE) is a common cardiovascular disease that can be easily missed or misdiagnosed. Electrocardiogram (ECG) is valuable in making early diagnoses and performing risk stratification with regard to acute PE. METHODS: A total of 147 hospitalized patients diagnosed with acute PE were enrolled in this study and divided into the following 2 groups: main pulmonary artery trunk or main pulmonary artery (MPA) embolism and lobar artery or remote branch embolism...
February 2016: American Journal of Emergency Medicine
Pınar Türker Bayır, Ümit Güray, Serkan Duyuler, Burcu Demirkan, Oya Kayaalp, Selçuk Kanat, Yeşim Güray
OBJECTIVE: Polycystic ovary syndrome (PCOS) is associated with increased cardiovascular risk, including ischemic stroke. Prolonged atrial electromechanical interval (EMI) is related to increased atrial fibrillation (AF) risk. The aim of the study is to evaluate atrial EMI and electrocardiographic P-wave indices related to increased AF risk in patients with PCOS. METHODS: Forty PCOS patients diagnosed on the basis of the Rotterdam criteria and 20 age-matched controls were prospectively included...
February 2016: Anatolian Journal of Cardiology
Praveen Hariharan, David M Dudzinski, Ikenna Okechukwu, James Kimo Takayesu, Yuchiao Chang, Christopher Kabrhel
BACKGROUND: Electrocardiographic (ECG) changes may be seen with pulmonary emboli (PE). Whether ECG is associated with short-term adverse clinical events after PE is less well established. HYPOTHESIS: ECG findings are associated with short-term clinical deterioration after PE. METHODS: Consecutive adult PE patients were enrolled in an academic emergency department from 2008 to 2011. The primary outcome was right heart strain (RHS) on echocardiogram or CT pulmonary angiography, or TnT ≥0...
April 2015: Clinical Cardiology
V Vukadinovic, J D Chiou, D L Morris
BACKGROUND: Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) can be complicated by pulmonary emboli (PE). Patients are at high risk due to surgery, underlying malignancy, immobility and indwelling lines. OBJECTIVES: This paper aims to identify clinically significant signs and symptoms preceding acute PE in post CRS-HIPEC patients, assess the PE investigative approach in this population and the significance of PE on patient management...
May 2015: European Journal of Surgical Oncology
Hanae Ida, Kazuhito Hirata, Takanori Takahashi, Takanobu Hirosawa
Cases with thrombi in multiple cardiac chambers are rare. We report an extremely rare case in which thrombi were formed in all four cardiac chambers at the same time. A 55-year-old man presented with biventricular failure and liver dysfunction. A 12-lead ECG and an echocardiogram revealed an old anteroseptal myocardial infarction with aneurysm formation and atrial flutter. A transesophageal echocardiogram and a CT of the chest revealed thrombi in the right and left atrial appendage, right ventricular apex and left ventricular aneurysm...
2014: BMJ Case Reports
Cuneyt Toprak, Anil Avci, Burak Ozturkeri, Mehmet Mustafa Tabakci, Gokhan Kahveci
A 55-year-old man presented with the emergency department after having a short syncopal episode and angina during the exertion for 1 month. His initial electrocardiogram showed minimal ST-segment changes on precordial leads. While waiting for the laboratory tests, abruptly, the patient went into cardiopulmonary arrest. After a short resuscitation, a new electrocardiogram revealed ST-segment elevations in leads V1-3 and AVR, mimicking an anteroseptal myocardial infarction. Although, the angiography showed severe coronary artery disease, coronary flow was normal and main branches of pulmonary artery were almost fully occluded by large pulmonary emboli...
December 2014: American Journal of Emergency Medicine
Robert W Derlet, Robert M McNamara, Amin Antoine Kazzi, John R Richards
We report the case of a 32-year-old male recently diagnosed with type 2 diabetes treated at an urban university emergency department (ED) crowded to 250% over capacity. His initial symptoms of shortness of breath and feeling ill for several days were evaluated with chest radiograph, electrocardiogram (EKG), and laboratory studies, which suggested mild diabetic ketoacidosis. His medical care in the ED was conducted in a crowded hallway. After correction of his metabolic abnormalities he felt improved and was discharged with arrangements made for outpatient follow-up...
March 2014: Western Journal of Emergency Medicine
Min-Hee Kang, Hee-Myung Park
The incidence and significance of subsegmental pulmonary (SSP) thromboembolism is currently under investigation. We aimed to evaluate the clinical and diagnostic features of SSP thromboembolism in an experimental canine model. Obstruction of pulmonary arterial branches was induced in three beagle dogs by intravenous injection of a barium-coated autologous blood clot (size, approximately 1.7 × 5 mm). The clinical signs, haemodynamic changes (blood pressure, electrocardiogram, echocardiography), coagulation (aPTT, PT, FDPs and D-dimer test) and cytokine variations (TNF-a, IL-4, IL-6, and IL-10) were evaluated over a 24-hour period...
October 2013: International Journal of Experimental Pathology
R Bajaj, Ajay Ramanakumar, Suresh Mamidala, Deepti Kumar
An 89-year-old woman came with symptoms of progressively worsening dyspnoea at rest over the preceding week. She was normotensive, had elevated jugular venous pressure and clear lungs. ECG revealed atrial fibrillation with the rapid ventricular rate. Labs were significant for markedly elevated pro-brain natriuretic peptide of 43,000 pg/mL and troponin-T of 1 ng/mL. An urgent 2D echocardiogram was obtained, which revealed the severely dilated right atrium and a large linear mobile mass in the right atrium consistent with a thrombus...
