| NBC’s David Bloom dies in Iraq [message #12371] |
Mon, 07 April 2003 13:46   |
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K9Trooper
Messages: 821
Registered: February 2003
Karma:
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Colonel |
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| NHJ BV |
What is pulmonary embolism?
Anyway I think it's really ironic to die in a war but not from the war itself...
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Pulmonary embolism (PE) is an extremely common and highly lethal condition that is a leading cause of death in all age groups. A good clinician actively seeks the diagnosis as soon as any suspicion of PE whatsoever is warranted, because prompt diagnosis and treatment can dramatically reduce the mortality rate and morbidity of the disease. Unfortunately, the diagnosis is missed far more often than it is made, because PE often causes only vague and nonspecific symptoms.
The most sobering lessons about PE are those obtained from a careful study of the autopsy literature. Deep vein thrombosis (DVT) and PE are much more common than usually realized. Most patients with DVT develop PE and the majority of cases are unrecognized clinically. Untreated, approximately one third of patients who survive an initial PE die of a future embolic episode. This is true whether the initial embolism is small or large.
Most patients who die of PE have not had any diagnostic workup, nor have they received any prophylaxis for the disease. In most cases, the diagnosis has not even been considered, even when classic signs and symptoms are documented in the medical chart. Sadly, appropriate diagnostic and therapeutic management often is withheld even when the potential diagnosis of PE has been considered explicitly and documented in the chart.Massive PE is one of the most common causes of unexpected death, being second only to coronary artery disease as a cause of sudden unexpected natural death at any age. Most clinicians do not appreciate the extent of the problem, because the diagnosis is unsuspected until autopsy in approximately 80% of cases.
Although PE often is fatal, prompt diagnosis and treatment can reduce the mortality rate dramatically.
Approximately 10% of patients in whom acute PE is diagnosed die within the first 60 minutes. Of the remainder, the condition eventually is diagnosed and treated in one third and remains undiagnosed in two thirds.
Among the group whose PEs are correctly diagnosed and treated, only about one twelfth die from massive PE or its complications. Among the group whose PEs are undiagnosed and therefore untreated, roughly one third die. The diagnosis of PE is missed more than 400,000 times in the US each year, and approximately 100,000 patients die who would have survived with the proper diagnosis and treatment.
Patients who survive an acute PE are at high risk for recurrent PE and for the development of pulmonary hypertension and chronic cor pulmonale, which occurs in up to 70% of patients and carries its own attendant mortality and morbidity.
R.I.P. TreyD. You will be missed, but not forgotten.
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