General Internal Medicine

Pulmonary Embolus

Questions discussed in this category

How do you manage concurrent non-life-threatening hemoptysis and acute pulmonary embolism?

Estimating blood loss from hemoptysis is not always reliable. The bleeding may be due to the PE itself. Is anticoagulation with any degree of hemoptys...

1 Answer available

What is your protocol for transitioning to oral anticoagulation post-thrombolysis for pulmonary embolism?

High-risk PEs are typically treated with loading doses of anticoagulants or bridging with LMWH. Do you omit the bridging/loading period and go straigh...

1 Answer available

How does your approach to subsegmental PE differ from segmental PE both diagnostically and therapeutically?

3 Answers available

For patients with newly diagnosed VTE on IV heparin planned for transition to DOAC, would you start at the loading or maintenance DOAC dose?

If they have been on IV heparin for 3 days, for example, would you subtract those days from the recommended loading dose time?

3 Answers available

How would you manage a patient with morbid obesity who presents with new symptomatic pulmonary embolism a few days after he was started on DOAC for DVT?

What is your preferred anticoagulation in patients with BMI >50?

5 Answers available

How do you follow pulmonary embolism patients who have completed anticoagulation?

1 Answer available

Do you obtain an echocardiogram as a part of risk stratification in all patients hospitalized with an acute pulmonary embolism?

2 Answers available

Would you restart prophylactic anticoagulation in a patient with a history of unprovoked PE who received short term anticoagulation with a prior physician?

E.g. low dose DOAC

1 Answer available

Do you consider extensive clot burden as a factor in determining whether patients with submassive PE may be appropriate for thrombolytic therapy?

3 Answers available

Papers discussed in this category

Radiology, 2012-10

Short-term mortality in acute pulmonary embolism: clot burden and signs of right heart dysfunction at CT pulmonary angiography.

The New England journal of medicine, 2014-04-10

Fibrinolysis for patients with intermediate-risk pulmonary embolism.

The American journal of cardiology, 2016-11-15

Relation Among Clot Burden, Right-Sided Heart Strain, and Adverse Events After Acute Pulmonary Embolism.

Blood Adv,

American Society of Hematology 2020 guidelines for management of venous thromboembolism: treatment of deep vein thrombosis and pulmonary embolism.

CMAJ,

Identifying unprovoked thromboembolism patients at low risk for recurrence who can discontinue anticoagulant therapy.

J Thromb Haemost, 2021 Jul 14

Use of direct oral anticoagulants in patients with obesity for treatment and prevention of venous thromboembolism: Updated communication from the ISTH SSC Subcommittee on Control of Anticoagulation.

Blood, 2020 Mar 19

How I treat obese patients with oral anticoagulants.

JAMA network open, 2023 Aug 01

Prevalence of and Eligibility for Surveillance Without Anticoagulation Among Adults With Lower-Risk Acute Subsegmental Pulmonary Embolism.

Blood, 2013 Jun 04

Risk profile and clinical outcome of symptomatic subsegmental acute pulmonary embolism.

Annals of internal medicine, 2021 Nov 23

Risk for Recurrent Venous Thromboembolism in Patients With Subsegmental Pulmonary Embolism Managed Without Anticoagulation : A Multicenter Prospective Cohort Study.

AJR Am J Roentgenol,

Overdiagnosis of Pulmonary Embolism by Pulmonary CT Angiography.

Respirology (Carlton, Vic.), 2018 Jul 16

Pulmonary infarction: A disease of the (mostly) young.

Stroke, 2015 Oct 29

Coagulation and Fibrinolytic Activity of Tenecteplase and Alteplase in Acute Ischemic Stroke.

Research and practice in thrombosis and haemostasis, 2023 May 20

The right time to measure anti-Xa activity in critical illness: pharmacokinetics of therapeutic dose nadroparin.

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