Department of Medicine, Division of ADM-Housestaff, Beth Israel Deaconess Medical Center, Harvard Medical School, Deac 311, 330 Brookline Avenue, Boston, MA 02215, USA.
Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 4th Floor, 375 Longwood Avenue, Boston, MA 02215, USA.
Cardiol Clin. 2021 Nov;39(4):551-566. doi: 10.1016/j.ccl.2021.06.008.
Venous thromboembolism (VTE), encompassing pulmonary embolism (PE) and deep vein thrombosis (DVT), is encountered commonly. Acute PE may present as a high-risk cardiovascular emergency, and acute DVT can cause acute and chronic vascular complications. The goal of this review is to ensure that cardiologists are comfortable managing VTE-including risk stratification, anticoagulation therapy, and familiarity with primary reperfusion therapy. Clinical assessment and determination of degree of right ventricular dysfunction are critical in initial risk stratification of PE and determination of parenteral versus oral anticoagulation therapy. Direct oral anticoagulants have emerged as preferred first-line oral anticoagulation strategy in VTE scenarios.
静脉血栓栓塞症（VTE）包括肺栓塞（PE）和深静脉血栓形成（DVT），较为常见。急性 PE 可能表现为高危心血管急症，急性 DVT 可导致急性和慢性血管并发症。本综述的目的是确保心脏病专家能够熟练管理 VTE，包括风险分层、抗凝治疗以及熟悉主要再灌注治疗。临床评估和确定右心室功能障碍程度是 PE 初始风险分层和确定静脉与口服抗凝治疗的关键。直接口服抗凝剂已成为 VTE 情况下首选的一线口服抗凝策略。
