As regards emboli of the pulmonary artery I would recall your attention briefly to the danger posed for a whole series of patients. You mentioned this briefly — I would like to go into this in more detail. The frequency and the dangerous nature of thrombo-embolism in chronic lung disease and in those with chronic respiratory failure. My experience which includes some 1200 emphysematous patients with hypoxemia and severe hypercapnia suggests that in 28% of these patients there is the onset of pulmonary thrombus. These are all patients with arterial PC02 higher than 60 mm of mercury. There are anatomo-pathologicaf studies of French authors Bignon and Parian who show that in chronic lung disease and respiratory failure there is not so much embolus but rather arterial thrombosis. The danger of such thromboses lies in the fact that they are unforeseeable and it is not possible to diagnose them rapidly and with certainty. Rapid dignosis is of paramount importance because these patients die after a very short interval — either there is sudden cardiac arrest or ventricular fibrillation with subsequent cardiac arrest, or they go into severe shock and death ensues.
KeywordsPulmonary Embolus Pulmonary Hypertension Pulmonary Arterial Hypertension Chronic Lung Disease Primary Pulmonary Hypertension
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