Pulmonary embolism - assessment of risk factors and emboli locations

Mateusz Komisarczuk, Michał Kaczor, Ewa Kopyto, Mateusz Woch, Piotr Piech

DOI: http://dx.doi.org/10.12775/JEHS.2020.10.02.021


INTRODUCTION: Pulmonary embolism (PE) is a widespread disorder, which appears as a result of closure or restriction of main pulmonary artery or its branches and is often associated with deep vein thrombosis (DVT).The severity and clinical picture is frequently erratic and what is worrying it is a major cause of hospitalization and mortality in Europe.


OBJECTIVE: The mainpurpose of our study was to demonstrate meaning of emboli location in prognosis,favour risk factors which could be overlooked by clinicians and help to avoid further misdiagnosis.


ABBREVIATED DESRCIPTION OF THE STATE OF KNOWLEDGE:We highlighted the importance of defining a genetic profile, personal and family history of VTE, especially in patients with atypical pulmonary symptoms. Moreover, the awareness of possible occurring PE among children,during serious infections or in patients with malignancy is still insufficient. Furthermore, according our analysis clinical symptoms in patients with pulmonary embolism are undoubtedly influenced by the location.The more massive the thrombus appears, the more serious consequences can be expected for the patient.Along with the size of the thrombus, the risk of its complications increases because of haemodynamic changes.


SUMMARY:Diagnosing of pulmonary embolism in hemodynamically stable patients is still challenging for clinicians. There were many attempts to find significant and unmistakeable relationship between emboli location in pulmonary vasculature and prognosis.That knowledge could be helpful for clinicians in setting accurate diagnosis, implementing appropriate treatment and avoid possible life-threatening consequences.Risk stratification is crucial to the management and prognosis of patients with acute PE.


Risk factors; venous thromboembolism; acute pulmonary embolism; clot location

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Kosch A, Junker R, Wermes C, Nowak-Göttl U. Recurrent pulmonary embolism in a 13-year-old male homozygous for the prothrombin G20210A mutation combined with protein S deficiency and increased lipoprotein (a). Thromb res. 2002;105(1):49–53. https://doi.org/10.1016/S0049-3848(01)00406-6.

Giordano N, Jansson P, Young M, Hagan K, Kabrhel C. Epidemiology, Pathophysiology, Stratification, and Natural History of Pulmonary Embolism.Tech Vasc Interv Radiol.2017;20(3):135–140. https://doi.org/10.1053/j.tvir.2017.07.002.

Konstantinides S, Torbicki A, Agnelli G, Danchin N, Fitzmaurice D, Galiè N, et al.ESC Guidelines on the diagnosis and management of acute pulmonary embolism. Kardiol Pol.2014;72(11):997–1053. https://doi.org/10.5603/KP.2014.0211.

Lenicek Krleza J, Jakovljevic G, Bronic A, Coen Herak D, Bonevski A, Stepan-Giljevic J, et al. Contraception-Related Deep Venous Thrombosis and Pulmonary Embolism in a 17-Year-Old Girl Heterozygous for Factor V Leiden, Prothrombin G20210A Mutation, MTHFR C677T and Homozygous for PAI-1 Mutation: Report of a Family with Multiple Genetic Risk Factors and Review of the Literature. Pathophysiol Haemos Thromb.2009;37(1):24–29. https://doi.org/10.1159/000319051.

Le Gal G, Righini M, Roy P.-M, Sanchez O, Aujesky D, Bounameaux H, et al. Prediction of Pulmonary Embolism in the Emergency Department: The Revised Geneva Score. Ann Intern Med.2006;144(3):165. https://doi.org/10.7326/0003-4819-144-3-200602070-00004.

Ramiz S, Rajpurkar M. Pulmonary Embolism in Children. Pediatr Clin N Am.2018;65(3):495–507. https://doi.org/10.1016/j.pcl.2018.02.002.

Rajpurkar M, Biss T, Amankwah E, Martinez D, Williams S, Van Ommen C, et al.. Pulmonary embolism and in situ pulmonary artery thrombosis in paediatrics. A systematic review. Thromb Haemost.2017;117(6):1199–1207. https://doi.org/10.1160/TH16-07-0529.

Kujovich J. Factor V Leiden thrombophilia. Genet Med.2011;13(1):1–16. https://doi.org/10.1097/GIM.0b013e3181faa0f2.

Neshat-Vahid S, Pierce R, Hersey D, Raffini L, Faustino E.. Association of thrombophilia and catheter-associated thrombosis in children: a systematic review and meta-analysis. J ThromHaemost.2016;14(9):1749–58. https://doi.org/10.1111/jth.13388.

Corral J, Roldan V, Vicente V. Deep venous thrombosis or pulmonary embolism and factor V Leiden: enigma or paradox. Haematologica.2010;95(6):863–866. https://doi.org/10.3324/haematol.2010.023432.

