warfarin and Remission--Spontaneous

Electrocardiography findings in patients with pulmonary embolism have been investigated since 1935. As medicine has evolved, more effective modalities have surpassed the electrocardiogram in diagnostic utility. Despite the advent of these other modalities, the diagnosis of pulmonary embolism remains elusive and the prognosis is variable amongst each clinical presentation of its pathology.. After presenting a case of a resolving S1Q3T3 in subsequent electrocardiogram findings of a patient with pulmonary embolism, this literature review will provide information on a 21-point electrocardiogram scoring system that helps the emergency physician stratify the risk of a patient with an acute presentation of pulmonary embolism. Why should emergency care staff be aware of this? Given the time-sensitive nature of diagnosis and appropriate treatment, Electrocardiogram continues to be a tool in the assessment of patients with a clinical suspicion of pulmonary embolism. Based on the information provided, 21-point electrocardiogram score has been shown to have strong usefulness in assessing prognosis of patients presenting with acute pulmonary embolism.

Topics: Adult; Electrocardiography; Emergency Service, Hospital; Enoxaparin; Humans; Male; Myocardial Ischemia; Pulmonary Embolism; Remission, Spontaneous; Venous Thromboembolism; Warfarin

Topics: Anticoagulants; Atrial Fibrillation; Dose-Response Relationship, Drug; Electric Countershock; Factor Xa Inhibitors; Female; Follow-Up Studies; Heart Rate; Humans; Male; Middle Aged; Pyridines; Remission, Spontaneous; Retrospective Studies; Thiazoles; Thromboembolism; Treatment Outcome; Warfarin

Topics: Aged; Anticoagulants; Hematoma, Subdural, Acute; Humans; Male; Myelodysplastic Syndromes; Pancytopenia; Remission, Spontaneous; Warfarin

Topics: Anticoagulants; Articulation Disorders; Cerebellar Diseases; Cerebellum; Female; Frontal Lobe; Functional Laterality; Humans; Infarction, Middle Cerebral Artery; Intracranial Hemorrhages; Middle Aged; Neural Pathways; Neuronal Plasticity; Parietal Lobe; Recovery of Function; Remission, Spontaneous; Speech; Verbal Behavior; Warfarin

Topics: Adult; Anticoagulants; Aortic Valve; Cardiomyopathy, Dilated; Fibrinolysis; Fluoroscopy; Heart Valve Prosthesis; Humans; Male; Remission, Spontaneous; Thrombosis; Ventricular Outflow Obstruction; Warfarin

Arthroscopic posterior cruciate ligament reconstruction may carry certain risks of complications, including injury to the neurovascular structures in the popliteal region. Acute occlusion of the popliteal artery, a limb-threatening complication, was reported after total knee arthroplasty. We report a case of acute popliteal artery occlusion after arthroscopic posterior cruciate ligament reconstruction. The possible causes included underlying artherosclerosis, the use of pneumatic tourniquet, surgical manipulation, and arterial spasm. Early diagnosis and prompt surgical treatment are the keys to success in the treatment of this limb-threatening complication. Spontaneous resolution of the thrombus such as is reported in this case is exceptional.

Topics: Anticoagulants; Arterial Occlusive Diseases; Arthroscopy; Heparin; Humans; Ischemia; Joint Instability; Leg; Male; Middle Aged; Popliteal Artery; Posterior Cruciate Ligament; Postoperative Complications; Remission, Spontaneous; Thrombosis; Tourniquets; Warfarin

Although left ventricular thrombi that form acutely after myocardial infarction frequently resolve spontaneously or with anticoagulant therapy, the fate of left ventricular thrombi in patients with remote myocardial infarction or with idiopathic cardiomyopathy remains unknown. To determine the natural history of such chronic left ventricular thrombi, we performed serial echocardiograms on 51 patients with remote myocardial infarction (greater than or equal to 3 months; mean, 31 +/- 41 months) and on nine patients with idiopathic dilated cardiomyopathy. Mean follow-up was 24 +/- 22 months during which 3.5 +/- 1.4 echocardiograms were obtained. Studies were interpreted by blinded observers, and an increase or decrease of more than 5 mm in maximal thrombus thickness was defined as significant. Among all 60 patients left ventricular thrombi were unchanged in 24 (40%), completely resolved in 24 (40%), decreased in size in four (7%), increased in size in five (8%), and decreased and then increased in size in three (5%). Results in patients with remote infarction and idiopathic cardiomyopathy were similar. Warfarin therapy, which was at the discretion of the primary physician, was associated with a higher prevalence of thrombus resolution compared with no therapy (59% vs. 29%, p = 0.02). Definite systemic emboli occurred in seven patients (12%), all at times while they were not anticoagulated. Among the 48 thrombi that were present on two or more echocardiograms, changes in thrombus shape (classified as protruding or flat) occurred in only 16%, and changes in thrombus movement (classified as mobile or immobile) occurred in only 10%.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Aged; Cardiomyopathies; Coronary Disease; Coronary Thrombosis; Echocardiography; Female; Humans; Male; Middle Aged; Myocardial Infarction; Prospective Studies; Remission, Spontaneous; Warfarin

Two groups of patients were observed for evidence of acute radiation hepatitis during "high dose" radiation to the liver. The first group of 18 patients with metastatic liver disease received an average of 4,050 rad to the whole liver. Half received anticoagulation with warfarin. One patient on anticoagulation developed evidence of acute radiation hepatitis while 2 patients did so without anticoagulation. Eleven patients with Hodgkin's disease received 4,000 rad to the left lobe of the liver during extended field radiation. Four of these 11 patients were anticoagulated to therapeutic range. Only one of the fully anticoagulated patients showed changes on liver scan consistent with radiation hepatitis whereas three did so without anticoagulation. No serious sequelae from anticoagulation occurred in either group. These preliminary data suggest that anticoagulation may be safely administered with high dose hepatic radiation and that further trials with anticoagulation are warranted.

Topics: Adult; Aged; Female; Hepatitis; Hodgkin Disease; Humans; Male; Middle Aged; Neoplasms; Radiation Injuries; Radiation Tolerance; Radiotherapy Dosage; Radiotherapy, High-Energy; Remission, Spontaneous; Warfarin

A study of warfarin anticoagulation as an adjunct to amputation of osteosarcomas was undertaken after finding dramatic results in experimental systems. Anticoagulation was started 7 days preoperatively, continued during the operation, and for up to six months postoperatively. Three of 21 (14%) non-anticoagulated control patients are alive at 5-11 years. Five of 9 (56%) of the anticoagulated patients remain alive 5-8 years. The presumed mechanism of increased survival is an inhibition of fibrin deposition around circulating tumor cells, thereby preventing their adherence to capillary endothelium to initiate metastasis formation.

Topics: Adolescent; Adult; Amputation, Surgical; Bone Neoplasms; Female; Hemorrhage; Humans; Male; Middle Aged; Neoplasm Metastasis; Neoplastic Cells, Circulating; Osteosarcoma; Prothrombin Time; Remission, Spontaneous; Time Factors; Warfarin