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ESC Clinical Practice Guidelines aim to present all the relevant evidence to help physicians weigh the benefits and risks of a particular diagnostic or therapeutic procedure on Acute Pulmonary Embolism. They should be essential in everyday clinical decision making.
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6 de jul. de 2022 · Published July 6, 2022. N Engl J Med 2022;387: 45 - 57. DOI: 10.1056/NEJMcp2116489. VOL. 387 NO. 1. 00:00. 28:53. This Journal feature begins with a case vignette highlighting a common...
25 de ago. de 2022 · 5.3.4. Pulmonary embolism. Chronic thrombo-embolic pulmonary hypertension is an uncommon and under-diagnosed complication of acute PE . The reported cumulative incidence of CTEPH after acute, symptomatic PE ranges 0.1–11.8%, depending on the collective investigated [112, 178, 197–199].
- 1. Preamble
- 2. Introduction
- 2.1. What is new
- 5.1.9. Blood tests and immunology
- 5.2.1 Step 1 (suspicion)
- 5.2.2. Step 2 (detection)
- 5.2.3. Step 3 (confirmation)
- 6.3.1.5. Cardiovascular drugs
- 7.4.1. Diagnosis
- 7.8. Paediatric pulmonary hypertension
- 8.2.2. Evaluation of pulmonary hypertension and patient phenotyping
- 14.4. Chronic thrombo-embolic pulmonary hypertension (group 4)
- ‘What to do and‘What not to do messages from the Guidelines
- 18. Data availability statement
- ESC/ERS Scientific Document Group
Guidelines summarize and evaluate available evidence, with the aim of assisting health professionals in proposing the best management strategies for an individual patient with a given condition. Guidelines and their recommendations should facilitate decision-making of health professionals in their daily practice. However, guidelines are not a subst...
Pulmonary hypertension (PH) is a pathophysiological disorder that may involve multiple clinical conditions and may be associated with a variety of cardiovascular and respiratory diseases. The complexity of managing PH requires a multifaceted, holistic, and multidisciplinary approach, with active involvement of patients with PH in partnership with c...
One of the most important proposals from the 6th World Symposium on Pulmonary Hypertension (WSPH) was to reconsider the haemodynamic definition of PH [1]. After careful evaluation, the new definitions of PH have been endorsed and expanded in these guidelines, including a revised cut-off level for pulmonary vascular resistance (PVR) and a definition...
The initial diagnostic assessment of patients with newly diagnosed PH/PAH aims to identify comorbidities and possible causes or complications of PH. Laboratory tests that should be obtained at the time of PH diagnosis include: blood counts (including haemoglobin [Hb]); serum electrolytes (sodium, potassium); kidney function (creatinine, calculation...
Patients with PH are likely to be seen by first-line physicians, mainly general practitioners, for non-specific symptoms. Initial evaluation should include a comprehensive medical (including familial) history, thorough physical examination (including measurement of blood pressure, heart rate, and pulse oximetry), blood test to determine BNP/NT-proB...
The second step includes classical, non-invasive lung and cardiac testing. Among those tests, echocardiography is an important step in the diagnostic algorithm (Figure 6), as it assigns a level of probability of PH, irrespective of the cause. In addition, it is an important step in identifying other cardiac disorders. Based on this initial assessme...
Patients should be referred to a PH centre for further evaluation in the following situations: (1) when an intermediate/high probability of PH is established; (2) in the presence of risk factors for PAH, or a history of PE. A comprehensive work-up should be performed, with the goal of establishing the differential diagnoses and distinguishing betwe...
No data from rigorous clinical trials are available on the usefulness and safety of drugs that are effective in systemic hypertension or left-sided HF, such as angiotensin-converting enzyme inhibitors, angiotensin receptor blockers (ARBs), angiotensin receptor–neprilysin inhibitors (ARNIs), sodium–glucose cotransporter-2 inhibitors (SGLT-2is), beta...
The diagnosis of PoPH is based on the presence of otherwise unexplained pre-capillary PH in patients with portal hypertension or a portosystemic shunt. The diagnostic approach is the same as in other patients with suspected or newly detected PH. Transthoracic echocardiography is usually the first non-invasive assessment in patients with suspected P...
Pulmonary hypertension may present at all ages, including in infants and children. Pulmonary hypertension in childhood shares many common features with PH in adulthood; however, there are also important differences, which concern epidemiology, aetiology, genetic background, age-dependent diagnostic and treatment approaches, and disease monitoring. ...
Patients with LHD and suspected PH should be evaluated following the diagnostic strategy for PH (see Section 5). This requires identifying clinical features and a multimodal approach using non-invasive diagnostic tests such as echocardiography, ECG, and BNP/NT-proBNP levels. In the presence of mild PH and predominant LHD, no further testing may be ...
The differentiation between acute and chronic PE in imaging (CTPA) has to be improved. In patients with suspected CTEPH, the diagnostic role of DECT or iodine subtraction mapping versus V/Q lung scintigraphy has to be validated. The effect of drug therapy on the outcome of patients with CTEPH needs to be established. The treatment goals in patients...
’ ’ Recommendations Classa Levelb Recommendations for right heart catheterization and vasoreactivity testing Continued BOX 4 Continued Recommendations Classa Levelb Vasoreactivity testing Recommendations for diagnostic strategy Other diagnostic tests Systemic sclerosis CTEPH/CTEPD Recommendations for evaluating the disease severity and risk of deat...
No new data were generated or analysed in support of this research.
Includes Document Reviewers and ESC National Cardiac Societies. Document reviewers: Markus Schwerzmann (ESC Review Coordinator) (Switzerland), Anh-Tuan Dinh-Xuan (ERS Review Coordinator) (France), Andy Bush (UK), Magdy Abdelhamid (Egypt), Victor Aboyans (France), Eloisa Arbustini (Italy), Riccardo Asteggiano (Italy), Joan-Albert Barberà (Spain), Ma...
5 de may. de 2020 · Overall, these new guidelines introduce several key changes and knowledge and adherence to them will improve the outcome of patients with PE. Keywords: Pulmonary embolism, Guidelines, Diagnosis, Treatment, D-dimers, Pregnancy. Core tip: We discuss the basic changes between the recent guidelines published in August 2019 by the ...
- Anastasia Erythropoulou-Kaltsidou, Stelina Alkagiet, Konstantinos Tziomalos
- 10.4330/wjc.v12.i5.161
- 2020
- World J Cardiol. 2020 May 26; 12(5): 161-166.
31 de ago. de 2019 · 2019 ESC Guidelines for the diagnosis and management of acute pulmonary embolism developed in collaboration with the European Respiratory Society (ERS): The Task Force for the diagnosis and management of acute pulmonary embolism of the European Society of Cardiology (ESC)
8 de ago. de 2022 · Show details. Acute Pulmonary Embolism. Vrinda Vyas; Amandeep Goyal. Author Information and Affiliations. Last Update: August 8, 2022. Go to: Acute pulmonary embolism is a common clinical condition with a variable clinical presentation, making its diagnosis challenging.