Mäkelburg A, Veeger N, Middeldorp S, Hamulyák K, Prins M, Büller H, et al. . Different risk of deep vein thrombosis and pulmonary embolism in carriers with factor V Leiden compared with non-carriers, but not in other thrombophilic defects. Results from a large retrospective family cohort study. Haematologica.2010;95(6):1030–1033. https://doi.org/10.3324/haematol.2009.017061.

Biss T, Brandão L, Kahr W, Chan A, Williams S. Clinical features and outcome of pulmonary embolism in children. Br J Haematol.2008;142(5):808–18. https://doi.org/10.1111/j.1365-2141.2008.07243.x.

Gruettner J, Viergutz T, Bolte M, Henzler T, Schoenberg S, Sudarski S, et al. Importance of risk factors for the evaluation of patients with a suspected pulmonary embolism. Exp Ther Med.2015;9(6):2281–2284. https://doi.org/10.3892/etm.2015.2395.

Cha S-I, Shin K-M, Lim J-K, Yoo S-S, Lee S-Y, Lee J, et al. Pulmonary embolism concurrent with lung cancer and central emboli predict mortality in patients with lung cancer and pulmonary embolism. J Thorac Dis.2018;10(1):262–272. https://doi.org/10.21037/jtd.2017.12.32.

Chew H, Wun T, Harvey D, Zhou H, White R. Incidence of Venous Thromboembolism and Its Effect on Survival Among Patients With Common Cancers. Arch Intern Med.2006;166(4):458. https://doi.org/10.1001/archinte.166.4.458.

Yu Y-B, Gau J-P, Liu C-Y, Yang M-H, Chiang S-C, Hsu H-C, et al. A nation-wide analysis of venous thromboembolism in 497,180 cancer patients with the development and validation of a risk-stratification scoring system. Thromb Haemost.2012;108(08):225–235. https://doi.org/10.1160/TH12-01-0010.

Alcalay A, Wun T, Khatri V, Chew H, Harvey D, Zhou H, et al. Venous Thromboembolism in Patients With Colorectal Cancer: Incidence and Effect on Survival. J Clin Oncol.2006;24(7):1112–1118. https://doi.org/10.1200/JCO.2005.04.2150.

Jain C, Chang Y, Kabrhel C, Giri J, Channick R, Rodriguez-Lopez J, et al. Impact of Pulmonary Arterial Clot Location on Pulmonary Embolism Treatment and Outcomes (90 Days). Am J Cardiol.2017;119(5):802–807. https://doi.org/10.1016/j.amjcard.2016.11.018.

Doherty S. Pulmonary embolism An update. Aust Fam Physician.2017;46(11):816–820.

Weeda E, Caranfa J, Zeichner S, Coleman C, Nguyen E, Kohn C. External Validation of Generic and Cancer-Specific Risk Stratification Tools in Patients With Pulmonary Embolism and Active Cancer. J Natl Compr Canc Netw.2017;15(12):1476–1482. https://doi.org/10.6004/jnccn.2017.7004.

Cohoon K, Ashrani A, Crusan D, Petterson T, Bailey K, Heit J. Is Infection an Independent Risk Factor for Venous Thromboembolism? A Population-Based, Case-Control Study. Am J Med.2018;131(3):307-316.e2. https://doi.org/10.1016/j.amjmed.2017.09.015.

Alonso Martinez J, Anniccherico Sánchez F, Urbieta Echezarreta M, García I, Álvaro J. Central versus peripheral pulmonary embolism: Analysis of the impact on the physiological parameters and long-term survival. N Am J Med Sci.2016;8(3):134. https://doi.org/10.4103/1947-2714.179128.

García-Sanz M, Pena-Álvarez C, López-Landeiro P, Bermo-Domínguez A, Fontúrbel T, González-Barcala F. Symptoms, location and prognosis of pulmonary embolism. Rev Port Pneumol.2014;20(4):194–199. https://doi.org/10.1016/j.rppneu.2013.09.006.

Nagel S, Steffen I, Schwartz S, Hamm B, Elgeti T. Age-dependent diagnostic accuracy of clinical scoring systems and D-dimer levels in the diagnosis of pulmonary embolism with computed tomography pulmonary angiography (CTPA). Eur radiol. 2019;29:4563 https://doi.org/10.1007/s00330-019-06039-5.

Jovanovic L, Subota V, Stavric M, Subotic B, Dzudovic B, Novicic N, et al. Biomarkers for the prediction of early pulmonary embolism related mortality in spontaneous and provoked thrombotic disease. ClinChim Acta.2019;492:78–83. https://doi.org/10.1016/j.cca.2019.02.008.

Gonzalez Della Valle A, Blanes Perez A, Lee Y-Y, Saboeiro G, Konin G, Endo Y, et al. The Clinical Severity of Patients Diagnosed With an In-Hospital Pulmonary Embolism Following Modern, Elective Joint Arthroplasty Is Unrelated to the Location of Emboli in the Pulmonary Vasculature. J Arthroplasty.2017;32(4):1304–1309.https://doi.org/10.1016/j.arth.2016.11.023.

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Journal of Education, Health and Sport formerly Journal of Health Sciences

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