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Acute pulmonary embolism

Yıl 2009, Cilt: 14 Sayı: 2, 57 - 68, 14.01.2013

Öz

Abstract. Pulmonary embolism is a common illness with a potential for considerable morbidity and mortality. It is often misdiagnosed because patients present with a wide array of symptoms and signs. The clinical setting can raise suspicion, and certain inherited and acquired risk factors predispose susceptible individuals. A quantitative D-dimer level in the blood is the best screening test where pretest clinical probability is low. Computed tomographic angiography has become the most commonly used modality for diagnosis in all other settings. Treatment requires rapid and accurate risk stratification before development of right ventricular dysfunction and cardiogenic shock. Anticoagulation is the cornerstone of treatment. Thrombolysis is mainly indicated in patients with hemodynamic compromise and hypotension. Right ventricular dysfunction on echocardiography identifies another high-risk group who might require thrombolysis even if normotensive on presentation. This article reviews the current concepts in the diagnosis and management of pulmonary embolism.

 

Key words: Pulmonary embolism, pulmonary thromboembolism, venous thromboembolism, deep venous thrombosis

Kaynakça

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Yıl 2009, Cilt: 14 Sayı: 2, 57 - 68, 14.01.2013

Öz

Kaynakça

  • Hyers TM. Venous thromboembolism. Am J Respir Crit Care Med 1999; 159: 1-14.
  • Kroegel C, Reissig A. Principle mechanisms underlying venous thromboembolism: epidemiology, risk factors, pathophysiology and pathogenesis. Respiration 2003; 70: 7-30.
  • Nicolaides AN, Kakkar VV, Field ES, Renney JT. The origin of deep vein thrombosis: a venographic study. Br J Radiol 1971; 44: 653-663.
  • Kakkar VV, Howe CT, Flanc C, Clarke MB. Natural history of postoperative deep-vein thrombosis. Lancet 1969; 2: 230-232.
  • Flanc C, Kakkar VV, Clarke MB. The detection of venous thrombosis of the legs using 125-I-labelled fibrinogen. Br J Surg 1968; 55: 742-747.
  • Moser KM, LeMoine JR. Is embolic risk conditioned by location of deep venous thrombosis? Ann Intern Med 1981; 94: 439-444.
  • Flordal PA, Bergqvist D, Ljungstrom KG, Torngren S. Clinical relevance of the fibrinogen uptake test in patients undergoing elective general abdominal surgery--relation to major thromboembolism and mortality. Fragmin Multicentre Study Group. Thromb Res 1995; 80: 491-497.
  • Hull R, Hirsh J, Sackett DL, et al. Replacement of venography in suspected venous thrombosis by impedance plethysmography and 125I-fibrinogen leg scanning: a less invasive approach. Ann Intern Med 1981; 94: 12-15.
  • Doyle DJ, Turpie AG, Hirsh J, et al. Adjusted subcutaneous heparin or continuous intravenous heparin in patients with acute deep vein thrombosis. A randomized trial. Ann Intern Med 1987; 107: 441-445.
  • Huisman MV, Buller HR, ten Cate JW, et al. Unexpected high prevalence of silent pulmonary embolism in patients with deep venous thrombosis. Chest 1989; 95: 498-502.
  • Moser KM, Fedullo PF, LitteJohn JK, et al. Frequent asymptomatic pulmonary embolism in patients with deep venous thrombosis. JAMA 1994; 271: 223-225.
  • Nielsen HK, Husted SE, Krusell LR, et al. Silent pulmonary embolism in patients with deep venous thrombosis. Incidence and fate in a randomized, controlled trial of anticoagulation versus no anticoagulation. J Intern Med 1994; 235: 457-461.
  • Hull RD, Hirsh J, Carter CJ, et al. Diagnostic value of ventilation-perfusion lung scanning in patients with suspected pulmonary embolism. Chest 1985; 88: 819-828.
  • Value of the ventilation/perfusion scan in acute pulmonary embolism. Results of the prospective investigation of pulmonary embolism diagnosis (PIOPED). The PIOPED Investigators. JAMA 1990; 263: 2753-2759.
  • Heijboer H, Jongbloets LM, Buller HR, et al. Clinical utility of real-time compression ultrasonography for diagnostic management of patients with recurrent venous thrombosis. Acta Radiol 1992; 33: 297-300.
  • Prandoni P, Cogo A, Bernardi E, et al. A simple ultrasound approach for detection of recurrent proximal-vein thrombosis. Circulation 1993; 88: 1730-1735.
  • Holmstrom M, Lindmarker P, Granqvist S, et al. A 6-month venographic follow-up in 164 patients with acute deep vein thrombosis. Thromb Haemost 1997; 78: 803-807.
  • Piovella F, Crippa L, Barone M, et al. Normalization rates of compression ultrasonography in patients with a first episode of deep vein thrombosis of the lower limbs: association with recurrence and new thrombosis. Haematologica 2002; 87: 515-522.
  • Prandoni P, Lensing AW, Prins MH, et al. Residual venous thrombosis as a predictive factor of recurrent venous thromboembolism. Ann Intern Med 2002; 137: 955-960.
  • Prandoni P, Lensing AW, Cogo A, et al. The long- term clinical course of acute deep venous thrombosis. Ann Intern Med 1996; 125: 1-7.
  • Prandoni P, Lensing AW, Prins MH, et al. Which is the outcome of the post-thrombotic syndrome? Thromb Haemost 1999; 82: 1196-1197.
  • Stein PD, Henry JW. Prevalence of acute pulmonary embolism among patients in a general hospital and at autopsy. Chest 1995; 108: 978-981.
