Medicus, Vol. 33 No. 1 Tromboembolije, 2024.
Review article
Pulmonary Embolism
Gordana Pavliša
Ena Tolić
Abstract
Pulmonary embolism is a diagnosis characterized by non-specific symptoms along with significant mortality. It is typically caused by the migration of a thrombus formed in the veins of the lower extremities. Given the non-specific clinical picture (difficulty breathing, cough, chest pain), it is essential to recognize the risk factors that may contribute to the formation of thrombosis (the most important ones being fractures of the lower extremities, recent placement of a hip or knee endoprosthesis, major trauma, spinal cord injuries and previous history of venous thromboembolism). The clinical presentation varies from sudden cardiac death and severe hemodynamic instability (massive embolism) to asymptomatic cases. Today, pulmonary embolism is confirmed in 5% of patients who undergo a diagnostic procedure (CT pulmonary angiography or perfusion scintigraphy). To better identify those who require advanced procedures, the Wells and Geneva scoring system, PERC system, and D-dimers are used. Patients with a confirmed pulmonary embolism are categorized into four groups: low risk, intermediate low risk, intermediate high risk, and high risk. Anticoagulant therapy is the cornerstone of treating acute pulmonary embolism and preventing recurrence. Direct oral anticoagulants (DOAC) allow a portion of lowrisk patients to start treatment in outpatient settings. All patients should remain on anticoagulant therapy for at least 3 months, and the decision for prolonged treatment is made individually depending for the risk of thromboembolism recurrence and the risk of bleeding.
Keywords
acute pulmonary embolism; risk factors; dyspnea; anticoagulant therapy; DOAC
Hrčak ID:
321769
URI
Publication date:
24.10.2024.
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