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Pulmonary embolism (PE) occurs when a thrombus, fat or air embolus, amniotic fluid, or tumor tissue blocks one or more pulmonary arteries. These blockages originate in the venous system or the right side of the heart.EtiologyPE primarily arises from deep vein thrombosis (DVT) and other hypercoagulable states, such as inherited thrombophilias. Additional etiological factors include venous stasis, commonly seen in obesity, and endothelial injury from surgery and trauma. Less common causes include...
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Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
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A pneumothorax is a condition where air builds up in the space between the lung and the chest wall, causing the lung to collapse. This condition arises when air enters the space between the parietal and visceral pleura, disrupting the negative pressure essential for lung inflation. This can lead to a partial or complete collapse of the lung.
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Managing flail chest, a condition characterized by a segment of the chest wall moving independently from the rest of the thoracic cage, requires a comprehensive approach. It includes a thorough assessment of the patient's condition, a diagnostic evaluation to determine the extent of the injury, and the implementation of appropriate medical interventions tailored to the individual's needs.
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Correction to: 2026 AHA/ACC/ACCP/ACEP/CHEST/SCAI/ SHM/SIR/SVM/SVN Guideline for the Evaluation and Management of Acute Pulmonary Embolism in Adults: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.

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2026 AHA/ACC/ACCP/ACEP/CHEST/SCAI/SHM/SIR/SVM/SVN Guideline for the Evaluation and Management of Acute Pulmonary Embolism in Adults: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.

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A Porcine Model of Acute Autologous Pulmonary Embolism
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Immediate post-traumatic pulmonary embolism is not associated with right ventricular dysfunction.

Rondi B Gelbard1, Efstathios Karamanos2, Amin Farhoomand1

  • 1Division of Trauma Surgery and Surgical Critical Care, Emory University School of Medicine, 69 Jesse Hill Jr. Drive SE, Glenn Memorial Building, Rm. 310, Atlanta, GA, 30303, USA.

American Journal of Surgery
|November 8, 2015
PubMed
Summary

Early post-traumatic pulmonary embolism (PE) shows fewer right ventricular (RV) changes than late PE. This suggests early PE may be primary thrombosis, potentially impacting management guidelines.

Keywords:
Computed tomography pulmonary angiographyPost-traumatic pulmonary embolismRight ventricular dysfunction

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Area of Science:

  • Trauma surgery
  • Cardiology
  • Radiology

Background:

  • Post-traumatic pulmonary embolism (PE) is a significant cause of morbidity.
  • Computed tomographic (CT) scans can predict right ventricular (RV) dysfunction after PE.
  • Differences in physiological effects and clinical outcomes between early (<48 hours) and late (≥48 hours) post-traumatic PE are not well understood.

Purpose of the Study:

  • To investigate whether physiological effects and clinical outcomes differ between early and late post-traumatic pulmonary embolism (PE).

Main Methods:

  • Retrospective study of patients with traumatic injury and CT-diagnosed PE from 2008-2013.
  • Patients were categorized into early (<48 hours) and late (≥48 hours) PE groups.
  • Primary outcome was PE-related mortality.

Main Results:

  • Fifty patients were identified: 14 early PE and 36 late PE.
  • Late PE group showed significantly higher PE-related mortality (16.7% vs 0%).
  • Late PE was associated with larger RV diameters, RV/left ventricular diameter ratios, RV volumes, and RV/left ventricular volume ratios (P < .05).

Conclusions:

  • Early post-traumatic PE is linked to fewer RV physiological changes compared to late PE.
  • Early PE may represent primary pulmonary thrombosis, warranting further investigation.
  • The clinical management of early PE based on CT findings requires further evaluation against existing embolic disease guidelines.