Acute Pulmonary Embolism  

Oleh:

Konstantinides, Stavros

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: The New England Journal of Medicine (keterangan: ada di Proquest) vol. 359 no. 26 (Dec. 2008), page 2804-2813.
Topik: acute pulmonary embolism

Ketersediaan

Perpustakaan FK Nomor Panggil: N08.K.2008.06 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

A 62-year-old man presented with a 5-day history of progressively worsening dyspnea and orthopnea after returning from a 3-day business trip to the Far East. On physical examination, the heart rate was 102 beats per minute, and the blood pressure 110/60 mm Hg. The arterial oxygen saturation was 86% while the patient was breathing ambient air. The neck veins were distended. There was no heart murmur. The lungs were clear, and the extremities appeared normal. The D-dimer level was 5.13 mg per liter (normal level, less than 0.5), and the troponin T level was less than 0.01 µg per liter. A computed tomographic (CT) scan showed multiple thrombi in the pulmonary arteries and a dilated right ventricle. How should this case be managed? Acute pulmonary embolism is a major cause of complications and death associated with surgery, injury, and medical illnesses, and it may occur after long-distance air travel. Venous thromboembolism is responsible for up to 15% of all in-hospital deaths, and it also accounts for 20 to 30% of deaths associated with pregnancy and delivery in the United States and Europe. Overall, the annual incidence of pulmonary embolism has been reported to range between 23 and 69 cases per 100,000 population. Case fatality rates vary widely depending on the severity of the disease; at an average case fatality rate within 2 weeks of diagnosis of approximately 11%, the Surgeon General estimates that venous thromboembolism accounts for at least 100,000 deaths each year.

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