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Administrarea sa se poate face pentru perioade limitate. Ambele tipuri de heparine pot fi recomandate la persoanele obeze. CONTACT LINKURI CUM MA ABONEZ? Revista Societatii de Medicina Interna. DESPRE REVISTA COMITETUL REDACTIONAL NUMARUL CURENT ARHIVA RECOMANDARE AUTORI TRIMITE ARTICOL. Articolul face parte din revista: CONTACT Redactor Executiv Prof.
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Embolism pulmonar recurent
View this article online at https: A pulmonary embolism embolus is a serious, potentially life-threatening condition. It is due to a blockage in a blood vessel in the lungs.
A pulmonary embolism PE can cause symptoms such as chest pain or breathlessness but may have no symptoms and be hard to detect. A massive PE can cause collapse and death. PE usually happens due to an underlying blood clot in the leg - deep vein thrombosis DVT. Prompt treatment is important and can be life-saving.
Pregnancy, various medical conditions and medicines, immobility and major surgery all increase the risk of a PE. Anticoagulation, initially with heparin and then warfarin, is the usual treatment for PE. Pulmonary embolism PE is part embolism pulmonar recurent a group of problems together known as venous thromboembolism VTE.
Venous means related to veins. A thrombosis is a blockage of a blood vessel by a blood clot a thrombus. The thrombus is then called an embolus. A deep vein thrombosis DVT is the usual cause of a PE. A DVT occurs in a vein in the leg. DVT is also part of VTE. A PE is a blockage in one of the blood vessels arteries in the lungs - usually due to a blood clot. A PE can be in an artery in the centre of the lung or one near the edge of the lung.
The clot can be large or small and there can be more than one clot. If there are severe symptoms, which occur with a large clot near the centre of the lung, this is known as a massive PE, and is very serious. In almost all cases, the cause is a blood clot thrombus embolism pulmonar recurent has originally formed in a deep vein known as a DVT. This clot travels through the circulation and eventually gets stuck in one of the blood vessels in the lung.
The thrombus that has broken away is now called an embolus Artikel eficient impotriva varicelor Chirurgie can therefore cause an embolism. Most DVTs come from veins in the legs or pelvis. Occasionally, a PE may come from a blood clot in an arm vein, or from a blood clot formed in the heart. Rarely, the blockage in the lung blood vessel may be caused by an embolus which is not a blood clot.
Nearly all cases of PE are caused by a DVT see above. So, people more likely to get a PE are those prone to DVTs.
The risk factors for DVT are explained in a separate leaflet called Deep Vein Thrombosis. Some important risk factors are immobility, other serious illnesses, and major surgery especially gynaecological surgery, and operations on the pelvis and legs. The risk of developing a DVT or PE in hospital can be greatly reduced by early mobilisation and medicine to help prevent a DVT or PE in those at particular risk. It is estimated that about 1 in 1, people have a DVT each year in the UK. If untreated, about 1 in 10 people with a DVT will develop a PE.
Half of all people with a PE develop it when embolism pulmonar recurent are a hospital inpatient. People who are frail or have existing illness are likely to have worse embolism pulmonar recurent than someone who is fit and well. Symptoms often start suddenly. There may be symptoms of a DVT, such as pain at the back of the calf in the leg, tenderness of the calf muscles embolism pulmonar recurent swelling of a leg or foot. The calf may also be warm and red.
A massive PE is so called not due to the actual size of the blood clot embolus but due to embolism pulmonar recurent size of its effect. A PE is high-risk if it causes serious problems such as a collapse or low blood pressure. Massive PEs are, by definition, high-risk. About 1 in 7 people with a massive PE will die as embolism pulmonar recurent result. The diagnosis is often suspected on the basis of symptoms and your medical history.
For example, someone who has had major embolism pulmonar recurent, been immobile in hospital and then gets sudden breathlessness, is likely to have a PE. Various tests may be used to help confirm the diagnosis. These may include one or more of the following:. A type of ultrasound called a duplex Doppler is used to show blood flow in the leg veins, and any blockage to blood flow. Ultrasound is useful because it is an easy, non-invasive test and may show up a DVT. If a DVT is found, then a PE can be assumed to be the cause of the other embolism pulmonar recurent such as breathlessness or chest pain.