2013: BMJ Case Reports
Kanai Garala, Rajesh Chelliah, Ian Hudson
Pulmonary embolism (PE) is a common condition seen regularly by emergency physicians. The authors describe a patient who presented with shortness of breath and syncope. He also experienced drowsy, clammy and sweaty episodes. He was tachycardic, tachypnoeic and saturating at 92% on air. A chest X-ray was normal but an ECG showed S1Q3T3. A CT pulmonary angiography performed showed bilateral pulmonary emboli with a large inferior vena cava (IVC) thrombus. Echocardiography revealed severely dilated right ventricle and atrium, severe right ventricular impairment, pulmonary hypertension, large mobile friable clots seen extending into the tricuspid valve...
2013: BMJ Case Reports
Leslie Wilke, Marcia Henderson, Shannon Ward, William Petersen
SESSION TYPE: Cardiovascular Case Report PostersPRESENTED ON: Tuesday, October 23, 2012 at 01:30 PM - 02:30 PMINTRODUCTION: Hypoxemia with cor pulmonale in patients with malignancy has a broad differential.CASE PRESENTATION: An 83-year-old white female presented to the Pulmonary clinic with five days of progressive dyspnea. She was three weeks status post mastectomy for high-grade invasive ductal carcinoma with sarcomatoid features. (Fig 1) Exam revealed tachycardia with a blood pressure 130/65 mmHg, a room air saturation of 85% and a new III/VI systolic murmur...
October 1, 2012: Chest
Amr Mohsen, Karim El-Kersh
An elderly man with a recent diagnosis of invasive rectal adenocarcinoma was admitted to the hospital because of a lower gastrointestinal bleeding and low haemoglobin. During the hospitalisation he complained of chest pain. ECG showed new onset ST-segment elevation in leads III, aVF and in the precordial leads V1-V4. Shortly thereafter, he became hypotensive and coded. Despite resuscitation he passed away. Autopsy revealed massive pulmonary emboli with near complete obstruction of the involved branches of the pulmonary arteries...
2013: BMJ Case Reports
Ann H Tsung, Justin B Williams, Allen C Whitford
BACKGROUND: Pulmonary embolism (PE) is a life-threatening condition that is extremely uncommon in the healthy pediatric population. OBJECTIVE: Because pediatric PE is rarely on the Emergency Physician's differential diagnosis, with this case we hope to increase the clinical suspicion for PE in children who present to the Emergency Department (ED). CASE REPORT: This is a case of bilateral pulmonary embolism in a 16-year-old basketball player whose only risk factor is oral contraceptive medication...
May 2013: Journal of Emergency Medicine
Alan Tan, Joseph Yikona
Patients with pulmonary embolism (PE) can show changes on the ECG. Here, we report the case of a 48-year-old man who initially presented with calf discomfort and swelling. He was discharged with no anticoagulation after a negative complex duplex venous ultrasonography for deep vein thrombosis (DVT). He presented 4 days later with shortness of breath and pleuritic chest pain. Multiple pulmonary emboli were found on CT pulmonary angiogram. His ECGs showed left-ventricular strain which is unusual for PE. He was anticoagulated and discharged...
2012: BMJ Case Reports
Dow-Chung Chi, Frances Brogan, Ithamar Turenne, Sarah Zelonis, Lawrence Schwartz, Muhammad Wasif Saif
BACKGROUND: Gemcitabine is the only approved cytotoxic agent for the treatment of pancreatic cancer by the Food and Drug Administration. In addition, gemcitabine is also commonly used for the management of breast, ovarian, and non-small cell lung cancer. Myelosuppression is the most common toxicity of gemcitabine therapy. Pulmonary toxicities due to gemcitabine have, however, been reported. Dyspnea occurs in approximately 25% of patients treated with gemcitabine, whereas serious pulmonary toxicities are much less common, approximately 0...
September 2012: Anticancer Research
Deacon Zhao Jun Lee, Marzena Whittaker, Abdallah Al-Mohammad
Pulmonary embolism (PE) is a common cardiovascular emergency, by which occlusion of a part of the pulmonary arterial bed may lead to acute life threatening but potentially reversible right ventricular failure. Early diagnosis is fundamental to implement immediate effective treatment to reduce mortality. However, the diagnosis can be easily missed due to non-specific clinical presentation. We wish to present an unusual case whereby a patient with no risk factors for PE, symptoms suggestive of acute pericarditis and an ECG showing concave ST segment elevation was found to have multiple pulmonary emboli...
2012: BMJ Case Reports
Ib Diall, S Coulibaly, I Minta, Ho Ba, M Diakite, N Sidibe, I Sangare, S Diakite, K Sanogo, Ba Diallo
Authors studied 30 cases of pulmonary emboli in BAMAKO in the departments of Cardiology at Point G hospital. The purpose of this work was to determine the pulmonary emboli's frequency, their signs and symptoms and to observe their outcome. Was eligible to study every patient hospitalised for pulmonary emboli confirmed by clinical signs and D- dimere test, with ECG and echocardiogram in most cases. The pulmonary emboli' frequency was 1,7%, with an average age of 51 years ± 16,9. Among causes the most frequent were hypertension (50%), phlebitis (40%), chronic cor pulmonale (30%), and heart failure (40%)...
2011: Le Mali Médical
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