MyMedR

Fulltext Anterior praecordial ST-segment elevation

Liao CM, Soo CS

Singapore Med J, 1996 Feb;37(1):101, 122-3.

PMID: 8783924

Matched MeSH terms: Pulmonary Embolism/diagnosis*

Postoperative venous thromboembolism in Asia: a critical appraisal of its incidence

Liew NC, Moissinac K, Gul Y

Asian J Surg, 2003 Jul;26(3):154-8.

PMID: 12925290

Venous thromboembolism (VTE) has historically been perceived to be a rare disorder in Asia. However, new evidence has emerged recently that contradicts this perception. The question of routine VTE prophylaxis has been hotly debated in Asia due to disagreement on its incidence. We reviewed and analysed studies on postoperative VTE in Asian patients to determine if the condition was indeed rare and if the routine prophylactic measures as recommended by internationally accepted guidelines should be adopted in Asia.

Matched MeSH terms: Pulmonary Embolism/diagnosis

Acute pulmonary thromboembolism in a case of fatal child abuse

Rahimi R, Zulkifli ZF, Omar E, Ismail H, Md Noor S

Malays J Pathol, 2017 Apr;39(1):83-87.

PMID: 28413210 MyJurnal

Child abuse is a worldwide problem. The four major types of abuse include physical abuse, child neglect, psychological maltreatment and sexual violence. We describe a fatal case of child abuse which presented with numerous old and recent soft tissue injuries all over the body. The injuries on the legs have immobilized the victim for quite some time, giving rise to deep vein thrombosis, leading to death as a result of acute pulmonary thromboembolism. This case demonstrates presence of both elements of abuse and neglect in one victim. As this category of crime involves a helpless child, we would also like to reiterate that the community has an obligation to prevent such tragedies and educating the public to recognize the signs and symptoms of abuse would be of utmost important. Ultimately, the community must also be responsible for reporting such offences and the act of silence is akin to condoning a crime witnessed.

Matched MeSH terms: Pulmonary Embolism/diagnosis

Fulltext Acute pulmonary embolism following Achilles tendon repair

Yusof MI

Singapore Med J, 2007 Aug;48(8):e234-6.

PMID: 17657374

Achilles tendon injury is common and surgical procedures related to it are frequently performed and are safe. The incidence of acute pulmonary embolism following these procedures is extremely rare. This case illustrates an incidence of acute pulmonary embolism following Achilles tendon repair in a 35-year-old woman. We discuss the possible causes and the need for thromboprophylaxis.

Matched MeSH terms: Pulmonary Embolism/diagnosis*

Fulltext "Fishing for lines": removal of endovascular catheters from the cardiovascular system

Wong AR, Suhaimi H, Ridzuan MA, Rizal MM, Saedah A

Singapore Med J, 2009 Oct;50(10):e358-61.

PMID: 19907875

We present two infants whose endovascular lines were accidentally cut or fractured, and had to be retrieved via transcatheter means in the cardiac catheterisation laboratory. The first case was a two-month-old infant with transposition of the great arteries, requiring an emergency balloon atrial septostomy. An indwelling vascular catheter that was placed in the right femoral vein was accidentally cut and had migrated into the inferior vena cava, before being retrieved. The second case was a one-week-old neonate who presented with pneumonia at birth, and had a long intravenous catheter placed in the left saphenous vein, which became fractured, and subsequently migrated into the heart. This case presented as a pulmonary embolus with haemodynamic instability, as the catheter had partially obstructed the right ventricular outflow tract. This was later retrieved via transcatheter means.

Matched MeSH terms: Pulmonary Embolism/diagnosis

Fulltext A case of cardiac arrest due to air embolism during scoliosis surgery

Haji Mohd Amin MZ, Beng JTB, Young BTY, Faruk Seman NA, Ching TS, Chek WC

J Orthop Surg (Hong Kong), 2019 4 9;27(2):2309499019840083.

PMID: 30955449 DOI: 10.1177/2309499019840083

Cardiac arrest during scoliosis surgery is rare in idiopathic scoliosis. We present a case of cardiorespiratory collapse during corrective surgery in a young patient with idiopathic scoliosis. A diagnosis of venous air embolism was made by exclusion. A cardiorespiratory resuscitation was performed in supine position. Patient recovered without any sequelae and had operation completed 6 weeks later.

Matched MeSH terms: Pulmonary Embolism/diagnosis

Fulltext Sudden maternal deaths probably due to obstetrical pulmonary embolism in Malaysia for 1991

Ravindran J

Med J Malaysia, 1994 Mar;49(1):53-61.

