eISSN: 1896-9151
ISSN: 1734-1922
Archives of Medical Science
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SCImago Journal & Country Rank
6/2012
vol. 8
 
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abstract:

State of the art paper
Management of massive and nonmassive pulmonary embolism

Vishal Sekhri
,
Nimeshkumar Mehta
,
Naveen Rawat
,
Stuart G. Lehrman
,
Wilbert S. Aronow

Arch Med Sci 2012; 8, 6: 957-969
Online publish date: 2012/12/19
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Massive pulmonary embolism (PE) is characterized by systemic hypotension (defined as a systolic arterial pressure < 90 mm Hg or a drop in systolic arterial pressure of at least 40 mm Hg for at least 15 min which is not caused by new onset arrhythmias) or shock (manifested by evidence of tissue hypoperfusion and hypoxia, including an altered level of consciousness, oliguria, or cool, clammy extremities). Massive pulmonary embolism has a high mortality rate despite advances in diagnosis and therapy. A subgroup of patients with nonmassive PE who are hemodynamically stable but with right ventricular (RV) dysfunction or hypokinesis confirmed by echocardiography is classified as submassive PE. Their prognosis is different from that of others with non-massive PE and normal RV function. This article attempts to review the evidence-based risk stratification, diagnosis, initial stabilization, and management of massive and nonmassive pulmonary embolism.
keywords:

pulmonary embolism, anticoagulation, thrombolysis, embolectomy

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