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Pulmonary embolism historical perspective

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] The APEX Trial Investigators

Overview

Throughout history, many renowned researchers and health care professionals have contributed to the understanding, definition, and treatment of pulmonary embolism. Though the first documented case of pulmonary embolism occurred in 1837, historical record of thrombotic disease dates as far back as the 7th century BCE.[1]

Historical Perspective

Year Event
600-1000 BCE Ayurveda physician and surgeon, Sushruta, makes the first written reference to thrombotic disease in a patient. He notes the patient’s condition as having had a “swollen and painful leg which was difficult to treat”.
1837 French pathologist Jean Cruveilhier documents the first case report on pulmonary embolism.
1922 Researchers publish a description of pulmonary embolism characteristics visible within a chest x-ray.
Prior to 1930 The practicing consensus viewed a pulmonary embolism as universally fatal. They believed surgery was the only treatment despite an operative mortality of 100%.
1935 Researchers begin to utilize heparin in clinical trials aimed at treating pulmonary embolisms.
1940 Researchers, Hampton and Castleman, describe the radiographic appearance of pulmonary embolisms and pulmonary infarctions. These observations are later referred to as Hampton’s hump.
1960 Barritt et al demonstrate that anticoagulant therapy reduces death and recurrent venous thromboembolism in patients with pulmonary embolism.[2]
1977 Physician Eugene Robin published a landmark article recommending the use of pulmonary angiography as an approach to diagnosing pulmonary embolism.[3]
1995 Goodman et al. compared Helical CT angiography (CTA) with pulmonary angiography in patients with unresolved suspicion for pulmonary thromboembolism.[4]
2005 CT replaced scintigraphy as the noninvasive test of choice for suspected pulmonary thromboembolism.[5]

References

  1. Wood KE (2009). “A history of pulmonary embolism and deep venous thrombosis”. Crit Care Clin. 25 (1): 115–31, viii. doi:10.1016/j.ccc.2008.12.014. PMID 19268798.
  2. BARRITT DW, JORDAN SC (1960). “Anticoagulant drugs in the treatment of pulmonary embolism. A controlled trial”. Lancet. 1 (7138): 1309–12. PMID 13797091. Unknown parameter |month= ignored (help); |access-date= requires |url= (help)
  3. Robin ED (1977). “Overdiagnosis and overtreatment of pulmonary embolism: the emperor may have no clothes”. Ann Intern Med. 87 (6): 775–81. PMID 931212.
  4. Goodman LR, Curtin JJ, Mewissen MW, Foley WD, Lipchik RJ, Crain MR; et al. (1995). “Detection of pulmonary embolism in patients with unresolved clinical and scintigraphic diagnosis: helical CT versus angiography”. AJR Am J Roentgenol. 164 (6): 1369–74. PMID 7754875.
  5. Goldhaber SZ (2005). “Multislice computed tomography for pulmonary embolism–a technological marvel”. N Engl J Med. 352 (17): 1812–4. doi:10.1056/NEJMe058041. PMID 15858192.

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