A 21-year-old male patient with massive acute pulmonary embolism was treated by thrombolysis, interventional thrombus fragmentation, and surgical pulmonary embolectomy. Within the following 2 years, the patient developed progressive dyspnea at exertion. Chronic thromboembolic pulmonary hypertension was diagnosed by right-heart catheter, VQ scan, magnetic resonance, and conventional pulmonary an...

Massive pulmonary embolism associated with total cardiovascular collapse occurred during the surgical repair of a ruptured abdominal aortic aneurysm with an aortocaval fistula. Pulmonary artery pressure monitoring permitted immediate diagnosis whereas central venous pressures did not reflect the obstruction to right ventricular outflow. Pulmonary embolectomy without cardiopulmonary bypass was p...

until a week later, when on provocation she muttered two expletives. Thereafter she was mobilized and made satisfactory progress. The tracheostomy was closed and it subsequently healed. Four weeks after stopping the diazepam it was clear that her mental faculties were unimpaired and that she retained a remarkably good sense of humour. She was discharged home three months after her admission wal...

for Acute Pulmonary Embolism To the Editor: We read with great interest a review paper titled “Acute Pulmonary Embolism, Part II: Risk Stratification, Treatment, and Prevention” by Goldhaber and associates in the December 2003 issue of the journal.1 The strategies for acute pulmonary embolism in their review are anticoagulation, inferior vena caval filters, thrombolysis, and embolectomy. They m...