Complete Resolution of Massive Pulmonary Thromboembolism

Sautter, Richard D.; Fletcher, Fred W.; Emanuel, Dean A.; Lawton, Ben; Olsen, Tandy G.

doi:10.1001/jama.1964.03070120070022

Cited by 88 publications

(10 citation statements)

References 2 publications

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“…Underlying coronary heart disease and other cardiac or lung diseases were as common in patients with embolism (12, 13, 5%, respectively) as in patients with unconfirmed embolism (20,18, 2%, re- spectively, p>0.05, table I). On the con trary, total underlying heart diseases were more frequent in non embolic patients (p< 0.05; table I).…”

Section: Resultsmentioning

confidence: 90%

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Routine Electrocardiography in Screening for Pulmonary Embolism

et al. 1986

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In a group of 245 patients with clinical suspicion of pulmonary embolism we analyzed the ECG for 22 signs that have been associated with this disease. Subsequently, the patients were divided into two groups: those with confirmed embolism and those in whom embolism was not confirmed. The occurrence of the ECG signs was assessed separately for the two groups. Furthermore, we related ECG features to severity of embolism as estimated at lung scan. Tachycardia and S-T depression were the commonest findings in both groups. P-R displacement, late R in aVR, S₁Q₃T₃, S slurred and T inversion in V₁-V₂ were more frequent in embolic than in nonembolic patients (p < 0.05 or less). All the abovementioned signs were more frequent at diagnosis than at recovery in embolic patients (p < 0.05 or less), whereas only tachycardia was more frequent at diagnosis than at control in nonembolic patients (p < 0.001). S-T depression and T inversion in V₁-V₂ were also associated to severity of embolism.Since some ECG signs are very frequent or specific in pulmonary embolism, this condition should always be suspected when they are found and, particularly, when previously absent in the same patients and/or not explained by other conditions

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Section: Resultsmentioning

confidence: 90%

“…Such a period should allow the resolution of emboli, according to the angiographic data of Sautter et al [20]. Control ECG, usually obtained in the follow-up period, was available in 26 nonembolic patients.…”

Section: Methodsmentioning

confidence: 99%

Routine Electrocardiography in Screening for Pulmonary Embolism

et al. 1986

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“…However, heparin is of proven value in the treatment of pul monary embolism [11][12][13], even in the se verely ill patients [14] in whom this condi tion represents a life-threatening emerg ency. Moreover, resolution of thrombo emboli, reported in the literature as spon taneous [15,16], occurred actually after the patients had been treated with heparin. Thus a fibrinolytic effect of heparin can not be ruled out.…”

Section: Introductionmentioning

confidence: 99%

Fibrinolytic Effects of Urokinase and Heparin in Acute Pulmonary Embolism: A Randomized Clinical Trial

et al. 1988

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Dissolution of pulmonary emboli with heparin and urokinase is ascribed, respectively, to anticoagulation and fibrinolysis. Since truly independent assessment of these effects in man is lacking, we administered each drug alone. Fibrinogen and plasminogen plasma levels and the resolution of pulmonary emboli were measured in three randomized groups of 10 patients each: groups A and C infused with small repeated doses of urokinase and a large single dose of urokinase, respectively, and group B who received heparin. After 6 h of treatment, fibrinogen fell in all the groups, while, after 12 h, remained equally reduced in groups A and B and declined further in group C. Plasminogen behaved similarly. Up to 60 h, statistical analysis showed that these effects were related to timing and amount of urokinase and heparin infusion. These observations suggest that heparin may induce a lytic state. As to signs of pulmonary emboli resolution, no differences between groups were found in lung perfusion and gas exchange recovery at any time (from 1 day to 1 year) and in pulmonary artery pressure reduction at 1 week. The greater angiographic and scintigraphic recovery observed with urokinase, versus heparin alone, after 1 day of treatment in the Urokinase Pulmonary Embolism Trial may be ascribed to a synergistic effect with urokinase of heparin administered during the diagnostic work-out. The indications of heparin and urokinase should be evaluated in the light of these results

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“…If anticoagulant or thrombolytic treatment is undertaken repeated lung scanning can demonstrate the restoration of pulmonary blood flow without resorting to repeated pulmonary angiography (Sautter at al, 1964;Shibata et al, 1966;Poe et al, 1967;Tow and Wagner, 1967). In the present series complete restoration of pulmonary blood flow as shown by a normal lung scan has not been seen in less than eight days.…”

Section: Discussionmentioning

confidence: 45%

Scintillation scanning of lungs in diagnosis of pulmonary embolism.

Secker-Walker¹

1968

BMJ

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Complete Resolution of Massive Pulmonary Thromboembolism

Cited by 88 publications

References 2 publications

Routine Electrocardiography in Screening for Pulmonary Embolism

Routine Electrocardiography in Screening for Pulmonary Embolism

Fibrinolytic Effects of Urokinase and Heparin in Acute Pulmonary Embolism: A Randomized Clinical Trial

Scintillation scanning of lungs in diagnosis of pulmonary embolism.

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