Journal of the Louisiana State Medical Society
Figure 2: Computed tomographic angiogram of the chest performed soon after admission shows multiple bilateral pulmonary arterial filling defects consistent with extensive pulmonary arterial embolization.
shock (Figure 2). The patient was declared brain dead the day after admission. At the request of the family, support was with- drawn, and the patient expired soon thereafter. Autopsy revealed diffuse intra-abdominal malignant lymphoma. REFERENCES 1. McGinn S, White PD. Acute cor pulmonale resulting from pulmonary embolism: its clinical recognition. JAMA 1935;104:1473- 1480. 2. Stein PD, SaltzmanHA, Weg JG. Clinical characteristics of patients with acute pulmonary embolism. Am J Cardiol 1991; 68:1723-1724. 3. Heit JA, O’Fallon WM, Petterson TM, et al. Relative impact of risk factors for deep vein thrombosis and pulmonary embolism: a population-based study. Arch Intern Med 2002;162:1245-1248. 4. Darze ES Latado AL, Guimaraes AG, et al. Incidence and clinical predictors of pulmonary embolism in severe heart failure patients admitted to a coronary care unit. Chest 2005;128:2576-2580. 5. Zöller B, Li X, Sundquist J, et al. Risk of pulmonary embolism in patients with autoimmune disorders: a nationwide follow-up study from Sweden. Lancet 2012;379:244-249. 6. Goldhaber SZ, Grodstein F, Stampfer MJ, et al. A prospective study of risk factors for pulmonary embolism in women. JAMA 1997;277:642-645. 7. Kucher N, Goldhaber SZ. Recent advances in the diagnosis and treatment of pulmonary thromboembolism. ACC Current Journal Review ; Nov/Dec 2003:28-32. 8. Brugada P, Gorgels AP, Wellens HJJ. The electrocardiogram in pulmonary embolism. In Wellens HJJ, Kulbertus HE, eds. What’s New in Electrocardiography . The Hague: Martinus Nijhoff;1981:366-380. 9. Geibel A, Zehender M, Kasper W, et al. Prognostic value of the
ECG on admission in patients with acute major pulmonary embolism. Eur Respir J 2005; 25:843-848. 10. Panos RJ, Barish RA, Whye DW Jr, et al. The electrocardiographic manifestations of pulmonary embolism. J Emerg Med 1988; 6:301- 307. 11. Ferrari E, Imbert A, Chevalier T, et al. The ECG in pulmonary embolism. Chest 1997;111:537-543. 12. Ullman E, Brady W, Perron A, et al. Electrocardiographic manifestations of pulmonary embolism. Am J Emerg Med 2001;19:514-519. 13. Chan CT, Vilke GM, Pollack M, et al. Electrocardiographic manifestations: pulmonary embolism. J Emerg Med 2001;21:263- 270. 14. Glancy DL, Mikdadi GM. Syncope in a 67-year-old man. BUMC Proceedings 2005;18:74-75. 15. McConnell MV, Solomon SD, Ryan ME, et al. Regional right ventricular dysfunction detected by echocardiography in acute pulmonary embolism. Am J Cardiol 1996;78:469-473.
Drs. El Hajj and Bordelon are Residents in the Louisiana State University Internal Medicine Program in Baton Rouge. Dr. Glancy is a Professor of Medicine at the LSU Health Sciences Center in New Orleans.
178 J La State Med Soc VOL 166 July/August 2014
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