Acute Pulmonary Embolism

The value of echocardiography in the diagnostic work-up of patients with suspected acute pulmonary embolism.- New developments in the thrombolytic therapy of venous thrombosis.- Mechanism of blood coagulation. Newer aspects of anticoagulant and antithrombotic therapy.MR-angiography in the diagnosis of pulmonary embolism.Scintigraphy-ventilation/perfusion scanning and imaging of the embolus.- Clinical course and prognosis of acute pulmonary embolism.- The molecular mechanisms of inherited thombophilia.

Inspite of considerable progress in prevention, diagnosis, and treatment, pulmonary embolism has remained a threat to the patient and a challenge for the physician both in conservative, as well as in operative disciplines. Pulmonary embolism is according to pathology observations still the most frequently overlooked clinical diagnosis. In 1-5 per 100 autopsies, clinically unexpected pulmonary emboli are found. In addition, the sequelae of recurrent pulmonary emboli, the syndrome of pulmonary hypertension with or without right heart failure, continues to present a therapeutic dilemma - and no progress is in sight. In intensive care medicine pulmonary embolism, either acute, massive, and/or recur­ rent, continues to be both a therapeutic as well as a preventive challenge mobilizing pharmacotherapeutic, catheter-interventional, and operative resources. Diagnostic, therapeutic, and preventive strategies are currently in use. Their basis, however, seems surprisingly thin, as far as our knowledge on the natural course of this chameleon-like illness with and without fibrinolytic, anticoagulative, catheter or opera­ tive treatment is concerned. A large European multicenter register has been initiated by Professors Kasper and Geibel with the help of Boehringer Ingelheim Pharmaceutics, in order to better describe the natural course of pulmonary embolism under current treat­ ment modalities. Furthermore, recently the clinical significance of the valve patent foramen ovale as a source of paradoxical emboli is beginning to be better understood. Many concepts therefore require revision.

This book is a comprehensive guide to the diagnosis and management of all stages of pulmonary embolism, starting with acute and ending with chronic thromboembolic pulmonary hypertension. Acute pulmonary embolism (PE) is responsible for 150-250,000 hospitalizations and 60-100,000 deaths each year in the United States, making it the third most common cause of cardiovascular death. Acute PE spans a wide spectrum of clinical outcomes mainly based on the right ventricle’s (RV) capacity to tolerate strain. There have been many recent advances in the field of PE, including guidelines on classification and risk stratification, anticoagulation, as well as evolving areas in treatment options and follow up. The text begins with a review of the epidemiology and risk factors for PE. Chapters then delve into reviewing the decision pathways based on PE severity and treatment options, including the use of oral anticoagulation, systemic and catheter-directed thrombolysis, mechanical and surgical thrombectomy, and hemodynamic support with extracorporeal membrane oxygenation. The text then focuses on post-PE complications such as post-PE syndrome, chronic thromboembolic disease, and chronic thromboembolic pulmonary hypertension (CTEPH). This is an ideal guide for providers of lung health, including pulmonary and critical care physicians, cardiologists, thoracic and cardiovascular surgeons. Physician-trainees, physician assistants, nurses and respiratory therapists with interest in pulmonary disorders, cardiovascular disease, pulmonary embolism, critical care or pulmonary hypertension will also find great value in this comprehensive guide.

This practical volume highlights traditional, novel, and evolving aspects of the diagnosis and treatment of pulmonary embolism (PE). The contributors comprise an international team of experts. Important aspects of diagnosis, risk stratification, and differential treatment of patients with PE are presented in a concise, yet comprehensive manner. Emphasis is placed on specific issues related to PE, including pregnancy, cancer, thrombophilia, and air travel.

This book is a comprehensive review of pulmonary embolism (PE) which, with deep vein thrombosis, is assigned to the term venous thromboembolism (VTE) and currently the third most frequent acute cardiovascular syndrome globally. In the past decade we have seen a remarkable improvement in new diagnostic tools as well as novel therapeutic options to manage patients with VTE and this book provides a thorough clinical discussion of the diagnosis and management of these patients. Pulmonary Embolism presents a comprehensive review of all aspects of the epidemiology, pathophysiology, diagnosis, risk assessment and therapeutic options to manage the patient with PE. To aid healthcare providers caring for patients with acute PE, it encapsulates a novel, comprehensive, yet simple, pathway for the management of patients with PE, which can be used in many health care systems around the globe. This pathway is at the core of the book and all chapters are related to this unique algorithm.

A must have resource for clinicians and investigators interested in pulmonary embolism and deep venous thrombosis Highly illustrated with numerous tables and graphs alongside clear concise text Includes chapters addressing pulmonary embolism (PE) and deep venous thrombosis (DVT) in relation to diseases and disorders such as; chronic heart failure, cancer, diabetes, stroke, chronic obstructive pulmonary disease (COPD) and many more Discusses the role the different tools offered in imaging for PE, including echocardiography, multidetector computed tomography (CT), single photon emission computed tomography (SPECT), ventilation-perfusion (V-Q) imaging, dual energy CT, and magnetic resonance angiography Contains 29 new chapters and includes new content on epidemiology of deep venous thrombosis; use of the new anticoagulants (dabigatran, rivaroxaban, and apixaban) for DVT and PE; indications and results with thrombolytic therapy and with vena cava filters; and information and indications for invasive mechanical thrombectomy and thrombolysis Written by an internationally recognized and respected expert in the field

This manual provides medical professionals with a script to run, discuss, and evaluate effective emergency drills in the perioperative setting.