Autor(es): STEIN
Editorial: WILEY
Fecha de publicación: mayo 2016
Nº de edición:
Nº de páginas: 688
Medidas: 18x26x3 cms



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Pulmonaryembolism (PE) is the third most common acute cardiovascular disease after acutemyocardial infarction and stroke. This fully updated third edition supplies thelatest information on epidemiology, methods of diagnosis, preferred diagnosticpathways, new medications including the new anticoagulants, and newrecommendations for prophylaxis and treatment of pulmonary embolism and itsimmediate cause, deep vein thrombosis.

  • An essential and comprehensive resource for physicians and allied professionals in the field of this difficulttodiagnose and life threatening condition

  • Highly illustrated with numerous tables and graphs alongside clear concise text

  • Includes chapters addressing pulmonary embolism (PE) and deep venous thrombosis (DVT) in relation to diseases and disorders such as; chronic heart failure, cancer, diabetes, stroke, chronic obstructive pulmonary disease (COPD) and many more

  • Discusses the role the different tools in imaging for PE, including, echocardiography, multidetector computed tomography (CT), single photon emission computed tomography (SPECT), ventilationperfusion (VQ) imaging, dual energy CT, and magnetic resonance angiography

  • Contains 29 new chapters and includes new content on epidemiology of deep venous thrombosis; use of the new anticoagulants (dabigatran, rivaroxaban, and apixaban) for DVT and PE; indications and results with thrombolytic therapy and with vena cava filters; and information and indications for invasive mechanical thrombectomy

  • Written by an internationally recognized and respected expert in the field

This book isa dependable and well referenced resource for indepth information aboutpulmonary embolism (PE) and deep venous thrombosis (DVT).


Preface to the Third Edition

Part I Prevalence, risks, and prognosis ofpulmonary embolism and deep venous thrombosis

1 Pulmonaryembolism and deep venous thrombosis at autopsy 5

2 Incidenceof pulmonary embolism and deep venous thrombosis in hospitalized patients andin emergency departments 18

3 Casefatality rate and population mortality rate from pulmonary embolism and deepvenous thrombosis 24

4 Prognosisinacutepulmonary embolism based on right ventricular enlargement andbiochemical markers in stable patients 31

5 Prognosisinacutepulmonary embolism based on scoring systems 43

6Pulmonaryembolismfollowingdeep venous thrombosis and outcome with untreatedpulmonary embolism 49

7Resolutionofpulmonaryembolism 54

8 Upperextremity deep venous thrombosis 61

9 Thromboembolicdisease involving the superior vena cava and brachiocephalic veins 66

10 Venousthromboembolic disease in the four seasons 69

11 Regionaldifferences in the United States of rates of diagnosis of pulmonary embolismand deep venous thrombosis and mortality from pulmonary embolism 73

