Acute Pulmonary Thromboembolism: A Historical Perspective

摘要

Acute pulmonary thromboembolism is the third most common cause of cardiovascular death. Accurate diagnosis of thiscondition is essential to minimize mortality and treatment-related morbidity. Over many decades, new diagnostic methods and treatments have been explored. The classic articles by Hampton and Castleman [1] in 1940 and by Goodman et al. [2] in 1995 nicely bracket the advances in imaging of pulmonary thromboembolism over more than five decades.The celebrated article by Hampton and Castleman [1] in 1940 described the radio-graphic appearance of pulmonary embolism and pulmonary infarction. Hampton's hump, the peripheral, wedge-shaped consolidation with its base against the pleural surface and with a rounded central margin, is now a well-known sign of pulmonary infarction. This article has enjoyed widespread popularity, reflecting the excellent radiologic-pathologic correlation from postmortem examinations. The descriptions were subsequently confirmed by other imaging techniques and are still valid today. Other signs of infarction besides Hampton's hump include peripheral consolidation without air bronchogram [3]; the melting sign of resolving infarct [4]; aseptic cavitation [5]; and, recently, consolidation containing air lucencies (distinct from air bronchograms) [6]. Infarction caused by acute pulmonary thromboembolism is less common than might be expected because the bronchial artery can maintain perfusion to the lung when pulmonary arterial perfusion is blocked by pulmonary thromboembolism [7-9].