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Akut Pulmoner Embolide Tanı

Diagnosis of Acute Pulmonary Embolism

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Abstract (2. Language): 
Acute pulmonary embolism represents a potentially fatal disease. The disease presents mostly with silent or nonspecific symptoms. A number of fundamental questions continue to exist regarding the pathogenesis, clinical presentation and diagnosis. Although there is a wide range of diagnostic techniques, pulmonary embolism still remains as a diagnostic challenge for the pulmonary physicia. Therefore, in a patient with suspected pulmonary embolism, understanding the pathogenesis and clinical presentation can result in a more precise diagnosis without delay. Despite vigorous debate for optimal therapeutic approach, the majority of deaths from PE are a result of prophylactic oversight or diagnostic error.
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REFERENCES

References: 

1. White RH. The epidemiology of venous thromboembolism.
Circulation 2003; 107: 4-8.
2. Carson JL, Kelley MA, Duff A, Weg JG, Fulkerson WJ,
Palevsky HI, Schwartz JS, Thompson BT, Popovich
J Jr, Hobbins TE ve ark. The clinical course of pulmonary
embolism. N Engl J Med 1992; 326: 1240-1245.
3. Silverstein MD, Heit JA, Mohr DN, Petterson TM, O’
Fallon WM, Melton LJ 3rd. Trends in the incidence
of deep vein thrombosis and pulmonary embolism:
a 25 –year population based study. Arch Intern Med
1998; 158: 585-593.
4. Douketis JD, Keaton C, Bates S, Duku EK, Ginsberg
JS. Risk of fatal pulmonary embolism in patients with
treated venous thromboembolism. JAMA 1998; 279:
458-462.
5. Heit JA, Silverstein MD, Mohr DN, Petterson TM, O’
Fallon WM, Melton LJ. Predictors of survival after deep
venous thrombosis and pulmonary embolism: a
population-based, cohort study. Arch Intern Med
1999; 159: 445-453.
6. Heit JA, O’Fallon WM, Petterson TM, Lohse CM, Silverstein
MD, Mohr DN, Melton LJ 3rd. Relative impact
of risk factors for deep vein thrombosis and pulmonary
embolism: a population-based study. Arch Intern Med
2002 10; 162: 1245-1248.
7. Macik BG, Ortel T.Clinical and laboratory evaluation
of the hypercoagulable states. Clin Chest Med 1995;
16: 375-389.
8. Fedullo PF, Morris TA. Pulmonary thromboembolim.
Mason RJ, Murray FJ, Broaddus VC, Nadel JA, editör.
Textbook of Respiratory Medicine. Philadelphia, Elsevier
Saunders. 2005; 1425-1458.
9. Goldhaber SZ, Grodstein F, Stampfer MJ, Manson JE,
Colditz GA, Speizer FE, Willett WC, Hennekens CH.
A prospective study of risk factors for pulmonary embolism
in women. JAMA 1997; 277: 642-645.
10. Donati MB. Cancer and thrombosis. Hemostasis 1994;
24: 128-131.
11. Merli GJ. Deep vein thrombosis and pulmonary embolism
prophylaxis in orthopedic surgery. Med Clin
North Am 1993; 77: 397-411.
12. Geerts WH, Heit JA, Clagett GP, Pineo GF, Colwell
CW, Anderson FA Jr, Wheeler HB. Prevention of venous
thromboembolism: Chest 2001; 119: 132-175.
13. Prandoni P, Piccioli A, Girolami A. Cancer and venous
thromboembolism: an overview. Haematologica
1999; 84: 437-445.
14. Joffe HV, Goldhaber SZ. Hypercoagulable states and
C. TET‹KKURT
125
other risk factors for venous thromboembolism. Dalen
EJ, editör. Venous Thromboembolism. New York,
Marcel Dekker. 2003, 11-21.
15. Heit JA. Risk factors for venous thromboembolism.
Tapson VF, editör. Venous thromboembolism. Clin
Chest Med 2003; 24: 1-12.
