9781119039082
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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.
This book isa dependable and well referenced resource for indepth information aboutpulmonary embolism (PE) and deep venous thrombosis (DVT).
Prologue
Preface to the Third Edition
Introduction
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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