  • Bell WR, Simon TL. Current status of pulmonary thromboembolic disease: pathophysiology, diagnosis, prevention, and treatment. Am Heart J 1982; 103: 239-262.
  • Carson JL, Kelley MA, Duff A, et al. The clinical course of pulmonary embolism. N Engl J Med 1992; 326: 1240-1245.
  • Ribeiro A, Lindmarker P, Juhlin-Dannfelt A, et al. Echocardiography Doppler in pulmonary embolism: right ventricular dysfunction as a predictor of mortality rate. Am Heart J 1997; 134: 479-487.
  • Van Beek EJ, Kuijer PM, Buller HR, et al. The clinical course of patients with suspected pulmonary embolism. Arch Intern Med 1997; 157: 2593-2598.
  • Goldhaber SZ, Visani L, De Rosa M. et al. Acute pulmonary embolism: clinical outcomes in the International Cooperative Pulmonary Embolism Registry (ICOPER). Lancet 1999; 353:1386-1389.
  • Heit JA, Silverstein MD, Mohr DN, et al. Predictors of survival after deep vein thrombosis and pulmonary embolism: a population-based, cohort study. Arch Intern Med 1999; 8; 159: 445- 453.
  • Ribeiro A, Lindmarker P, Johnsson H, et al. Pulmonary embolism: one-year follow-up with echocardiography doppler and five-year survival analysis. Circulation 1999; 99: 1325-1330.
  • Wicki J, Perrier A, Perneger TV, et al. Predicting adverse outcome in patients with acute pulmonary embolism: a risk score. Thromb Haemost 2000; 84: 548-552.
  • Jerjes-Sanchez C, Ramirez-Rivera A, de Lourdes Garcia M, et al. Streptokinase and Heparin versus Heparin Alone in Massive Pulmonary Embolism: A Randomized Controlled Trial. J Thromb Thrombolysis 1995; 2: 227-229.
  • Goldhaber SZ. Pulmonary embolism. N Engl J Med 1998; 339: 93-104.
  • Grifoni S, Olivotto I, Cecchini P, et al. Short-term clinical outcome of patients with acute pulmonary embolism, normal blood pressure, and echocardiographic right ventricular dysfunction. Circulation 2000; 101: 2817-2822.
  • Girard P, Musset D, Parent F, et al. High prevalence of detectable deep venous thrombosis in patients with acute pulmonary embolism. Chest 1999; 116: 903-908.
  • Stein PD, Terrin ML, Hales CA, et al. Clinical, laboratory, roentgenographic, and electrocardiographic findings in patients with acute pulmonary embolism and no pre-existing cardiac or pulmonary disease. Chest 1991; 100: 598-603.
  • Cheely R, McCartney WH, Perry JR, et al. The role of noninvasive tests versus pulmonary angiography in the diagnosis of pulmonary embolism. Am J Med 1981; 70: 17-22.
  • Goldhaber SZ, Haire WD, Feldstein ML, et al. Alteplase versus heparin in acute pulmonary embolism: randomised trial assessing right- ventricular function and pulmonary perfusion. Lancet 1993; 341: 507-511.
  • Urokinase pulmonary embolism trial. Phase 1 results: a cooperative study. JAMA 1970; 21; 214: 2163-2172.
  • Paraskos JA, Adelstein SJ, Smith RE, et al. Late prognosis of acute pulmonary embolism. N Engl J Med 1973; 289: 55-58.
  • Hall RJ, Sutton GC, Kerr IH. et al. Long-term prognosis of treated acute massive pulmonary embolism. Br Heart J 1977; 39: 1128-1134.
  • Sutton GC, Hall RJ, Kerr IH. Clinical course and late prognosis of treated subacute massive, acute minor, and chronic pulmonary thromboembolism. Br Heart J 1977; 39: 1135-1142.
  • Riedel M, Stanek V, Widimsky J, et al. Longterm follow-up of patients with pulmonary thromboembolism. Late prognosis and evolution of hemodynamic and respiratory data. Chest 1982; 81: 151-158.
  • Tissue plasminogen activator for the treatment of acute pulmonary embolism. A collaborative study by the PIOPED Investigators. Chest 1990; 97: 528- 533.
  • Kearon C. Natural history of venous thromboembolism. Semin Vasc Med 2001; 1: 27- 37.
  • Kearon C. Epidemiology of venous thromboembolism. Semin Vasc Med 2001; 1: 7-26.
  • Douketis JD, Foster GA, Crowther MA, et al. Clinical risk factors and timing of recurrent venous thromboembolism during the initial 3 months of anticoagulant therapy. Arch Intern Med 2000; 160: 3431-3436.
  • Murin S, Romano PS, White RH. Comparison of outcomes after hospitalization for deep venous thrombosis or pulmonary embolism. Thromb Haemost 2002; 88: 407-414.
  • Anderson FA, Jr., Wheeler HB, Goldberg RJ, et al. A population-based perspective of the hospital incidence and case-fatality rates of deep vein thrombosis and pulmonary embolism. The Worcester DVT Study. Arch Intern Med 1991; 151933-151938.
  • Siddique RM, Siddique MI, Connors AF, Thirty- day case-fatality rates for pulmonary embolism in the elderly. Arch Intern Med 1996; 156: 2343- 2347.
  • Silverstein MD, Heit JA, Mohr DN, et al. Trends in the incidence of deep vein thrombosis and pulmonary embolism: a 25-year population-based study. Arch Intern Med 1998; 158: 585-593.
  • Crowther MA, Kelton JG. Congenital thrombophilic states associated with venous thrombosis: a qualitative overview and proposed classification system. Ann Intern Med 2003; 138128-138134.
  • Turpie AG, Chin BS, Lip GY. Venous thromboembolism: pathophysiology, clinical features, and prevention. BMJ 2002; 325: 887-890.
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Toplam 106 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Bölüm Letter to the Editor
Yazarlar

