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| {{Pulmonary embolism}}
| | #Redirect [[Pulmonary embolism natural history, complications and prognosis]] |
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| {{CMG}}
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| '''Associate Editors-in-Chief:''' [[User:Ujjwal Rastogi|Ujjwal Rastogi, MBBS]] [mailto:urastogi@perfuse.org]
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| ==Overview==
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| ===Predicting mortality===
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| The PESI and Geneva prediction rules can estimate mortality and so may guide selection of patients who can be considered for outpatient therapy.<ref name="pmid17625081">{{cite journal |author=Jiménez D, Yusen RD, Otero R, ''et al'' |title=Prognostic models for selecting patients with acute pulmonary embolism for initial outpatient therapy |journal=Chest |volume=132 |issue=1 |pages=24-30 |year=2007 |pmid=17625081 |doi=10.1378/chest.06-2921}}</ref>
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| Right ventricular dysfunction on echocardiography and higher than normal concentrations of troponin identify high risk patients who might need escalation of therapy with thrombolysis or embolectomy even if the blood pressure is normal on presentation.
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| After a first PE, the search for secondary causes is usually brief. Only when a second PE occurs, and especially when this happens while still under [[anticoagulant]] therapy, a further search for underlying conditions is undertaken. This will include testing ("thrombophilia screen") for Factor V Leiden mutation, antiphospholipid antibodies, protein C and S and antithrombin levels, and later prothrombin mutation, MTHFR mutation, Factor VIII concentration and rarer inherited [[coagulation]] abnormalities.
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| For prevention of recurrences, when patients are admitted to medical wards or when patients undergo surgery, their physicians should prescribe prophylactic measures to prevent PE. After hospital discharge, prophylaxis should continue for about a month for patients at high risk of thromboembolism.
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| ==References==
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| {{reflist|2}}
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| [[Category:Hematology]]
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| [[Category:Pulmonology]]
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| [[Category:Cardiology]]
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| [[Category:Emergency medicine]]
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| {{WH}}
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| {{WS}}
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