Abstract
Pulmonary thromboembolism (PTE) ranges from incidental, clinically unimportant thromboembolism to massive embolism with sudden death. Its treatment is well established in two groups of patients: heparin for those with normal systemic blood pressure without right ventricular dysfunction (RVD) and thrombolysis for those with RVD and circulatory shock. In an intermediate group of patients with systemic blood pressure stability combined with RVD, which is usually associated with worse outcome, the treatment is controversial. There are authors who strongly suggest thrombolysis while others contraindicate this procedure and recommend anticoagulation with heparin. This is a narrative review that includes clinical trials comparing thrombolysis and heparin for the treatment of PTE patients with systemic blood pressure stability and RVD published since 1973. The results show that there are only four trials on this subject with less than 500 patients. Many PTE patients with systemic blood pressure stability and RVD might benefit from thrombolysis but, on the other hand, the risk for hemorrhagic events may be increased. Large randomized clinical trials are required to clarify this.
Keywords: Systemic blood pressure, pulmonary thromboembolism, right ventricular dysfunction, treatment, thrombolysis
Current Respiratory Medicine Reviews
Title: Treatment of Pulmonary Thromboembolism in Patients with Systemic Blood Pressure Stability and Right Ventricular Dysfunction
Volume: 4 Issue: 1
Author(s): Thais Thomaz Queluz, Hugo Hyung Bok Yoo and Haroldo Rodrigues
Affiliation:
Keywords: Systemic blood pressure, pulmonary thromboembolism, right ventricular dysfunction, treatment, thrombolysis
Abstract: Pulmonary thromboembolism (PTE) ranges from incidental, clinically unimportant thromboembolism to massive embolism with sudden death. Its treatment is well established in two groups of patients: heparin for those with normal systemic blood pressure without right ventricular dysfunction (RVD) and thrombolysis for those with RVD and circulatory shock. In an intermediate group of patients with systemic blood pressure stability combined with RVD, which is usually associated with worse outcome, the treatment is controversial. There are authors who strongly suggest thrombolysis while others contraindicate this procedure and recommend anticoagulation with heparin. This is a narrative review that includes clinical trials comparing thrombolysis and heparin for the treatment of PTE patients with systemic blood pressure stability and RVD published since 1973. The results show that there are only four trials on this subject with less than 500 patients. Many PTE patients with systemic blood pressure stability and RVD might benefit from thrombolysis but, on the other hand, the risk for hemorrhagic events may be increased. Large randomized clinical trials are required to clarify this.
Export Options
About this article
Cite this article as:
Queluz Thomaz Thais, Bok Yoo Hyung Hugo and Rodrigues Haroldo, Treatment of Pulmonary Thromboembolism in Patients with Systemic Blood Pressure Stability and Right Ventricular Dysfunction, Current Respiratory Medicine Reviews 2008; 4 (1) . https://dx.doi.org/10.2174/157339808783497828
DOI https://dx.doi.org/10.2174/157339808783497828 |
Print ISSN 1573-398X |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-6387 |
Call for Papers in Thematic Issues
Exposure to PM2.5 components is associated with respiratory diseases
Through continuous research on the relationship between risk factors and health, it has been found that air pollution, especially atmospheric particulate matter pollution, has become one of the main sources of global disease burden. From 1990 to 2022, the concentration of atmospheric particulate matter pollution has increased by more than ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
Related Articles
-
The Metabolic Treatment of Patients with Coronary Artery Disease: Effects on Quality of Life and Effort Angina
Current Pharmaceutical Design Leptin- and Leptin Receptor-Deficient Rodent Models: Relevance for Human Type 2 Diabetes
Current Diabetes Reviews Hydrogen Sulfide: From Physiology to Pharmacology
Inflammation & Allergy - Drug Targets (Discontinued) Anesthetic Cardioprotection in Clinical Practice From Proof-of-Concept to Clinical Applications
Current Pharmaceutical Design Recent Developments on Coronary Microvasculopathy after Heart Transplantation:A New Target in the Therapy of Cardiac Allograft Vasculopathy
Current Vascular Pharmacology Herbal Highs: Review on Psychoactive Effects and Neuropharmacology
Current Neuropharmacology The Role of Inflammatory Biomarkers in the Detection and Therapy of Atherosclerotic Disease
Current Vascular Pharmacology Novel Inflammatory Indices in Aortic Disease
Current Medicinal Chemistry Biomarkers Determining Cardiovascular Risk in Patients with Kidney Disease
Current Medicinal Chemistry Adverse Effects of Cigarette Smoke and Induction of Oxidative Stress in Cardiomyocytes and Vascular Endothelium
Current Pharmaceutical Design Profile of IKs During the Action Potential Questions the Therapeutic Value of IKs Blockade
Current Medicinal Chemistry Vascular Disease: A New Progenitor Biology
Current Vascular Pharmacology Recent Patents on Cardiovascular Stem Cells
Recent Patents on Cardiovascular Drug Discovery Impact of N-acetylcysteine and Etodolac Treatment on Systolic and Diastolic Function in a Rat Model of Myocardial Steatosis Induced by High-Fat-Diet
Endocrine, Metabolic & Immune Disorders - Drug Targets Therapeutic Opportunities for Trophic Factors in Brain Inflammation
Current Pharmaceutical Analysis Mesenchymal Stem Cells as a Source of Dopaminergic Neurons: A Potential Cell Based Therapy for Parkinson's Disease
Current Stem Cell Research & Therapy C-type Natriuretic Peptide (CNP): Cardiovascular Roles and Potential as a Therapeutic Target
Current Pharmaceutical Design Novel Therapeutic Approaches in Limiting Oxidative Stress and Inflammation
Current Pharmaceutical Biotechnology Possible Use of Autologous Stem Cell Therapies for Alzheimers Disease
Current Alzheimer Research Innate Immune Inflammatory Response in the Acutely Ischemic Myocardium
Medicinal Chemistry