12 Venousthromboembolism according to age and in the elderly 78

13 Pulmonarythromboembolism in infants and children 95

14 Venousthromboembolism in men and women 99

15 Pulmonaryembolism and deep venous thrombosis in blacks and whites 103

16 Pulmonarythromboembolism in Asians/Pacific Islanders 108

17 Pulmonarythromboembolism in American Indians and Alaskan Natives 116

18 Venousthromboembolism in patients with cancer 118

19 Venousthromboembolism in patients with heart failure 128

20 Obesityas a risk factor in venous thromboembolism 133

21Hypertension, smoking, and cholesterol 139

22 Overlapof venous and arterial thrombosis risk factors 141

23 Venousthromboembolism in patients with ischemic and hemorrhagic stroke 143

24Paradoxical embolism 146

25 Pulmonaryembolism and deep venous thrombosis in hospitalized adults with chronicobstructive pulmonary disease 149

26 Pulmonaryembolism and deep venous thrombosis in hospitalized patients with asthma 156

27 Deepvenous thrombosis and pulmonary embolism in hospitalized patients with sicklecell disease 158

28Diabetesmellitus and risk of venous thromboembolism 162

29 Risk ofvenous thromboembolism with rheumatoid arthritis 164

30 Venousthromboembolism with inflammatory bowel disease 166

31 Venousthromboembolism with chronic liver disease 168

32 Nephroticsyndrome 171

33 Humanimmunodeficiency virus infection 173

34 Venousthromboembolism in pregnancy 176

35 Amnioticfluid embolism 182

36 Airtravel as a risk for pulmonary embolism and deep venous thrombosis 184

37Estrogencontaining oral contraceptives and venous thromboembolism 187

38 Estrogenand testosterone in men 192

39 Tamoxifen194

40 Venousthromboembolism following bariatric surgery 198

41Hypercoagulable syndrome 204

Part II Diagnosis of deep venous thrombosis

42 Deepvenous thrombosis of the lower extremities: clinical evaluation 215

43 Clinicalscoring system for assessment of deep venous thrombosis 220

44 Clinicalprobability score plus single negative ultrasound for exclusion of deep venousthrombosis 223

45 Ddimerfor the exclusion of acute deep venous thrombosis 225

46 Ddimercombined with clinical probability assessment for exclusion of acute deepvenous thrombosis 234

47 Ddimerand single negative compression ultrasound for exclusion of deep venousthrombosis 236

48 Contrastvenography 237

49Compression ultrasound for the diagnosis of deep venous thrombosis 240

50 Impedanceplethysmography and fibrinogen uptake tests for diagnosis of deep venousthrombosis 247

51 AscendingCT venography and venous phase CT venography for diagnosis of deep venousthrombosis 250

52 Magneticresonance venography for diagnosis of deep venous thrombosis 255

53Pselectin and microparticles to predict deep venous thrombosis 260

Part III Diagnosis of acute pulmonary embolism

54 Clinicalcharacteristics of patients with no prior cardiopulmonary disease 265

55 Relationof rightsided pressures to clinical characteristics of patients with no priorcardiopulmonary disease 272

56 Thehistory and physical examination in all patients irrespective of priorcardiopulmonary disease 275

57 Clinicalcharacteristics of patients with acute pulmonary embolism stratified accordingto their presenting syndromes 280

58 Clinicalassessment in the critically ill 286

59 Theelectrocardiogram 289

60 The plainchest radiograph 303

61 Arterialblood gases and the alveolar arterial oxygen difference in acute pulmonaryembolism 308

62 Fever inacute pulmonary embolism 316

63Leukocytosis in acute pulmonary embolism 319

64 Alveolardeadspace in the diagnosis of pulmonary embolism 321

65 Empiricalassessment and clinical models for diagnosis of acute pulmonary embolism 324

66Prognostic models for pulmonary embolism 329

67 Ddimerfor the exclusion of acute pulmonary embolism 335

68 Ddimercombined with clinical probability for exclusion of acute pulmonary embolism346

69 Ddimerin combination with aminoterminal proBtype natriuretic peptide for exclusionof acute pulmonary embolism 349

70 Tissueplasminogen activator, plasminogen activator inhibitor1, and thrombinantithrombin III complexes in the exclusion of acute pulmonary embolism 350

71Echocardiogram in the diagnosis of acute pulmonary embolism 352

72 Trends inthe use of diagnostic imaging in patients hospitalized with acute pulmonaryembolism 356

73Techniques of perfusion and ventilation imaging 358

74Ventilation perfusion lung scan criteria for interpretation prior to theProspective Investigation of Pulmonary Embolism Diagnosis (PIOPED) 363

75Observations from PIOPED: ventilation perfusion lung scans alone and incombination with clinical assessment 367

76Ventilation perfusion lung scans according to complexity of lung disease 374

77 Perfusionlung scans alone in acute pulmonary embolism 376

78Probability interpretation of ventilation perfusion lung scans in relation tothe largest pulmonary arterial branches in which pulmonary embolism is observed379

79 Revisedcriteria for evaluation of lung scans recommended by nuclear physicians inPIOPED 381

80 Criteriafor verylowprobability interpretation of ventilation perfusion lung scans,385

81Probability assessment based on the number of mismatched segmental equivalentperfusion defects 391

82Probability assessment based on the number of mismatched vascular defects andstratification according to prior cardiopulmonary disease 395

83 The additionof clinical assessment to stratification according to prior cardiopulmonarydisease further optimizes the interpretation of ventilation perfusion lungscans 401

