Interní Med. 2014; 16(5): 184-188

Pulmonary embolism - still underestimated diagnosis in outpatient practice

MUDr.Tomáš Indra
3. interní klinika, Všeobecná fakultní nemocnice v Praze

Pulmonary embolism is one of the most common cardiovascular diseases. Although this disease is well known even among general public,

diagnosis can be really difficult for its nonspecific and heterogeneous symptoms. Acute pulmonary embolism is characterized by high

mortality especially in untreated patients. This article focuses on diagnosis possibilities in stable patients with suspected pulmonary

embolism in outpatient practice and on treatment and secondary prevention of venous thromboembolism according to contemporary

guidelines. New possibilities of treatment using new oral anticoagulants are mentioned as well.

Keywords: pulmonary embolism, diagnosis, treatment, new anticoagulants

Published: November 1, 2014  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Indra T. Pulmonary embolism - still underestimated diagnosis in outpatient practice. Interní Med. 2014;16(5):184-188.
Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    References

    1. Oger E. Incidence of venous thromboembolism: a community-based study in Western France. EPI-GETBP Study Group. Groupe d'Etude de la Thrombose de Bretagne Occidentale. Thromb Haemost 2000; 83(5): 657-660. Go to original source... Go to PubMed...
    2. Stein PD, Kayali FandOlson RE. Estimated case fatality rate of pulmonary embolism, 1979 to 1998. Am J Cardiol 2004; 93(9): 1197-1199. Go to original source... Go to PubMed...
    3. Torbicki A, Perrier AandKonstantinides S. Guidelines on the diagnosis and management of acute pulmonary embolism. European Heart Journal 2008; 29: 2276-2315. Go to original source... Go to PubMed...
    4. Widimský J, Malý J, Eliáš P, et al. Doporučení diagnostiky, léčby a prevence plicní embolie, verze 2007. Cor Vasa 2008; 50(Suppl): 1S25-21S72. Go to original source...
    5. Stein PD, Hull RDandPineo G. Strategy that includes serial noninvasive leg tests for diagnosis of thromboembolic disease in patients with suspected acute pulmonary embolism based on data from PIOPED. Prospective Investigation of Pulmonary Embolism Diagnosis. Arch Intern Med 1995; 155(19): 2101-2104. Go to original source...
    6. Wells PS, Anderson DR, Rodger M, et al. Derivation of a Simple Clinical Model to Categorize Patients Probability of Pulmonary Embolism: Increasing the Models Utility with the SimpliRED D-dimer. Thrombosis and Haemostasis 2000; 83(3): 416-420. Go to original source... Go to PubMed...
    7. Le Gal G, Righini M, Roy PM, et al. Prediction of pulmonary embolism in the emergency department: the revised Geneva score. Ann Intern Med 2006; 144(3): 165-171. Go to original source... Go to PubMed...
    8. Geersing G-J, Erkens PMG, Lucassen WAM, et al. Safe exclusion of pulmonary embolism using the Wells rule and qualitative D-dimer testing in primary care: prospective cohort study. BMJ 345.
    9. Di Nisio M, Squizzato A, Rutjes AW, et al. Diagnostic accuracy of D-dimer test for exclusion of venous thromboembolism: a systematic review. J Thromb Haemost 2007; 5(2): 296-304. Go to original source... Go to PubMed...
    10. Stein PD, Fowler SE, Goodman LR, et al. Multidetector computed tomography for acute pulmonary embolism. N Engl J Med 2006; 354(22): 2317-2327. Go to original source... Go to PubMed...
    11. Wiener RS, Schwartz LMandWoloshin S. When a test is too good: how CT pulmonary angiograms find pulmonary emboli that do not need to be found. BMJ 347.
    12. Anderson DR, Kahn SR, Rodger MA, et al. Computed tomographic pulmonary angiography vs ventilation-perfusion lung scanning in patients with suspected pulmonary embolism: a randomized controlled trial. Jama 2007; 298(23): 2743-2753. Go to original source... Go to PubMed...
    13. Tunariu N, Gibbs SJ, Win Z, et al. Ventilation-perfusion scintigraphy is more sensitive than multidetector CTPA in detecting chronic thromboembolic pulmonary disease as a treatable cause of pulmonary hypertension. J Nucl Med 2007; 48(5): 680-684. Go to original source... Go to PubMed...
    14. Buller HR, Agnelli G, Hull RD, et al. Antithrombotic therapy for venous thromboembolic disease: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest 2004; 126(3 Suppl): 401S-428S. Go to original source... Go to PubMed...
    15. Quinlan DJ, McQuillan AandEikelboom JW. Low-molecular-weight heparin compared with intravenous unfractionated heparin for treatment of pulmonary embolism: a meta-analysis of randomized, controlled trials. Ann Intern Med 2004; 140(3): 175-183. Go to original source... Go to PubMed...
    16. Optimum duration of anticoagulation for deep-vein thrombosis and pulmonary embolism. Research Committee of the British Thoracic Society. Lancet 1992; 340(8824): 873-876.
    17. Schulman S, Granqvist S, Holmstrom M, et al. The duration of oral anticoagulant therapy after a second episode of venous thromboembolism. The Duration of Anticoagulation Trial Study Group. N Engl J Med 1997; 336(6): 393-398. Go to original source... Go to PubMed...
    18. Oral Rivaroxaban for the Treatment of Symptomatic Pulmonary Embolism. New England Journal of Medicine 366(14): 1287-1297. Go to original source... Go to PubMed...
    19. Agnelli G, Buller HR, Cohen A, et al. Oral Apixaban for the Treatment of Acute Venous Thromboembolism. New England Journal of Medicine 369(9): 799-808.
    20. Agnelli G, Buller HR, Cohen A, et al. Apixaban for Extended Treatment of Venous Thromboembolism. New England Journal of Medicine 368(8): 699-708.
    21. Schulman S, Kakkar AK, Goldhaber SZ, et al. Treatment of Acute Venous Thromboembolism with Dabigatran or Warfarin and Pooled Analysis. Circulation.

    Return to the content


    Internal Medicine for Practice

    Madam, Sir,
    please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
    Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

    I declare:

    1. that I have met the above instruction
    2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited

    No
    Yes

    If your statement is not true, please be aware
    that brings the risk of danger to their health or the health of others.