Pulmonary embolism (PE) is a preventable cause of morbidity and mortality which needs prompt recognition. Ventilation-perfusion (V/Q) scan is a well-established diagnostic test for evaluation of suspected PE. We report a 32-year-old woman with history of rheumatologic disease and acute dyspnea, who was referred for V/Q scintigraphy. The planar images revealed multiple mismatched defects through...

a pulmonary embolus clogs the artery that provides blood supply to a part of the lung. the embolus not only prevents the exchange of oxygen and carbon dioxide but also decreases blood supply to the lung tissue itself, potentially causing the tissue to die (infarct). a 52-year-old man presented with syncope and anxiety. he had sinus tachycardia and dilated right ventricle with trabeculations. a ...

Inhaled nitric oxide (INO) has been shown to preferentially lower resistance in the pulmonary vasculature. The relative selectiveness of INO in accomplishing this effect makes it an attractive drug to administer as salvage therapy in patients with acute right ventricular failure secondary to pulmonary embolism. We describe 4 cases in which INO was used as a temporizing agent to decrease right ...

Pulmonary embolism (PE) can be life-threatening, and it is challenging to diagnose because of its nonspecific signs and symptoms. PE is also an important potential risk of osimertinib treatment, however, clinical courses regarding retreatment after osimertinib-induced acute pulmonary embolism remain unclear. We described a 77-year-old woman with postoperative recurrent lung adenocarcinoma who d...

Patients with pulmonary embolism and right ventricle dysfunction (determined with clinical, hemodynamic or echocardiographic methods) are a subgroup at high risk for complications. One of the pathogenic factors of right ventricular dysfunction in pulmonary embolism is myocardial ischemia, usually secondary to hemodynamic overload, and sometimes worsened by underlying coronary artery disease. We...

Clinical question Are four common clinical decision rules, in combination with normal D-dimer results, comparable in their ability to clinically exclude the diagnosis of pulmonary embolism? Article chosen Douma RA, Mos ICM, Erkens PMG, et al. Performance of 4 clinical decision rules in the diagnostic management of acute pulmonary embolism: a prospective cohort study. Ann Intern Med 2011;154:709...

Systolic time intervals (STI) were measured in matched patients with and without right ventricular failure (RVF). STI were calculated from brachial arterial pressure tracings obtained at cardiac catheterization in four groups of patients: 1) controls, without RVF; 2) acute pulmonary embolism with and without acute RVF; 3) mitral stenosis, with and without chronic RVF; 4) primary pulmonary hyper...

The aim of this study was to evaluate whether right ventricle dilation at computed tomography (CT) angiography can be used to assess the risk of death in patients with acute pulmonary embolism. Medline and EMBASE were searched up to April 30, 2013. Studies reporting on the association between right ventricle dilation (right-to-left ventricle diameter) or dysfunction (inter-ventricular septal bo...

Right heart thrombus represents a mobilized deep venous thrombosis that is lodged temporarily in the right atrium and ventricle, and is often referred to as "emboli in transit." Floating right heart thrombus is an uncommon but life-threatening condition, and usually coexists with an already massive pulmonary embolism. The presence of floating right heart thrombus appears to substantially increa...