[Acute thromboembolism].
The diagnosis of acute pulmonary embolism is based on the assessment of risk factors, consistent symptoms and signs, and the lack of an alternative clinical explanation for the condition of the patient. If the probability of pulmonary embolism is low or intermediate, the diagnosis can be reliably excluded by a negative D-dimer test. A positive D-dimer test requires further evaluation by spiral angio computed tomography technique to confirm or rule out pulmonary embolism. The angiocoexisting pulmonary diseases. If the clinical probability for pulmonary embolism is high an angio-CT rather then a D-dimer should be performed at the first place. If there are signs of deep leg vein thrombosis, massive pulmonary embolism with hemodynamic instability and in other special circumstances the diagnostic approach has to be adapted accordingly. A timely diagnosis and treatment with heparin and oral anticoagulation significantly reduces the acute and chronic morbidity and mortality of pulmonary embolism.
Bloch
K E
KE
Abteilung Pneumologie, Universitätsspital Zürich. pneubloc@usz.unizh.ch
D000208:Acute Disease; D000284:Administration, Oral; D000328:Adult; D000790:Angiocardiography; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004562:Electrocardiography; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products; D006493:Heparin / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000175:diagnosis; D011379:Prognosis; D011655:Pulmonary Embolism / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology / Q000401:mortality; D011877:Radionuclide Imaging; D012307:Risk Factors; D013923:Thromboembolism / Q000175:diagnosis / Q000188:drug therapy; D013924:Thrombophlebitis / Q000150:complications / Q000175:diagnosis; D013997:Time Factors; D036542:Tomography, Spiral Computed
D000925:Anticoagulants; D005338:Fibrin Fibrinogen Degradation Products; D006493:Heparin