MASSIVE PULMONARY EMBOLISM. V. EVOLUTION OF ELECTROCARDIOGRAPHIC AND ENZYME CHANGES IN SURVIVORS.

Abstract

RECOGNITION of the growing importance and increasing frequency of pulmonary embolism has centered attention on these aspects of thromboembolism: diagnosis, differentiation from and contribution to myocardial infarction, and evolution and prognosis. Awareness of thromboembolism is essential for its diagnosis. The electrocardiogram (ECG) and serial x-rays are useful aids, but the presence of small clots in the pulmonary artery remains difficult to establish conclusively. Wacker and co-workers1described a potentially useful triad for the diagnosis of pulmonary embolism: (1) an increase in serum lactic acid dehydrogenase (SLDH) levels within 24 hours after the embolic episode; (2) normal levels of serum glutamic oxalacetic transaminase (SGOT); and (3) an increase in serum bilirubin levels. The present report describes the evolution of electrocardiographic changes following nonlethal pulmonary embolism in dogs, relates such changes to variation in SLDH and SGOT levels following embolism, and presents the electrocardiograph patterns observed after embolization of animals with