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肺栓塞的临床表现与风险分层

Clinical Presentation and Risk Stratification of Pulmonary Embolism.

作者信息

Mohammed Abdul Qudoos Iqbal, Berman Lorin, Staroselsky Mark, Wenn Peter, Hai Ofek, Makaryus Amgad N, Zeltser Roman

机构信息

Department of Cardiology, Nassau University Medical Center, East Meadow, NY.

Department of Cardiology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY.

出版信息

Int J Angiol. 2024 May 13;33(2):82-88. doi: 10.1055/s-0044-1786878. eCollection 2024 Jun.

Abstract

Pulmonary embolism (PE) presents with a spectrum of symptoms, ranging from asymptomatic cases to life-threatening events. Common symptoms include sudden dyspnea, chest pain, limb swelling, syncope, and hemoptysis. Clinical presentation varies based on thrombus burden, demographics, and time to presentation. Diagnostic evaluation involves assessing symptoms, physical examination findings, and utilizing laboratory tests, including D-dimer. Risk stratification using tools like Wells score, Pulmonary Embolism Severity Index, and Hestia criteria aids in determining the severity of PE. PE is categorized based on hemodynamic status, temporal patterns, and anatomic locations of emboli to guide in making treatment decisions. Risk stratification plays a crucial role in directing management strategies, with elderly and comorbid individuals at higher risk. Early identification and appropriate risk stratification are essential for effective management of PE. As we delve into this review article, we aim to enhance the knowledge base surrounding PE, contributing to improved patient outcomes through informed decision-making in clinical practice.

摘要

肺栓塞(PE)的症状表现多样,从无症状病例到危及生命的事件都有。常见症状包括突发呼吸困难、胸痛、肢体肿胀、晕厥和咯血。临床表现因血栓负荷、人口统计学特征以及就诊时间而异。诊断评估包括评估症状、体格检查结果,并利用实验室检查,包括D - 二聚体。使用Wells评分、肺栓塞严重程度指数和赫斯提亚标准等工具进行风险分层有助于确定PE的严重程度。PE根据血流动力学状态、时间模式和栓子的解剖位置进行分类,以指导治疗决策。风险分层在指导管理策略中起着关键作用,老年人和患有合并症的个体风险更高。早期识别和适当的风险分层对于PE的有效管理至关重要。在深入探讨这篇综述文章时,我们旨在加强围绕PE的知识库,通过临床实践中的明智决策为改善患者预后做出贡献。

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