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Multiple Small Pulmonary Emboli in Refractory Chronic Congestive Heart Failure.

Robert R. Burch, M.D., F.A.C.P.; Maurice A. Pearl, M.D., F.A.C.P.; and Eugene Gonzales, M.D.
Ann Intern Med. 1967;66(5):1034. doi:10.7326/0003-4819-66-5-1034_2
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This excerpt has been provided in the absence of an abstract.

Progressive chronic congestive heart failure unresponsive to the usual therapeutic measures is a frequent clinical problem. Because of the absence of an obvious source, as well as the usual clinical picture, pulmonary emboli are often not given serious consideration as the cause of the progressive course of this illness.

Twelve cases studied illustrate a clinical picture characteristic of repeated small pulmonary emboli as the cause of the progressive course of refractory chronic congestive heart failure. All 12 cases had the following common features: [1] large heart with refractory chronic congestive heart failure; [2] partially or completely bedridden patient; [3] stepwise


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