Pulmonary embolism

Research output: Contribution to journalArticle

Abstract

Pulmonary embolism remains a challenging problem in diagnosis and management for the emergency physician. Although its clinical presentation is protean and often ambiguous, risk stratification can be accomplished based on the predictive power of a limited number of physical and historical characteristics. Ventilation-perfusion lung scanning occupies a central position in the work-up of suspected PE; however, evidence exists that it may be misused by many physicians. A low probability V-Q scan does not exclude the diagnosis of PE. Patients with other than normal- or high-probability patterns of pulmonary ventilation and perfusion on lung scanning require further investigation. Noninvasive venous studies are useful when indicative of proximal deep venous thrombosis, but are normal in many patients with acute PE. Heparin remains the standard of treatment for most patients with PE. Vena cava filters effectively reduce the incidence of recurrent PE in patients with contraindications to anticoagulation. Thrombolytic therapy offers potential advantages in the treatment of patients with shock due to their PE. Case reports of PE treated with tissue-type plasminogen activator, a new thrombus-specific fibrinolytic agent, are encouraging but preliminary.

Original languageEnglish (US)
Pages (from-to)253-266
Number of pages14
JournalEmergency Medicine Clinics of North America
Volume6
Issue number2
StatePublished - 1988

Fingerprint

Pulmonary Embolism
Perfusion
Vena Cava Filters
Physicians
Pulmonary Ventilation
Lung
Fibrinolytic Agents
Thrombolytic Therapy
Tissue Plasminogen Activator
Venous Thrombosis
Ventilation
Heparin
Shock
Emergencies
Thrombosis
Incidence
Therapeutics

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Emergency Medicine
  • Nursing(all)

Cite this

Pulmonary embolism. / Valenzuela, Terence D.

In: Emergency Medicine Clinics of North America, Vol. 6, No. 2, 1988, p. 253-266.

Research output: Contribution to journalArticle

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