16. Greaves M. Antiphospholilid antibodies and thrombosis.
Lancet 1999; 353: 1348-1353.
17. Levine JS, Branch DW, Rauch J. The antiphospholipid
syndrome. N Engl J Med 2002; 346: 752-763.
18. Eichinger S, Stumpflen A, Hirschl M, Bialonczyk C,
Herkner K, Stain M, Schneider B, Pabinger I, Lechner
K, Kyrle PA. Hyperhomocysteinemeia is a risk factor
for recurrent thromboembolism. Thromb Haemost
1998; 80: 566-569.
19. den Heijer M, Koster T, Blom HJ, Bos GM, Briet E,
Reitsma PH, Vanderbroucke JP, Rosendaal FR. Hyperhomocysteinemia
as a risk factor for deep-vein thrombosis.
N Engl J Med 1996; 334: 759-762.
20. Ridker PM, Hennekens CH, Lindpaintner K, Stampfer
MJ, Eisenberg PR, Miletich JP. Mutation in the gene
coding for coagulation factor V and the risk of myocardial
infarction, stroke and venous thrombosis in apparently
healthy men. N Engl J Med 1995; 332: 912-917.
21. Franco RF, Reitsma OH.Genetic risk factors of venous
thrombosis. Hum Genet 2001; 109: 369-384.
22. Nguyen A. Prothrombin G20210A polymorphism
and thrombophilia. Mayo Clin Proc 2000; 75: 595-
604.
23. De Stefano V, Finazzi G, Mannucci PM. Inherited
thrombophilia: pathogenesis, clinical syndromes and
management. Blood 1996; 87: 3531-3544.
24. Sallah S, Thomas DP, Roberts HR. Warfarin and heparin-
induced skin necrosis and the purple toe syndrome:
infrequent complications of anticoagulant treatment.
Thromb Haemost 1997; 78: 785-790.
25. Morgenthaler TI, Ryu JH. Clinical characteristics of
fatal pulmonary embolism in a referral hospital: Mayo
Clin Proc 1995; 70: 417-424.
26. Stein PD, Saltzman HA, Weg JG. Clinical characteristics
of patients with acute pulmonary embolism. Am
J Cardiol 1991; 68: 1723-1724.
27. Susec O, Boudrow D, Kline JA. The clinical features
of acute pulmonary embolism in ambulatory patients.
Acad Emerg Med 1997; 4: 891-897.
28. Manganelli D, Palla A, Donnamaria V, Giuntini C.
Clinical features of pulmonary embolism: doubts and
certainities. Chest 1996; 107: 25-32.
29. The PIOPED Investigators. Value of the ventilation/
perfusion scan in acute pulmonary embolism: results
of the Prospective Investigation of Pulmonary Embolism
Diagnosis (PIOPED). JAMA 1990; 263: 2753-2759.
30. Ryu JH, Olson EJ, Pelikka PA. Clinical recognition of
pulmonary embolism: problem of unrecognized and
asymptomatic cases. Mayo Clin Proc 1998; 78: 873-879.
31. Kovacs MJ, MacKinnon KM, Anderson D, O’Rourke
K, Keeney M, Kearon C, Ginsberg JS, Wells PS. A
comparison of three rapid D-dimer methods for the
diagnosis of venous thromboembolism. Br J Haematol
2001; 115: 140-144.
32. Dempfle CE.Use of D-dimer assays in the diagnosis
venous thrombosis. Semin Thromb Hemost 2000; 26:
631-641.
33. Stein PD, Terrin ML, Hales CA, Palevsky HI, Saltzman
HA, Thompson BT, Weg JG.Clinical, laboratory, roentgenographic
and electrocardiographic findings in patients
with acute pulmonary embolism and no preexisting
cardiac or pulmonary disease. Chest 1991;
100: 598-603.
34. Elliot CG, Goldhaber SZ, Visani L, DeRosa M. Chest
radiographs in acute pulmonary embolism. Chest
2000; 118: 33-38.
35. Geerts WH, Selby R.Investigation of suspected deep
venous thrombosis.Dalen EJ, editör. Venous Thromboembolism.
New York, Marcel Dekker. 2003; 93-119.
36. Garg K, Mao J.Deep venous thrombosis: spectrum of
findings and pitfalls in interpretation on CT venography.
Am J Roentgenol 2001; 177: 319-323.
37. Moody AR, Pollock JG, O’Connor AR, Bagnall M.
