Early intervention in massive pulmonary embolism. A guide to diagnosis and triage for the critical first hour

Postgraduate Medicine
James R Gossage

Abstract

The diagnosis of massive pulmonary embolism should be considered expeditiously in all patients with unexplained hypotension, syncope, cardiac arrest, or hypoxemic respiratory failure. The presence of right ventricular overload on physical examination or electrocardiogram is an especially important clue. Depending on local expertise and the patient's stability, V/Q scanning, CT angiography, echocardiography, and right heart catheterization can be useful in establishing a diagnosis of pulmonary embolism. Supportive treatment includes oxygen, vasoactive medicines, and sometimes fluids. Although heparin is important in nearly all patients, 70% to 80% of patients also require an IVC filter, thrombolysis, or embolectomy.

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Citations

Oct 16, 2003·International Journal of Cardiology·Ijaz A Khan, Ramesh M Gowda
Sep 27, 2003·Internal Medicine Journal·K Kathir
Feb 22, 2011·IEEE Transactions on Information Technology in Biomedicine : a Publication of the IEEE Engineering in Medicine and Biology Society·Charalampos BratsasNicos Maglaveras
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Jun 6, 2013·Experimental and Therapeutic Medicine·Ai-Gui Jiang, Hui-Yu Lu
Jun 1, 2021·The Journal of International Medical Research·Xinyuan PangJiachun Feng

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