Acute Pulmonary Embolism

DeckerMed Medicine Pub Date : 2019-08-06 DOI:10.2310/im.1632
B. Carroll, Eric A. Secemsky
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Abstract

Pulmonary embolism (PE) is a frequently encountered clinical condition with both short- and long-term adverse consequences. An integrated approach to diagnosis is important to maximize early diagnosis but also to minimize the unnecessary utilization of diagnostic imaging. Comprehensive risk stratification with clinical features and assessment of right ventricular strain by diagnostic imaging and cardiac biomarker results are essential to guide initial management decisions. There is a growing treatment arsenal for acute PE, including increased anticoagulation and advanced therapeutic options such as catheter-based therapy.  Despite such advances, mortality remains high, particularly among those who present critically ill with PE, and long-term physical and psychological effects can persist in many patients for years after the initial diagnosis. This review contains 7 figures, 6 tables, and 69 references. Key Words: anticoagulation, catheter-directed therapy, chronic thromboembolic pulmonary hypertension pulmonary embolism, computed tomography, echocardiography, fibrinolysis, risk stratification, venous thromboembolism
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急性肺栓塞
肺栓塞(PE)是一种常见的临床疾病,具有短期和长期的不良后果。一个综合的诊断方法是重要的,以最大限度地提高早期诊断,但也尽量减少不必要的使用诊断成像。通过诊断成像和心脏生物标志物结果对临床特征和右心室劳损进行综合风险分层对指导初始管理决策至关重要。急性PE的治疗方法越来越多,包括抗凝治疗和先进的治疗选择,如导管治疗。尽管取得了这些进展,但死亡率仍然很高,特别是在那些患有肺心病的危重患者中,许多患者的长期生理和心理影响可能在最初诊断后持续数年。本综述包含7个图,6个表,69篇参考文献。关键词:抗凝,导管引导治疗,慢性血栓栓塞性肺动脉高压,肺栓塞,计算机断层扫描,超声心动图,纤溶,危险分层,静脉血栓栓塞
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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