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Overview of Pulmonary Embolism

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Pulmonary Embolism

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Summary

For too long, Eastern and Western cultures have approached the epidemiology, diagnosis, therapy, and prevention of pulmonary embolism in cultural isolation. Although the discovery of the factor V Leiden genetic mutation has revolutionized the epidemiology of venous thromboembolism in Caucasian populations of European ancestry, this finding has not advanced the epidemiological approach to pulmonary embolism in Japan, because this genetic mutation is so rare in Asians. However, advances in reliable noninvasive diagnostic techniques have been welcomed in the East and the West, particularly the D-dimer ELISA, echocardiography, spiral chest CT scanning, and magnetic resonance imaging. The use of subcutaneously administered low molecular weight heparins has made home treatment possible for pulmonary embolism patients at low risk. Perhaps the most exciting advance in therapy is implementation of routine risk stratification, especially by establishing the status of the right ventricle. Right ventricular hypokinesis on echocardiography is becoming increasingly recognized as a poor prognostic sign. By understanding that pulmonary embolism encompasses a wide clinical spectrum, those patients at high risk of an adverse outcome can be selected for thrombolysis or catheter-based or surgical embolectomy in addition to anticoagulation. Finally, prevention of venous thromboembolism is crucially important. While effective pharmacologic strategies can be implemented, especially with low molecular weight heparins, mechanical measures such as insertion of an inferior vena caval filter are also effective.

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Authors and Affiliations

  1. Cardiovascular Division, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA

    Samuel Z. Goldhaber

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  1. Samuel Z. Goldhaber
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Editors and Affiliations

  1. The First Department of Internal Medicine, Mie University School of Medicine, 174-2 Edobashi, 514-8507, Tsu, Mie, Japan

    Takeshi Nakano M.D. (Professor) (Professor)

  2. Cardiovascular Division, Department of Medicine, Brigham and Woman’s Hospital Harvard Medical School, 75 Francis Street, 02115, Boston, MA, USA

    Samuel Z. Goldhaber M.D. (Associate Professor) (Associate Professor)

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© 1999 Springer Japan

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Goldhaber, S.Z. (1999). Overview of Pulmonary Embolism. In: Nakano, T., Goldhaber, S.Z. (eds) Pulmonary Embolism. Springer, Tokyo. https://doi.org/10.1007/978-4-431-66893-0_1

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  • DOI: https://doi.org/10.1007/978-4-431-66893-0_1

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