PMID: 8057992

Obstetric pulmonary embolism forms the most serious vascular problem during pregnancy. The following report is a retrospective study into maternal deaths in Malaysian mothers probably due to obstetrical pulmonary embolism. Obstetric pulmonary embolism can be divided into amniotic fluid embolism and obstetric blood clot embolism. There were 37 maternal deaths attributable to this cause -9.9 per cent of all maternal deaths to blood clot embolism and 6.7 per cent to amniotic fluid embolism. Most cases were diagnosed clinically because a postmortem examination was not done. Eleven cases of embolism were associated with Caesarean delivery. The typical profile of a Malaysian mother dying from obstetrical pulmonary embolism is that of a Malay mother in the "non-risk" parities of one to four and usually aged between 31-35 years. In the management of these patients, there should be an urgency in diagnosis and improvement in diagnostic procedures. Health staff at all levels should be trained to pick up patients who present with features of deep vein thrombosis.

Matched MeSH terms: Pulmonary Embolism/diagnosis

Fulltext COVID-19 and Major Organ Thromboembolism: Manifestations in Neurovascular and Cardiovascular Systems

Pillai P, Joseph JP, Fadzillah NHM, Mahmod M

J Stroke Cerebrovasc Dis, 2021 Jan;30(1):105427.

PMID: 33137615 DOI: 10.1016/j.jstrokecerebrovasdis.2020.105427

COVID-19, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been shown to cause multisystemic damage. We undertook a systematic literature review and comprehensive analysis of a total of 55 articles on arterial and venous thromboembolism in COVID-19 and articles on previous pandemics with respect to thromboembolism and compared the similarities and differences between them. The presence of thrombosis in multiple organ systems points to thromboembolism being an integral component in the pathogenesis of this disease. Thromboembolism is likely to be the main player in the morbidity and mortality of COVID -19 in which the pulmonary system is most severely affected. We also hypothesize that D-dimer values could be used as an early marker for prognostication of disease as it has been seen to be raised even in the pre-symptomatic stage. This further strengthens the notion that thromboembolism prevention is necessary. We also examined literature on the neurovascular and cardiovascular systems, as the manifestation of thromboembolic phenomenon in these two systems varied, suggesting different pathophysiology of damage. Further research into the role of thromboembolism in COVID-19 is important to advance the understanding of the virus, its effects and to tailor treatment accordingly to prevent further casualties from this pandemic.

Matched MeSH terms: Pulmonary Embolism/diagnosis

Multiple systemic embolisms with septicemia after gastric variceal obliteration with cyanoacrylate

Tan YM, Goh KL, Kamarulzaman A, Tan PS, Ranjeev P, Salem O, et al.

Gastrointest Endosc, 2002 Feb;55(2):276-8.

PMID: 11818941

Matched MeSH terms: Pulmonary Embolism/diagnosis

The acute presentation of pulmonary thromboembolism: a retrospective viewpoint

Tan WP, Goh SH, Cham GW, Chng SM

Ann Acad Med Singap, 2002 May;31(3):375-81.

PMID: 12061300

INTRODUCTION: Acute pulmonary thromboembolism (PE) has been considered rare among Asians. We aim to describe the frequency and clinical features of this condition in a hospital in Singapore. Among patients admitted by the Emergency Department (ED), comparisons were made between those primarily diagnosed in the ED and those who were not.

MATERIALS AND METHODS: Retrospective review of all cases of radiologically proven acute PE over a 20-month period.

RESULTS: Sixty-two patients were identified. The mean age was 61.5 +/- 18.0 years with a female to male ratio of 1.8:1. There were more Malays compared to other races. There were also more Caucasians, given the proximity of the hospital to the airport and the inclusion of tourists. The commonest symptoms were dyspnoea and chest pain, while the commonest signs were tachycardia and tachypnoea. Prolonged immobilisation was the commonest risk factor. Electrocardiographic S1Q3T3 pattern was seen in more patients compared to Western studies. Cardiomegaly was the commonest chest X-ray finding. Thirty-two patients were identified to have a source of embolisation. Overall mortality rate was 21%. The ED diagnosed 36% of the cases. Alternative admitting diagnoses were predominantly ischaemic heart disease and pneumonia. The group diagnosed in the ED were notably female (P = 0.044), Caucasian (P = 0.002) and had prolonged immobilisation (P = 0.025) prior to the onset of PE.

CONCLUSION: Acute PE is not as rare here as previously thought. Clinical features reveal more similarities than differences compared to other studies in the literature. We advocate a high index of suspicion for earlier diagnosis in the ED.

Matched MeSH terms: Pulmonary Embolism/diagnosis*

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