Venous Thromboembolism Unit, Internal Medicine, Hospital General Universitario Gregorio Marañón, Calle doctor Esquerdo, 46, Madrid 28007, Spain; Sanitary Research Institute Gregorio Marañón, Calle doctor Esquerdo, 46, Madrid 28007, Spain; Universidad Complutense de Madrid, School of Medicine, Spain.
IRCCS SDN, Diagnostic and Nuclear Research Institute, Via Gianturco 131, Naples 80137, Italy.
Heart Fail Clin. 2020 Jul;16(3):317-330. doi: 10.1016/j.hfc.2020.03.004.
Acute pulmonary embolism (PE) is the third most common acute cardiovascular condition, and its prevalence increases over time. D-dimer has a very high negative predictive value, and if normal levels of D-dimer are detected, the diagnosis of PE is very unlikely. The final diagnosis should be confirmed by computed tomographic scan. However, echocardiography is the most available, bedside, low-cost, diagnostic procedure for patients with PE. Risk stratification is of utmost importance and is mainly based on hemodynamic status of the patient. Patients with PE and hemodynamic stability require further risk assessment, based on clinical symptoms, imaging, and circulating biomarkers.
急性肺栓塞（PE）是第三大常见的急性心血管疾病，其患病率随时间推移而增加。D-二聚体具有非常高的阴性预测值，如果检测到 D-二聚体的正常水平，则不太可能诊断为 PE。最终诊断应通过计算机断层扫描确认。然而，超声心动图是 PE 患者最可用的、床边的、低成本的诊断程序。风险分层至关重要，主要基于患者的血流动力学状态。对于血流动力学稳定的 PE 患者，需要根据临床症状、影像学和循环生物标志物进行进一步的风险评估。
