Criteria for the Recognition of Pulmonary Emboli

Humphries, J.O'Neal; Bell, William R.; White, Robert I.

doi:10.1001/jama.1976.03260440063033

Cited by 3 publications

(1 citation statement)

References 7 publications

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“…ECGs were evaluated blindly by an internist. ECG patterns suggestive of PE were defined as highly suggestive and non-specific (8). The highly suggestive signs were: inverted T wave in Vl-V4; right bundle branch block (especially if transient); S1Q3 or S I S~S~ pattern; right axis deviation; signs of right ventricular hypertrophy; tall and peaked P waves in leads 11,111 and aVF.…”

Section: Electrocardiographymentioning

confidence: 99%

Screening for Postoperative Pulmonary Embolism on the Basis of Clinical Symptomatology, Routine Electrocardiography and Plain Chest Radiography

Rissanen

Suomalainen

Karjalainen

et al. 1984

Journal of Internal Medicine

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The incidence of pulmonary embolism (PE) and the usefulness of various screening methods for its detection were studied in 108 patients undergoing elective hip surgery. Twenty patients had PE as shown by perfusion‐ventilation lung scintigraphy. Six of them had symptoms of embolism. Clinical symptoms of PE, highly suggestive electrocardiographic (ECG) signs and signs in chest radiographs showed high specificity but low sensitivity with regard to PE. If the non‐specific ECG signs and the symptoms and signs of deep vein thrombosis in the calves had also been taken into account, it would have been possible to identify 95% of the patients with PE. The use of all these screening tests revealed a suspicion of PE in two thirds of the patients. The simplest way to screen for postoperative PE seems to be to use a combination of the symptoms and signs of both PE and deep vein thrombosis, and to identify any tachycardia. This method gave a sensitivity of 85%.

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Section: Electrocardiographymentioning

confidence: 99%

Screening for Postoperative Pulmonary Embolism on the Basis of Clinical Symptomatology, Routine Electrocardiography and Plain Chest Radiography

Rissanen

Suomalainen

Karjalainen

et al. 1984

Journal of Internal Medicine

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Chest Pain in Patients Seen in Emergency Clinics

Kleiger¹

1976

JAMA

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A clinico-pathological study of fatal pulmonary embolism in a specialist orthopaedic hospital

Sheppeard

Henson

Ward

et al. 1981

Arch. Orth. Traum. Surg.

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A study of post-mortem examinations performed between 1970 and 1979 at a specialist orthopaedic hospital revealed that the overall mortality rate due to pulmonary embolism was 0.23% and that pulmonary embolism was responsible for 19.1% of hospital deaths. The majority of these fatalities occurred following operation for either fractured proximal femur or total hip replacement. During the decade, 928 patients were operated upon for fractured proximal femur, none received prophylactic anticoagulation therapy and the mortality rate due to pulmonary embolism was 17.7%. However, the yearly mortality rate decreased with time and this change was attributed to earlier operation and early mobilisation. Over the same period, 3016 patients underwent total hip replacement, 20% were anticoagulated prophylactically; the mortality rate due to pulmonary embolism was 0.63%. In those patients who died of pulmonary embolism, post-mortem evidence of deep vein thrombosis was usually found, but no relationship between site of thrombosis and side of operation was observed. Pulmonary embolism was diagnosed in only a few patients although on later consideration at least a third of patients had symptoms suggestive of previous emboli. Possible improvements in diagnosis are discussed and a more rational approach to prophylactic anticoagulation suggested.

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Criteria for the Recognition of Pulmonary Emboli

Cited by 3 publications

References 7 publications

Screening for Postoperative Pulmonary Embolism on the Basis of Clinical Symptomatology, Routine Electrocardiography and Plain Chest Radiography

Screening for Postoperative Pulmonary Embolism on the Basis of Clinical Symptomatology, Routine Electrocardiography and Plain Chest Radiography

Chest Pain in Patients Seen in Emergency Clinics

A clinico-pathological study of fatal pulmonary embolism in a specialist orthopaedic hospital

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