| Acute pulmonary embolism: risk stratification. | |
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MedLine Citation:
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PMID: 16855363 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The death rate from acute pulmonary embolism (PE) exceeds the mortality rate for acute myocardial infarction. Risk stratification helps optimize the selection of those patients who will benefit from more aggressive therapy, such as thrombolysis or embolectomy, in addition to anticoagulation. The classic paradigm was to observe patients deteriorate and to attempt to maintain acceptable hemodynamics by starting vasopressors. If hemodynamics failed to improve or if cardiogenic shock persisted, thrombolysis or surgical embolectomy was considered. Sadly, this "watch and wait" approach often resulted in irreversible cardiogenic shock and multisystem organ failure. The new approach hinges upon rapid and accurate risk stratification. There are four features of this strategy: 1) clinical evaluation, 2) bedside nonimaging tests-electrocardiography and pulse oximetry, 3) imaging tests-echocardiography and chest computed tomography,and 4) cardiac biomarkers-such as the troponin level. When high-risk patients are identified,they can be triaged for urgent or emergent therapy, usually prior to developing overt hypotension and cardiogenic shock. |
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Authors:
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Samuel Z Goldhaber |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Pathophysiology of haemostasis and thrombosis Volume: 35 ISSN: 1424-8832 ISO Abbreviation: Pathophysiol. Haemost. Thromb. Publication Date: 2006 |
Date Detail:
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Created Date: 2006-07-20 Completed Date: 2006-09-22 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101142710 Medline TA: Pathophysiol Haemost Thromb Country: Switzerland |
Other Details:
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Languages: eng Pagination: 153-6 Citation Subset: IM |
Affiliation:
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Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA. sgoldhaber@partners.org |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Acute Disease Biological Markers / analysis Diagnostic Imaging Electrocardiography Humans Oximetry Pulmonary Embolism / complications, diagnosis*, therapy Risk Assessment Triage / methods* |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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