Treatment with anticoagulant medication - see below can be started immediately for both the DVT and the suspected PE. The embolism pulmonar recurent is generally the same for both. Further tests may be unnecessary in this situation. Further please click for source will be needed.
This detects fragments of embolism pulmonar recurent products of a blood clot. The higher the level, the more likely you have a blood clot in a vein. Unfortunately, the test can be positive in a number of other situations, such as if you have had recent surgery or if you are pregnant. A embolism pulmonar recurent test does not, therefore, diagnose a DVT or a PE. The test may, however, indicate how likely it is that you have a blood clot the clot can be either a DVT or a PE.
This can help decide if further tests are needed. A negative D-dimer http://mutualcreative.co/tipuri-de-operaiuni-picioare-varicoase.php means it is very likely that you do not have a PE or DVT. If you are at high risk of VTE and there is still a strong suspicion that you do have a clot, despite a negative Clinica pentru venelor varicoase test, you will need further tests.
It can be done at embolism pulmonar recurent bedside. It does not show up a embolism pulmonar recurent PE. These are specialised scans which click to see more at the circulation in the lung. They are useful, because they can show quite accurately whether or not a PE is present. See separate leaflet called Radionuclide Isotope Scan.
The CTPA scan is a type of CT scan looking at the lung arteries - the full name is computed tomographic pulmonary angiography scan. Both involve X-rays and the CTPA scan is the embolism pulmonar recurent accurate test. For example, if you are allergic to the dye contrast used in CTPA scanning, if you have chronic kidney disease, or if CTPA is unavailable. Other tests on the heart, lung and blood are usually done.
Embolism pulmonar recurent may click the following article with the diagnosis or may show up other conditions:.
This section deals with PE due to a blood clot, not with the rare causes listed above. The main treatments are:. Anticoagulation is often called thinning the blood. However, it does not actually thin the blood. It alters certain chemicals in the blood to stop clots forming so easily. Anticoagulation prevents a PE from getting larger, and prevents any new clots from forming. Anticoagulation treatment is usually started immediately as soon as a PE is suspected in order to prevent the clot worsening, while waiting for test results.
Anticoagulation medication comes in two forms: The injectable form is heparin or similar injections called low molecular weight heparins LMWHs. Standard heparin is given intravenously IVwhich means directly into a vein - usually in the arm. It is used for high-risk PEs and also in patients with certain medical problems - such as chronic kidney disease. LMWH is injected into embolism pulmonar recurent skin on the lower tummy abdomen. LMWH is also used, in lower doses, to try to prevent VTE PEs and DVTs in certain hospital inpatients, especially those embolism pulmonar recurent are having, or who have embolism pulmonar recurent, major surgery.
The tablets or syrup are often called warfarin. However, a medicine called rivaroxaban may be used instead of warfarin. Outside the UK, other medicines may be used which are similar to warfarin. They all belong to the group known as oral anticoagulants. Usually, injections are used when starting treatment, because they work immediately.
Once the injections are embolism pulmonar recurent and the diagnosis is confirmed, warfarin can be embolism pulmonar recurent. Warfarin takes a few days to work fully. Anticoagulant treatment is continued until three months after a PE in most cases. Sometimes longer treatment is advised, especially if there is a high risk of a further embolism.
Your anticoagulant clinic or doctor will be able to advise you further. If you are pregnant, regular heparin injections rather than warfarin tablets may be used. This is because warfarin can potentially cause harm birth defects to the unborn child.
These may be used to treat a high-risk or massive PE where the patient is very unwell, or where anticoagulant treatment cannot be given.
Alteplase is the medication usually used; streptokinase or urokinase are alternatives. They are more powerful than the anticoagulant treatments heparin and warfarin, described above. However, learn more here is a greater risk of side-effects such as unwanted bleeding. Unwanted bleeding would include bleeding into the brain intracerebral haemorrhage - this is a type of stroke.
See separate leaflet called Stroke for more fotografie timpurie a venelor varicoase. The filter is placed in a large vein tromboflebita a extremităților inferioare că aceasta este o fotografie the inferior vena cava IVC.
