Treatment is with anticoagulants such as heparin, warfarin or one of the direct-acting oral anticoagulants (DOACs). These are recommended for at least three months. Severe cases may require thrombolysis using medication such as tissue plasminogen activator (tPA) given intravenously or through a catheter, and some may require surgery (a pulmonary thrombectomy). If blood thinners are not appropriate, a temporary vena cava filter may be used.Pulmonary emboli affect about 430,000 people each year in Europe. In the United States, between 300,000 and 600,000 cases occur each year, which contribute to at least 40,000 deaths. Rates are similar in males and females. They become more common as people get older. Signs and symptoms
Symptoms of pulmonary embolism are typically sudden in onset and may include one or many of the following: dyspnea (shortness of breath), tachypnea (rapid breathing), chest pain of a "pleuritic" nature (worsened by breathing), cough and hemoptysis (coughing up blood). More severe cases can include signs such as cyanosis (blue discoloration, usually of the lips and fingers), collapse, and circulatory instability because of decreased blood flow through the lungs and into the left side of the heart. About 15% of all cases of sudden death are attributable to PE. While PE may present with syncope, less than 1% of syncope cases are due to PE.On physical examination, the lungs are usually normal. Occasionally, a pleural friction rub may be audible over the affected area of the lung (mostly in PE with infarct).
If no motive for the amnesia was immediately apparent, deeper motives were usually sought by questioning the patient more intensely, often in conjunction with hypnosis and truth drugs. In many cases, however, patients were found to spontaneously recover from their amnesia on their own accord so no treatment was required. In popular culture
Psychogenic amnesia is a common fictional plot device in many films, books and other media. Examples include William Shakespeares King Lear, who experienced amnesia and madness following a betrayal by his daughters; and the title character Nina in Nicolas Dalayracs 1786 opera. In the 2009 Televisa-produced telenovela Sortilegio, the main female protagonist (Jacqueline Bracamontes) is kidnapped and her memory is wiped using drugs. In OMORI, one of the main characters (Sunny) has dissociative amnesia. In the 2009 Breaking Bad television programs second season episode Bit by a Dead Bee, the main protagonist, Walter White, fakes a fugue state to account for his whereabouts. See also
Effects of stress on memory
Depersonalization
Dissociative disorders

References


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