N E W O R L E A N S — The best predictors of in-hospital deterioration of patients diagnosed with acute pulmonary embolism in the emergency department are a shock index greater than 1 and a pulmonary embolism severity index score more than 100, according to data from the EMPEROR registry. The clinical implications: Calculate the pulmonary embolism severity index (PESI) and shock index routinely...

BACKGROUND Tissue factor (TF) is the initiation factor of the extrinsic coagulation pathway, and plays a critical role in the process of thrombosis. This study aimed to investigate the expression of TF and to explore their clinical effect on the pulmonary artery after acute pulmonary thromboembolism. METHODS Thirty-four Japanese white rabbits (Level II animals) supplied by Tianjin Medical Uni...

The Authors Reply It is very well known that the mortality in acute pulmonary embolism patients presenting with cardiac arrest is very high. One of the aims of our manuscript is to emphasize that thrombolytic therapy is a lifesaving choice of treatment even in resuscitated massive pulmonary embolism patients. The other aims of our manuscript are to highlight the fact that massive pulmonary embo...

for Acute Pulmonary Embolism To the Editor: We read with great interest a review paper titled “Acute Pulmonary Embolism, Part II: Risk Stratification, Treatment, and Prevention” by Goldhaber and associates in the December 2003 issue of the journal.1 The strategies for acute pulmonary embolism in their review are anticoagulation, inferior vena caval filters, thrombolysis, and embolectomy. They m...

Acute cytomegalovirus (CMV) infection occurs commonly in immunocompromised and immunocompetent patients, but is usually asymptomatic in the latter. Vascular events associated with acute CMV infection have been described, but are rare. Hence, such events are rarely reported in the literature. We report a case of pulmonary embolism secondary to acute CMV colitis in an immunocompetent 78-year-old ...

Copyright © 2006 American Heart Association. All rights reserved. Print ISSN: 0009-7322. Online 72514 Circulation is published by the American Heart Association. 7272 Greenville Avenue, Dallas, TX DOI: 10.1161/CIRCULATIONAHA.106.62088

CONTEXT AND OBJECTIVE The location of embolism is associated with clinical findings and disease severity in cases of acute pulmonary embolism. The level of gamma-glutamyl transferase increases under oxidative stress-related conditions. In this study, we investigated whether gamma-glutamyl transferase levels could predict the location of pulmonary embolism. DESIGN AND SETTING Hospital-based cr...

BACKGROUND Right ventricular dilatation in the setting of acute pulmonary embolism is associated with an adverse prognosis. Treatment with a pulmonary vasodilator has never been studied systematically. We evaluated the effect of epoprostenol on right ventricular diameter and function in patients with acute pulmonary embolism and right ventricular dilatation. METHODS In a randomized, single-bl...

Copyright © 2010 Massachusetts Medical Society. The clinical presentation of acute pulmonary embolism ranges from shock or sustained hypotension to mild dyspnea. Pulmonary embolism may even be asymptomatic and diagnosed by imaging procedures performed for other purposes. Depending on the clinical presentation, the case fatality rate for acute pulmonary embolism ranges from about 60% to less tha...

In the absence of significant symptoms and signs the diagnosis of pulmonary embolism remains difficult. Sensitivity and specificity of laboratory tests, chest x-ray, ECG, echocardiography and venous studies on their own is low. Ventilation-perfusion scanning establishes or excludes the diagnosis only in those patients with "high-probability" or "normal" scanning results. The diagnosis of pulmon...