Title |
Management of Pulmonary Embolism: 2010 State-of-the-Art Update
|
---|---|
Published in |
Current Treatment Options in Cardiovascular Medicine, March 2010
|
DOI | 10.1007/s11936-010-0064-y |
Pubmed ID | |
Authors |
Teresa L. Carman, Florian Gegaj |
Abstract |
The morbidity and mortality of venous thromboembolism remain underrecognized and underappreciated. Suspected pulmonary embolism should be risk stratified using a validated clinical risk prediction tool; intermediate to high clinical suspicion requires objective diagnostic testing to confirm or refute the diagnosis. Therapy with unfractionated heparin, low molecular weight heparin, or fondaparinux should be initiated while diagnostic testing is pursued. Conversion to vitamin K antagonists requires a minimum of 5 days' overlap between the parenteral agent and the vitamin K antagonist. Anticoagulation should be continued for a minimum of 3 to 6 months. Longer or even indefinite therapy may be required with a persistent hypercoagulable state. In patients with cancer, low molecular weight heparin monotherapy for the initial 3 to 6 months is preferred. In stable patients with normal biomarkers and a normal echocardiogram, accelerated discharge and outpatient therapy may be considered. In patients with hemodynamic instability, systemic thrombolytic therapy, catheter-directed therapy, or surgical embolectomy may be considered. Cancer screening and/or thrombophilia testing should be pursued only if the findings will directly affect patient therapy or long-term care. |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
United Kingdom | 1 | 2% |
Spain | 1 | 2% |
Canada | 1 | 2% |
Unknown | 62 | 95% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Researcher | 14 | 22% |
Other | 8 | 12% |
Student > Master | 8 | 12% |
Student > Doctoral Student | 5 | 8% |
Student > Bachelor | 5 | 8% |
Other | 16 | 25% |
Unknown | 9 | 14% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 37 | 57% |
Nursing and Health Professions | 5 | 8% |
Pharmacology, Toxicology and Pharmaceutical Science | 2 | 3% |
Agricultural and Biological Sciences | 2 | 3% |
Biochemistry, Genetics and Molecular Biology | 2 | 3% |
Other | 4 | 6% |
Unknown | 13 | 20% |