The filter is inserted via a thin tube, which is put into a large vein and then fed along the vein into the correct position. This procedure does not need an anaesthetic and can be done at the bedside. Filters are useful if anticoagulant treatment on its own is insufficient, or for patients who cannot have anticoagulant treatment for some reason. This is called embolectomy. This is a major operation because it involves surgery inside the chest, close to the heart.
It requires a specialist hospital and surgical team. It is generally considered as a last resort for very ill patients. Http://mutualcreative.co/fluxul-de-snge-cap-tulburare-gt.php operation carries a significant risk of death.
However, it would only be considered as an option if you had a massive PE which, in itself, gave a high risk of death if it were not treated. Surgery may also be used in place of anticoagulant or clot-dissolving treatment, for patients who cannot have those treatments. This would usually be because they were at a high risk of bleeding. Heart-lung bypass extracorporeal life support has rarely been used in some cases to treat a massive PE.
Treating the clot through embolism pulmonar recurent fine embolism pulmonar recurent catheter: It involves threading embolism pulmonar recurent catheter through blood vessels until it reaches the blood clot in the lung.
Once the clot is reached it may be possible to remove varice Cum a picioare pe unguent de trata or break it up fragment it using treatment given through the tube. This is highly specialised treatment and so is only available at certain hospitals.
There is an increased risk of PE at any stage of the pregnancy until six weeks postnatally. Any symptoms of DVT or a PE in a pregnant or postnatal woman should be taken seriously and investigated immediately. Treatment in pregnancy is with heparin injections rather than warfarin tablets. For a massive PE where the patient is unwell, any of the additional treatments listed above embolism pulmonar recurent be used. Treatment in pregnancy is continued until three months after the embolism or until six weeks postnatally, whichever is longer.
Postnatally, warfarin can be started in place of heparin, once bleeding from the birth has settled. Heparin and warfarin can be taken by breast-feeding mothers. If taking warfarin and go here, it is advisable to ensure that the baby has had its routine vitamin K injection.
This is because vitamin K helps counteract the effects of warfarin. In the UK, all babies are routinely given a vitamin K injection at birth, unless parents object. Vitamin K helps prevent clotting problems in newborn babies anyway, regardless of whether the mother is taking treatment. Most people with a PE are treated successfully and do not get complications.
However, there are some possible, serious complications and these include:. If a PE is treated promptly, the outlook is good, and most people can make embolism pulmonar recurent full recovery.
The outlook is less good if there read more an existing serious illness which helped to cause the embolism - for example, advanced cancer.
A massive PE is more difficult to treat and is life-threatening. A PE is a serious condition and can embolism pulmonar recurent a high risk of death but this is greatly reduced by early treatment in hospital. The most risky time for complications or embolism pulmonar recurent is in the first few hours after the embolism occurs.
Also, there is a high risk of another PE occurring within embolism pulmonar recurent weeks of the first one. This is why treatment is needed immediately and is continued for about three months. This involves preventing a DVT. See separate leaflet called Preventing DVT When You Travel. People having major surgery should be assessed for their DVT risk, and people at high risk of DVT may need preventative prophylactic doses of heparin or a similar medicine before and after surgery.
Other preventative measures are also possible while in hospital. Hi - I had several clots in my left lung 9 months ago. Now read about Thrombophilia. This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Patient Platform Limited has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions.
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Print PDF Email Bookmark You must be signed in to bookmark pages Sign in now. Notes You must be signed into your pro account to make notes Sign in now. On this embolism pulmonar recurent Venous thromboembolism VTE What is a pulmonary embolism PE? What causes a pulmonary embolism PE? Who gets a pulmonary embolism PE? How common is a pulmonary embolism PE?
What are the symptoms of a pulmonary embolism PE? How is a pulmonary embolism PE diagnosed? What is the embolism pulmonar recurent for a pulmonary embolism PE? Pregnancy embolism pulmonar recurent postnatal period What are the embolism pulmonar recurent of a pulmonary embolism PE? What is the outlook prognosis for a pulmonary embolism PE? How can a pulmonary embolism PE be prevented? References A pulmonary embolism embolus is a serious, potentially life-threatening condition.
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