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  • Tromboembolismul Pulmonar: Conf. Dr. Adriana Iliesiu

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    Tromboembolism is a major health issue, causing around 300,000 deaths per year. It involves two processes - deep vein thrombosis (DVT) and pulmonary embolism (PE). There are several genetic and acquired risk factors for developing tromboembolism. Genetic risk factors include mutations in certain genes, while acquired risks include older age, obesity, oral contraceptive use, cancer, and recent surgery or hospitalization. Symptoms of tromboembolism can include dyspnea, chest pain, cough, hemoptysis, and syncope. Diagnosis involves clinical scoring systems, imaging tests like ultrasound, CT scans, and ventilation-perfusion scans. Treatment involves antico

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    Tromboembolism is a major health issue, causing around 300,000 deaths per year. It involves two processes - deep vein thrombosis (DVT) and pulmonary embolism (PE). There are several genetic and acquired risk factors for developing tromboembolism. Genetic risk factors include mutations in certain genes, while acquired risks include older age, obesity, oral contraceptive use, cancer, and recent surgery or hospitalization. Symptoms of tromboembolism can include dyspnea, chest pain, cough, hemoptysis, and syncope. Diagnosis involves clinical scoring systems, imaging tests like ultrasound, CT scans, and ventilation-perfusion scans. Treatment involves antico

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    13 views25 pages

    Tromboembolismul Pulmonar: Conf. Dr. Adriana Iliesiu

    Uploaded by

    valik_c
    Tromboembolism is a major health issue, causing around 300,000 deaths per year. It involves two processes - deep vein thrombosis (DVT) and pulmonary embolism (PE). There are several genetic and acquired risk factors for developing tromboembolism. Genetic risk factors include mutations in certain genes, while acquired risks include older age, obesity, oral contraceptive use, cancer, and recent surgery or hospitalization. Symptoms of tromboembolism can include dyspnea, chest pain, cough, hemoptysis, and syncope. Diagnosis involves clinical scoring systems, imaging tests like ultrasound, CT scans, and ventilation-perfusion scans. Treatment involves antico

    Copyright:

    © All Rights Reserved
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    of 25

    Tromboembolismul pulmonar

    Conf. Dr. ADRIANA ILIESIU


    Tromboza venoasa profunda (TVP)
    +
    Embolism pulmonar (EP)


    Tromboembolismul venos (TEV)


    TEV si risc de deces
    300.000 decese / an

    7% TEV diagnosticat si tratat
    34% EP cu debut brusc, fatal
    59% EP nediagnosticat

    Factori predispozanti
    Genetici
    (autozomal dominanti)

    Factor V Leiden
    Mutatii ale genei
    protrombinei

    Deficite de
    proteina C
    proteina S

    Trombofilie + factor predispozant
    dobandit

    Dobanditi


    Varsta
    obezitate,
    contraceptive orale,
    boala varicoasa
    antecedente de TEP
    tratament hormonal de substitutie

    Chirurgie
    Sarcina /postpartum
    Traumatisme
    Boli medicale
    Sd antifosfolipidic
    Cancer / Tratament
    Boli neurologice
    BPOC
    Simptome si semne in TEV
    Dispnee
    Durere toracica pleurala
    - retrosternala
    Tuse
    Hemoprtizie
    Sincopa
    Scor de risc (Wells)
    Variabile clinice Scor
    Semne/simptome

    TVP 3.0
    Dg alternativ putin probabil 3.0
    FC >100/min 1.5
    Imobilizare >3 days 1.5
    Chirurgie (< 4 sapt) 1.5
    Antecedente EP/TVP 1.5
    Hemoptysis 1.0
    Cancer 1.0

    Risc clinic mare > 4 puncte

    Radiografia pulmonara


    Date paraclinice
    Analize uzuale
    Sa O2
    D-dimeri
    Troponine
    Peptide natriuretice
    Rx si Scintilatia de ventilatie
    perfuzie

    Ecografia venoasa
    Ecografia venoasa

    Computer tomografia cu contrast
    Tomografia spirala
    TEP la CT

    Stratificarea riscului de mortalitate

    Tratamentul anticoagulant
    Heparina nefractionata Heparine cu greutate
    moleculara mica
    Tratament fibrinolitic


    Algoritm de tratament

    Tratament anticoagulant
    Tratament curativ

    durata tratamentului anticoagulant
    filtre de vena cava inferioara

    Tratament profilactic
    Mesaje cheie
    Marele simulator / ucigasul tacut
    Suspiciunea clinica
    Algoritm de diagnostic
    Estimarea prognosticului atitudinea
    terapeutica
    Profilaxia TEP este esentiala

    Algoritm de diagnostic
    Suspiciune TEP HipoTA/Soc

    Algoritm de tratament

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