Venous thromboembolism - Pulmonary embolism

6 important questions on Venous thromboembolism - Pulmonary embolism

What are the symptoms of a pulmonary emoblism?

  • Dyspnoe
  • chest pain
  • dry cough
  • fever
  • syncope
  • hemoptysis
  • tachycardia en tachypnea
  • unilateral leg pain/ signs of DVT

What are the three different prediction tests for pulmonary emobolisms and how do you interpretate them?

  • Wells score
    • <4 D-dimer testing
    • >4 CT angiography
  • Genova score
    • <4 non high probability of PE
    • >4 high probability of PE
  • YEARS score
    • clinical signs of DVT
    • Hemoptysis
    • most likely diagnosis
      • No Years D-dimer 1000
      • 1-3 Years D-dimer 500

What are the additional diagnostic options for pulmonary embolisms?

  • ECG
  • Ventilation-perfusion scan (not used anymore)
  • MRI angiography
  • CT angiography (standard)
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What are the diagnostic steps to conclude that the patient has a pulmonary embolism?

1. YEARS criteria
2. D-dimer values
3. CT angiography

What are the therapeutic options for a pulmonary embolism?

  • DOAC
  • Vitamin K antagonist
  • Subcutaneous low-molecular-weight heparin
  • Unfractionated heparin

How long does the patient needs to use anticoagulants after a pulmonary emoblism?

  • Unprovoked: lifelong
  • Provoked: 3 months + cause needs to be eliminated + duplex echography

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