Acute fatal pulmonary embolism:its prevention, diagnosis and treatment Shumpei Okubo 1 , Takao Yoshioka 1 , Norifumi Nakanishi 1 , Takeyoshi Kunieda 1 , Chikao Yutani 2 , Akito Shimouchi 3 1Division of Cardiology, National Cardiovascular Center 2Division of Pathology, National Cardiovascular Center 3National Cardiovascular Center Research Institute Keyword: 致死的急性肺塞栓症(acute fatal pulmonary embolism) , 急性広範肺塞栓症(acute massive pulmonary embolism) , 突然死(sudden death) pp.375-381
Published Date 1990/4/15
DOI https://doi.org/10.11477/mf.1404900130
  • Abstract
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Acute fatal pulmonary embolism is one cause of sudden death which should be guarded against. It is the most often missed diagnosis in sudden death cases within the hospital. Clinical pictures of 10 pa-tients with acute fatal pulmonary embolism proved by autopsy were examined to elucidate the problems of diagnosis, and to look for an effective treatment, and a method of prevention. Common risk factors were old age and immobility due to stroke or post-operative state. Common past histories were hyper-tension, diabetes mellitus, obesity, atrial fibrillation and hyperlipidemia. Electrocardiogram and echocar-diogram showed that in these patients there was de-finite evidence of acute right ventricular overload. High doses of intravenous urokinase should be given whenever acute cardiovascular collapse develops in such high risk patients. Emergent pulmonary angio-gram and pulmonary embolectomy could be life-sav-ing in patients with acute massive pulmonary embo-lism. Prevention is, however, the best treatment. In addition to anticoagulation medication, frequent change of body position and early mobilization are important precautions to prevent fatal pulmonary embolism developing in such patients.

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