By American College of Chest Physicians
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Approximately 79% of patients who present with PE also will have concomitant DVT; conversely, only approximately 50% of patients presenting with DVT will have PE. The estimated annual incidence of VTE in the United States is one episode per 1,000 patients. As many as 3,000,000 people die each year in the United States from acute PE. Risk Factors Risk factors associated with VTE often are classified into acquired and genetic factors, and these can overlap in an individual patient. indd 21 inflammatory bowel disease; heparin-induced thrombocytopenia (HIT); and myeloproliferative disorders, such as polycythemia vera and hyperviscosity syndromes.
N Engl J Med 2008; 358:1037–1052. finding provides compelling evidence against the diagnosis of PE. In one study of 515 consecutive patients with clinically suspected PE who had anticoagulation therapy withheld on the basis of a normal perfusion scan finding, only 3 patients had symptomatic VTE (PE, 1 patient) during a 3-month follow-up period. When the . PIOPED criteria are used, a high-probability V/Q lung scan finding accompanied with a high prescan clinical suspicion is. associated with confirmed PE in Ͼ 96% of cases.
29 7/10/09 8:03:54 PM is a key contributor. Platelets likely play an important role as procoagulants by increasing the platelet release of serotonin, vascular endothelial growth factor, and platelet-derived growth factor. Clinical Features PH frequently presents with nonspecific symptoms (Table 5). The most common symptoms are dyspnea on exertion, fatigue, and syncope, resulting from reduced cardiac output during activity. Patients may also occasionally present with anginalike chest pain with normal coronary arteries.
ACCP pulmonary medicine board review by American College of Chest Physicians