Pulmonary embolism diagnosis

Indications for treatment with streptokinase include acute occlusion of arteries, deep vein thrombosis, and pulmonary embolism. Streptokinase therapy in coronary thrombosis, which is the usual cause of myocardial infarction (54,71,72), has proved to be valuable. In this frequently fatal condition, the enzyme is adrninistered intravenously at a dose of 1.5 million units over 60 min, or given by intracoronary infusion at a 20,000- to 50,000-unit bolus dose followed by 2000 to 4000 units/min for 60 min therapy must be instituted as soon as practicable after the diagnosis of heart attack is made. For deep vein thrombosis, pulmonary embolism, or arterial occlusion, streptokinase is infused at a loading dose of 250,000 units given over 30 min, followed by a maintenance dose of 100,000 units over a 60-min period. 

What signs and symptoms are consistent with the diagnosis of PE in BA s case What are the most likely etiologies for pulmonary embolism in this case ... 

The changes of serum CK and its MB isoenzyme following a myocardial infarction are discussed in Chapter 44. Other cardiac conditions have been reported to increase serum CK and CK-MB in serum. These conditions include cardioversion, cardiopulmonary bypass and coronary artery bypass surgery, cardiac transplantation, myocarditis, pericarditis, and pulmonary embolism. Despite improvements, in the diagnostic performance and practicality of CK and CK-MB assays, there is no controlled cUnicai impact trial showing that these tests are effective for decisions to send a patient home or to the appropriate level of care of admission for patients with suspected acute cardiac ischemia, either as one-time or serial tests.For diagnosis of acute myocardial infarction, it is now advantageous to use more cardiac-specific nonenzymatic tests, such as cardiac troponin I orT. 

Vargo JS, Becker DM, Philbrick JT, Schoonover FW, Davis JS. Plasma DNA. A simple, rapid test for aiding the diagnosis of pulmonary embolism. Chest 1990 97 63-8. 

Assessment of pulmonary ventilation in patients with chronic obstructive lung disease, and for the differential diagnosis of acute pulmonary embolism in combination with lung perfusion scintigraphy... 

Heparin is an anticoagulant that inhibits reactions that lead to clotting. It is indicated in prophylaxis and treatment of venous thrombosis and its extensions, pulmonary embolism (PE), peripheral arterial embolism, and atrial fibrillation with embolization diagnosis and treatment of acute and chronic consumption coagulopathies (DIC) and prevention of postoperative deep venous thrombosis. 

I missed the diagnosis of pulmonary embolism and treated the patient as a case of severe pneumonia until the day after. The patient s condition deteriorated and only then was the diagnosis put right. I felt guilty and lost confidence. ... 

Ghaye B, Remy J, Remy-Jardin M (2002) Non-traiunatic thoracic emergencies CT diagnosis of acute pulmonary embolism the first 10 years. Eur Radiol 12 1886-1905 He H, Stein MW, Zalta B, Haramati LB (2006) Computed tomography evaluation of right heart dysfunction in patients with acute pulmonary embolism. J Comput Assist Tomogr 30 262-266... 

Ryu JH, Swensen SJ, Olson EJ, Pellikka PA (2001) Diagnosis of pulmonary embolism with use of computed tomographic angiography. Mayo Clin Proc 76 59-65... 

Cardiovascular In a study of the risk of pulmonary embolism in 64 patients aged 3 months to 22 years, receiving parenteral nutrition, 25 (39%) had an abnormal ventilation-perfusion scan and 29 episodes of pulmonary embolism were diagnosed. The median age at time of diagnosis was 4.6 years [54 "]. Pulmonary embolism was bilateral in 56% and unilateral in 44% and was the main cause of two of 15 recorded deaths. 

WHO group IV includes patients with chronic thrombotic and embolic disease. For those with chronic thromboembolic disease, diagnosis and well-timed surgery may be curative if performed at a center proficient in performing pulmonary thromboendarterectomies. However, even with successful thromboendarterectomy... 

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