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Tag Archives: vascular
How can the Simplified Pulmonary Embolism Severity Index (sPESI) be used to manage patients presenting with a pulmonary embolism?
The Bottom Line: The Pulmonary Embolism Severity Index is a validated tool for predicting 30-day mortality in patients presenting at the hospital with PE. The Simplified PESI (sPESI) predicts 30-day mortality with accuracy similar to the PESI And can assist … Continue reading
Bottom line: Compared to LMWH The new oral anticoagulants (NOACs) are safe and effective for treatment of thromboembolism. Rivaroxaban and apixiban have lower bleeding risk compared to warfarin therapy. Summary: Lana A. Castellucci, et al. Clinical and safety outcomes associated with … Continue reading
What is the predictive value of blood pressure differential in predicting aortic dissection in patients with chest pain?
Bottom line: Presence of chest pain with blood pressure differential and/or pulse differential should raise clinical suspicion of aortic dissection. There is evidence that the presence of pressure difference >20mmHg is a strong predictor of dissection, but absence of pressure differential should … Continue reading
From Cirrhosis and its complications. In: Harrison’s Internal Medicine, 18th ed. Under Major Complications, toward the bottom of the page. Explains that patients with cirrhosis experience a decrease in production of clotting factors and diminished clearance of anticoagulants. Portal hypertension … Continue reading
In patients with acute pulmonary embolism, does elevated plasma lactate indicate an increased mortality risk?
Bottom line: An elevated plasma lactate is associated with an increased risk for 30-day mortality in patients presenting with acute pulmonary embolism. Summary: Vanni S, et al. Prognostic value of plasma lactate levels among patients with acute pulmonary embolism: the … Continue reading
Bottom line: While no individual CXR finding is diagnostic, some findings (when present, see below) do increase risk for PE. Absence of abnormal findings are not helpful. Summary: Worsley DF, et al. Chest radiographic findings in patients with acute pulmonary … Continue reading
Bottom line: Aspirin may decrease risk for recurrent symptomatic VTE in patients with first unprovoked VTE who have completed initial anticoagulation therapy. Summary: Pulmonary embolism, Treatment section, Antiplatelet therapy. In: DynaMed. DynaMed summarizes results of two RCTs evaluating effectiveness of … Continue reading