Lower-limb deep venous thrombosis: direct MR imaging
of the thrombus. Radiolgy 1998; 209: 349-355.
38. Fraser DGW, Moody AR, Morgan PS, Martel AL, Davidson
I.Diagnosis of lower-limb deep venous thrombosis:
a prospective blinded study of magnetic resonance
direct thrombus imaging. Ann Intern Med 2002;
136: 89-98.
39. Wells PS, Ginsberg JS, Anderson DR. Use of a clinical
model for safe management of patients with suspected
pulmonary embolism. Ann Intern Med 1998; 129:
997-1005.
40. Wicki J, Perneger TV, Junod AF.Assesing clinical probability
of pulmonary embolism in the emergency
ward. Arch Intern Med 2001; 161: 92-97.
41. Perrier A, Mirron MJ, Desmarais S. Using clinical evaluation
and lung scan to rule out suspected pulmonary
embolism. Arch Intern Med 2000; 160: 512-516.
42. Wells PS, Anderson DR, Rodger M.Excluding pulmonary
embolism at the bedside without diagnostic imaging:
management of patients with suspected pulmonary
embolism presenting to the emergency department
by using a clinical model and D-dimer. Ann Intern
Med 2001; 135: 98-107.
Cerrahpafla T›p Derg 2007; 38: 118 - 126
C. TET‹KKURT
126
43. van Beek EJR, Kuyer PMM, Schenk BE, Brandjes PM,
ten Cate JW, Büller HR.A normal perfusion scan in
patients with clinically suspected pulmonary embolism:
frequency and clinical validity. Chest 1995;
108: 170-173.
44. Trujillo NP, Pratt JP, Talusani S, Quaife RA, Kumpe
D, Lear JL. DTPA aeresol in ventilation / perfusion
scintigraphy for diagnosing pulmonary embolism. J
Nucl Med 1997; 38: 1781-1783.
45. Worsley DF, Palevsky HI, Alavi A. Clinical charactersitics
of patients with pulmonary embolism and low
or very low probability lung scan interpretations. Arch
Intern Med 1994; 154: 2737-2741.
46. Hiorns MP, Mayo JR.Spiral computed tomography
for acute pulmonary embolism. Can Assoc Radiol J
2002; 53: 258-268.
47. Ruiz Y, Caballero P, Caniego JL, Friera A, Olivera
MJ, Tagarro D, Alvarez-Sala K. Prospective comparison
of helical CT with angiography in pulmonary embolism:
Global and selective terriority analysis. Interobserver
agreement. Eur Radiol 2003; 13: 823-829.
48. Schoepf UJ, Castello P. Multidetector-row CT imaging
of pulmonary embolism. Semin Roentgenol 2003;
38: 106-114.
49. Stein FD, Fowler SE, Goodman LR. Multidetector
computed tomography for acute pulmonary embolism.
N Engl J Med 2006; 354: 2317-2327.
50. Meaney JFM, Weg JG, Chenevert TL, Starrford-Johnson
D, Hamilton BH, Prince MR. Diagnosis of pulmonary
embolism with magnetic resonance angiography. N
Engl J Med 1997; 336: 1422-1427.
51. Gupta A, Fraser CK, Ferguson JM, Kumar AB, Davis
SJ, Fallon MJ, Morris JT, Drury PJ, Cala LA. Acute pulmonary
embolism: diagnosis with MR angiography.
Radiology 1999; 210: 353-359.
52. Jardin F, Dubourg O, Bourdarias JP. Echocardiographic
pattern of acute cor pulmonale. Chest 1997; 111:
209-217.
53. Goldhaber SZ. Echocardiography in the management
of pulmonary embolism. Ann Intern Med 2002; 136:
691-700.
54. Stein PD, Athanasoulis C, Alavi A, Greenspan RH,
Hales CA, Saltzman HA, Vreim CE, Terrin ML, Weg
JG. Complications and validity of pulmonary angiography
in acute pulmonary embolism. Circulation
1992; 85: 462-468.
55. Hudson ER, Smith TP, McDermott VG, Newman GE,
Suhocki PV, Payne CS, Stackhouse DJ. Pulmonary
angiography performed with iopamidol: complications
in 1434 patients. Radiology 1996; 198: 61-65.

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