Pulmonary thromboembolism: Recent experience of 4 years at a cardiology hospital

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Erick Ramírez-Arias
Martín Rosas-Peralta
Gabriela Borrayo-Sánchez
Luis Antonio Moreno-Ruiz
Jorge Guillermo Arenas-Fonseca
Victor Manuel Arzola-Covarrubias
Luis Efrén Santos-Martinez
Efraín Arizmendi-Uribe

Keywords

Pulmonary embolism, Echocardiography, Thrombolytic therapy

Abstract

It comprised a series of cases over a period of 4 years, held at the Hospital of Cardiology of the Centro Médico Nacional Siglo XXI, IMSS. From 2008 to 2011, admitted to Emergency 184 patients with suspected pulmonary embolism, of which 41 were removed; of the 143 remaining cases, only 127 patients was diagnosed with PE. The other 16 patients had other diagnoses. In 86% of patients showed electrocardiographic pattern S1Q3T3 and 39% had RBBB, in 17 (13.3%) patients there was hemodynamic instability, and in 94.4% showed enlargement of the right chambers by echocardiography, 55.9% showed paradoxical septal motion, PASP was 66.2+22.8 mm Hg and in 43.3% the Mc Connell sign was positive. A total of 48 patients (37.7%) received thrombolysis, the remaining patients received conventional medical treatment with anticoagulation. Overall mortality was 14%.

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References

Torbicki A, Perrier A, Konstantinides S, Agnelli G, Galié N, Pruszyk P et al. Guías de Práctica Clínica de la Sociedad Europea de Cardiología sobre diagnóstico y manejo del tromboembolismo pulmonar agudo. Rev Esp Cardiol. 2008;1330.e1-1330.e52.

 

Roy PM, Meyer G, Vielle B, Le Gall C, Verschuren F, Carentier F et al. Appropriateness of diagnostic management and outcomes of suspected pulmonary embolism. Ann Intern Med. 2006;144:157-64.

 

White RH, The epidemiology of venous thromboembolism. Circulation. 2003;107 (Supl. 1):I4-8

 

Jerjes-Sánchez C, Elizalde GJ, Sandoval ZJ et al. Diagnóstico, estratificación y tratamiento de la tromboembolia pulmonar aguda. Guías y Recomendaciones de la Sociedad Mexicana de Cardiología. Arch Cardiol Mex. 2004;74 (Supl. 3):S548-S555.

 

Jerjes-Sánchez C. Terapia fibrinolítica en tromboembolia pulmonar. Arch Cardiol Mex. 2004;74 (Supl. 2);S358-S360.

 

Stein PD, Kayali F, Olson RE. Estimated case fatality rate of pulmonary embolism, 1979 to 1998. Am J Cardiol. 2004;93:1197-9.

 

Dalen JE, Alpert JS. Natural history of pulmonary embolism. Prog Cardiovasc Dis. 1975;17:259-70.

 

Nieto JA, Ruiz-Ribó MD. Tromboembolismo pulmonary. Luces y sombras. Rev Esp Cardiol. 2008;61:229-32.

 

Goldhaber SZ, Visani L, De Rosa M. Acute Pulmonary embolism: Clinical outcomes in the International Cooperative Pulmonary Embolism Registry (ICOPER). Lancet. 1999;353:1386-9.

 

McIntyre KM, Sasahara AA. The hemodynamic response to pulmonary embolism in patients without prior cardiopulmonary disease. Am J Cardiol. 1971;28:288-94.

 

Libby P, Bonow RO, Mann DL, Zipes DP. Braunwald: Tratado de cardiologia; 8ª edición. ELSEVIER. 2012.

 

Konstantinides SV, BarcoS, Lankeit M, MeyerG. Management of Pulmonary Embolism. An update. JACC. 2016;67(8):976-90.

 

Cabrera-Rayo Alfredo, Nellen-Hummel Haiko. Epidemiología de la enfermedad tromboembólica venosa. Gac Méd Méx. 2007;143 (Supl. 1):3-5.

 

Feigenbaum H, Armstrong WF, Ryan T. Ecocardiografía. 6ª Edición. Editorial Médica Panamericana. 

 

Haddad F, Hunt SA, Rosenthal D, Murphy DJ. Right ventricular function in cardiovascular disease, Part I: Anatomy, physiology, aging, and functional assessment of the right ventricle. Circulation. 2008;117(11):1436-48.

 

Haddad F, Doyle R, Murphy DJ, Hunt SA. Right ventricular function in cardiovascular disease, Part II: Pathophysiology, clinical importance, and management of right ventricular failure. Circulation. 2008;117(13):1717-31.

 

Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L et al. Recomendaciones para la cuantificación de las cavidades cardíacas por ecocardiografía en adultos: Actualización de la Sociedad Americana de Ecocardiografía y de la Asociación Europea de Imagen Cardiovascular. J Am Soc Echocardiogr. 2015;28:1-39.