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Pulmonary Embolism and Massive DVT for Emergency Critical Care

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Emergency Department Critical Care

Abstract

Venous thromboembolism (VTE) as a first event occurs in 100 per 100,000 persons each year in the United States with an incidence that rises exponentially with age (White RH, Circulation 107:14–8, 2003). More than 60% of symptomatic VTE cases manifest as deep vein thrombosis (DVT) alone, whereas one-third of patients present with pulmonary embolism (PE) (White RH, Circulation 107:14–8, 2003). Recurrence occurs in approximately 7% of patients and happens more frequently with PE than DVT (White RH, Circulation 107:14–8, 2003; Cushman et al., Am J Med 117:19–25, 2004). The incidence of death within 30 days of diagnosis occurs in 6% of patients with DVT and 12% with PE (White RH, Circulation 107:14–8, 2003). Less common manifestations of venous thrombosis include phlegmasia alba dolens, phlegmasia cerulea dolens (PCD), and venous gangrene, which form a clinical spectrum that carries significant morbidity (Sarwar S, Narra S, Munir A, Tex Heart Inst J 36:76, 2009; Haimovici H, J Cardiovasc Surg 5:164–73, 1965). It is important for the emergency practitioner (EP) to appropriately recognize and treat VTE, as delays in diagnosis and treatment may result in a significant increase in morbidity and mortality.

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Authors and Affiliations

  1. Department of Emergency Medicine, IU School of Medicine, IU Health-Methodist Hospital, Indianapolis, IN, USA

    Timothy J. Ellender

  2. Emergency Medicine, University of Michigan, Ann Arbor, MI, USA

    David Hackenson

  3. Emergency Medicine, UT Southwestern Medical Center, Dallas, TX, USA

    Emily Gundert

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  1. Timothy J. Ellender
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  2. David Hackenson
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Correspondence to Timothy J. Ellender .

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  1. College of Medicine, University of Florida Health Science Center, Jacksonville, FL, USA

    Joseph R. Shiber

  2. Resuscitation & Emergency Critical Care, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Scott D. Weingart

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Ellender, T.J., Hackenson, D., Gundert, E. (2020). Pulmonary Embolism and Massive DVT for Emergency Critical Care. In: Shiber, J., Weingart, S. (eds) Emergency Department Critical Care. Springer, Cham. https://doi.org/10.1007/978-3-030-28794-8_7

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