84 Pulmonaryscintigraphy scans since PIOPED 407

85 Singlephoton emission computed tomographic (SPECT) lung scans 412

86 SPECTwith radiolabeled markers 426

87 Standardand augmented techniques in pulmonary angiography 427

88Subsegmental pulmonary embolism 435

89Quantification of pulmonary embolism by conventional and CT angiography 440

90Complications of pulmonary angiography 442

91Contrastenhanced spiral CT for the diagnosis of acute pulmonary embolismbefore the Prospective Investigation of Pulmonary Embolism Diagnosis 446

92 Methodsof PIOPED II 458

93Multidetector spiral CT of the chest for acute pulmonary embolism: results ofthe PIOPED II trial 467

94Multidetector CT pulmonary angiography since PIOPED II 473

95 Outcomestudies of pulmonary embolism versus accuracy 478

96Contrastinduced nephropathy 480

97 Radiationexposure and risk 483

98 Magneticresonance angiography for the diagnosis of acute pulmonary embolism 490

99 Serialnoninvasive leg tests in patients with suspected pulmonary embolism 499

100Diagnosis of pulmonary embolism in the coronary care unit 501

101 Silentpulmonary embolism with deep venous thrombosis 506

102 Fatembolism syndrome 511

103Diagnostic approach to acute pulmonary embolism 516

Part IV Prevention and treatment of deep venousthrombosis and pulmonary embolism

104 Warfarinand other vitamin K antagonists 523

105Unfractionated heparin, lowmolecularweight heparin,heparinoid, andpentasaccharide 531

106Parenteral inhibitors of factors Va, VIIIa, tissue factor, and thrombin 540

107 Noveloral anticoagulants 545

108 Aspirinfor venous thromboembolism 552

109Immediate therapeutic levels of heparin in relation to timing of recurrentevents, 555

110Intermittent pneumatic compression 558

111Graduated compression stockings 561

112 Ankleexercise and venous blood velocity 565

113Thrombolytic therapy for deep venous thrombosis 567

114Mechanical and ultrasonic enhancement of catheterdirected thrombolytic therapyfor deep venous thrombosis 572

115Thrombolytic therapy for treatment of acute pulmonary embolism 574

116Cathetertip embolectomy in the management of acute massive pulmonary embolism589

117 Venacava filters 597

118Withholding treatment of patients with acute pulmonary embolism who have a highrisk of bleeding provided and negative serial noninvasive leg tests 615

119 Hometreatment of deep venous thrombosis 617

120 Hometreatment of acute pulmonary embolism 622

121Pulmonary embolectomy 626

122 Chronicthromboembolic pulmonary hypertension and pulmonary thromboendarterectomy 634

123Prevention and treatment of deep venous thrombosis and acute pulmonaryembolism: American College of Chest Physicians Guidelines 639

Index 647


Paul D. Stein MD,Professor of Osteopathic MedicalSpecialties, College of Osteopathic Medicine, Michigan State University, EastLansing, Michigan, USA.

Dr.Stein′s major research in recent years has been in the field of venousthromboembolism. Dr. Stein initiated the PIOPED II and PIOPED III nationalcollaborative studies and was national principal investigator and chairpersonof the steering committees. He has written over 240 articles on venousthromboembolism from among over 560 peer reviewed articles. Dr Stein is a pastpresident of the Laennec Society and of the American College of Chest Physicians.He is Fellow of the American College of Physicians and the American College ofCardiology and a Master Fellow of the American College of Chest Physicians. Heis also a Fellow of the American Society of Mechanical Engineers. Fellowship isreserved for those who have made a significant contribution to the field ofmechanical engineering. He received the Lifetime Achievement Award from theAmerican Heart Association Midwest Affiliate, the Laureate Award of theAmerican College of Physicians, Michigan Chapter, the Daniel Drake Award fromthe University of Cincinnati College of Medicine, and the Research ExcellenceAward from the Michigan State University College of Osteopathic Medicine. Dr. Stein also wrote a book, A Physical and Physiological Basis for the Interpretationof Cardiac Auscultation:  Evaluations Based Primarily on Second Sound andEjection Murmurs.




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