acute massive pulmonary embolism

Also found in: Acronyms.

acute massive pulmonary embolism

A condition defined as “…obstruction or significant filling defect involving two or more lobar pulmonary arteries, or the equivalent amount of emboli in smaller or other arteries”. It is the second most common cause of sudden death, after sudden cardiac death.

Clinical findings
Nonspecific; index of suspicion should be high in patients with dyspnea, tachypnea, or chest pain and risk factors for pulmonary embolism.

Pulmonary angiography is the gold-standard diagnostic modality, but is rarely performed, as CT angiography is nearly as sensitive and specific.

Immediate full anticoagulation followed by long-term anticoagulation, to prevent deep-vein thrombosis and recurrent pulmonary embolism.

Risk factors, pulmonary embolism
Major factors
Venous stasis
Hypercoagulable states
Surgery and trauma
Oral contraceptives and estrogen replacement
Hereditary factors resulting in a hypercoagulable state

Other factors
Acute medical illness
Central venous instrumentation within the past 3 months
Chronic obstructive pulmonary disease
Drug abuse (intravenous drugs)
Drug-induced lupus anticoagulant
Heart failure
Hemolytic anemias
Heparin-associated thrombocytopenia
Inflammatory bowel disease
Malignancy, especially lung cancer
Prior pulmonary embolism
Stroke, paresis, or paralysis
Surgery within the last 3 months
Current or past history of thrombophlebitis
Travel of 4 hours or more in the past month
Trauma to the lower extremities and pelvis during the past 3 months
Varicose veins
Venous pacemakers
Venous stasis
Warfarin (first few days of therapy)
Segen's Medical Dictionary. © 2012 Farlex, Inc. All rights reserved.
References in periodicals archive ?
This study was carried out to assess the safety and efficacy of the 2 hour regimen of streptokinase (SK) in acute massive pulmonary embolism in our population.
During this period 25 consecutive patients with recent symptoms ( less than 5 days) suggestive of acute massive pulmonary embolism were studied.
Comparative efficacy of a two-hour regimen of streptokinase versus alteplase in acute massive pulmonary embolism: immediate clinical and hemodynamic outcome and one-year follow-up.
Surgical embolectomy in acute massive pulmonary embolism. Asian Cardiovasc Thorac Ann 2007; 15: 149-53.
Strategy of treatment for acute massive pulmonary embolism in patients with contraindication for thrombolysis.
The clinical condition of the patient became worse due to acute massive pulmonary embolism and he fell in comatose state with cyanosis.

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