Ritesh Agarwal Bu kişi benim

Subhash Varma Bu kişi benim

Yayımlanma Tarihi 14 Ocak 2013
Yayımlandığı Sayı Yıl 2009 Cilt: 14 Sayı: 2

Kaynak Göster

APA Agarwal, R., & Varma, S. (2013). Acute pulmonary embolism. EASTERN JOURNAL OF MEDICINE, 14(2), 57-68.
AMA Agarwal R, Varma S. Acute pulmonary embolism. EASTERN JOURNAL OF MEDICINE. Mart 2013;14(2):57-68.
Chicago Agarwal, Ritesh, ve Subhash Varma. “Acute Pulmonary Embolism”. EASTERN JOURNAL OF MEDICINE 14, sy. 2 (Mart 2013): 57-68.
EndNote Agarwal R, Varma S (01 Mart 2013) Acute pulmonary embolism. EASTERN JOURNAL OF MEDICINE 14 2 57–68.
IEEE R. Agarwal ve S. Varma, “Acute pulmonary embolism”, EASTERN JOURNAL OF MEDICINE, c. 14, sy. 2, ss. 57–68, 2013.
ISNAD Agarwal, Ritesh - Varma, Subhash. “Acute Pulmonary Embolism”. EASTERN JOURNAL OF MEDICINE 14/2 (Mart 2013), 57-68.
JAMA Agarwal R, Varma S. Acute pulmonary embolism. EASTERN JOURNAL OF MEDICINE. 2013;14:57–68.
MLA Agarwal, Ritesh ve Subhash Varma. “Acute Pulmonary Embolism”. EASTERN JOURNAL OF MEDICINE, c. 14, sy. 2, 2013, ss. 57-68.
Vancouver Agarwal R, Varma S. Acute pulmonary embolism. EASTERN JOURNAL OF MEDICINE. 2013;14(2):57-68.