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Acute Pulmonary Embolism - Articles

Origin and location of chest pain in acute pulmonary embolism by Dr. Sangareddi V. Medical Doctor Posted Wed 21 Oct 2009 10:02pm Pulmonary embolism is  one of the  important  causes of acute chest pain . It can mimic  acute coronary syndrome . In fact along with aortic dissection  , it forms  a  differential diagnosis for STEMI especailly if the ECG is not typical. The Chest pain of acute pulmonary embolism can originate in one of the following structures  with diff ... Read on »
What are the mechanisms of hypoxia in Acute pulmonary embolism ? by Dr. Sangareddi V. Medical Doctor Posted Thu 31 May 2012 12:11pm Hypoxia is most important feature of acute pulmonary embolism. It occurs due to variety of mechanisms Ventilation perfusion mismatch is the major  mechanism  ( Normal ventilation /Reduced perfusion) Atelectasis of lung  ( Left to right shunt) Loss of lung volume due to pulmonary infarct  contribute later Low mixed venous ... Read on »
How will you manage failed pulmonary thrombolysis in acute pulmonary embolism ? by Dr. Sangareddi V. Medical Doctor Posted Sun 10 Oct 2010 10:26am Acute massive  pulmonary embolism is a dreaded medical  emergency  . In the past,  surgical embolectomy was the main option . Now , we have thrombolysis as a viable option.But , it does not work in all cases.* (90% success ?). It is critical to evaluate the success of thrombolyis , before embarking upon rescue embolectomy. As it is often ... Read on »
What are the echocardiographic signs of RV dysfunction in Acute pulmonary embolism ? by Dr. Sangareddi V. Medical Doctor Posted Sun 10 Oct 2010 10:26am 1 Comment There were days when acute pulmonary embolism(APE) was almost always  diagnosed  post-mortem. We are in the era , where we can recognise most of  the  pulmonary  embolism  without any difficulty. Experience has taught us ,  when to suspect this dreaded  syndrome . Any  unexplained, dyspnea, hypoxia, tachycardia , syncope* with  vague chest ... Read on »
Management issues in acute pulmonary embolism : Should heparin be started only after thrombolysis ? by Dr. Sangareddi V. Medical Doctor Posted Fri 08 Oct 2010 9:48am Acute pulmonary embolism is a vascular  emergency.Massive pulmonary embolism needs immediate thrombolysis or embolectomy. Success rate  of  thrombolysis  appears good . But , the symptom improvement  is slower . Sterptokinase is the commonly used drug to dissolve the pulmonary thrombus  . (Except in USA , where they  prefer the much costlie ... Read on »
Which is the commonest cause for death in acute pulmonary embolism by Dr. Sangareddi V. Medical Doctor Posted Wed 31 Oct 2012 12:16pm The  commonest  cause for death in massive pulmonary embolism is   RV shock  Massive Hemoptysis Primary VF   originating  right ventricle Refractory Type 1 Respiratory failure Answer : 1  .(RV shock , RV standstill and RV , RV stunning  is the unequivocal  cause for sudden death in pulmonary embolism . This RV shock oc ... Read on »
Changing definitions for massive pulmonary embolism by Dr. Sangareddi V. Medical Doctor Posted Wed 31 Oct 2012 12:10pm Conventionally  pulmonary embolism is classified as massive, sub massive  based on Degree  level of  obstruction in pulmonary anatomy (MPA,Branch PA, Segmental etc ) Thrombus burden Quantum  of pulmonary vascular bed  compromised But it is always intriguing ,    the clinical outcome was not linearly  correlating with the a ... Read on »
Malpractice defense: Lung Infection vs. Chronic Pulmonary Embolism by David W. Patient Expert Posted Wed 17 Mar 2010 2:10pm In addition to my consulting work and writing the Health Business Blog , I’m chairman of the board of Advanced Practice Strategies , a medical risk management firm that provides litigation support for malpractice defense and an eLearning curriculum focused on enhancing patient safety. Here’s the Advanced Practice Strategies case of the mo ... Read on »
Importance of recognising type C RVH in clinical cardiology ! by Dr. Sangareddi V. Medical Doctor Posted Sun 05 Feb 2012 3:21am RVH is  traditionally  categorized into three types . With  the  advent of echocardiography  diagnosing  RVH by ECG would  appear  redundant. Still , it gives vital information about the electro-physiologcal basis  of RVH. Knowing different mechanisms of RVH helps us decode  regional variations in RVH. Type A , Type B  are easy to diagnose ... Read on »
Is it pulmonary embolism? by Stephen Smith Posted Sat 02 Apr 2011 1:31pm This is a 41 year old male with severe asthma who barely avoided intubation.  His troponin returned at 0.13, and here is his ECG There is sinus tach with anterior T-wave inversion of the same morphology as the previous cases of PE which I have posted (see link below).  There is no TW inversion in lead III, so this is not pathognomoni ... Read on »