Tag Archives: pulmonary embolism

A literature search in Pubmed and Google scholar disclosed 13 examples of the association of type A aortic dissection and PE (table 1).2–14 Table 1. Co-existence of aortic dissection and pulmonary embolism First author Age Sex CP BKP ARG PRP BPD MDS SOB HPTY DVT EFF ARP Antithrombotic treatment Cruz2 71 F ✓ – – ✓ – – ✓ – ✓ – – OAC Radwan3 66 F ✓ – – – – – – – – – ✓ Information not available Kagawa4 71 F – ✓ – – – ✓ – – ✓ ✓ – IVC filter, UFH, OAC, elastic stocking Herera5 47 F – – ✓ – – – ✓

Case report A 74-year-old male with previous hypertension and myocardial infarction presented with light-headedness after walking down the stairs at home. He denied chest pain, but complained of shortness of breath on exertion. In the accident and emergency department he was noted to be pale and clammy. Initial observations were: regular pulse 88 bpm, blood pressure 127/81 mmHg, respiratory rate 20/min, and Sp02 95% (later consistently greater than 97%). He had stopped smoking aged 34 years. On examination his chest was clear, the heart sounds were normal, the jugular venous pressure was not elevated and he had no peripheral oedema. Initial e

Introduction Venous thromboembolism (VTE), comprising deep vein thrombosis (DVT) and pulmonary embolism (PE), causes considerable morbidity and mortality.1 VTE is associated with 370,000 deaths per year in the European Union (EU), an estimated 12% of annual deaths.1 The average incidence of VTE in Europe is approximately 160–180 per 100,000 person-years.1 Three large phase III trials with rivaroxaban, a direct factor Xa inhibitor approved for the treatment and prevention of VTE, have provided a strong safety and efficacy evidence base (table 1). The EINSTEIN-DVT study compared rivaroxaban (15 mg twice daily for 21 days, followed by 20 mg on

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When the NOACs (novel oral anticoagulants) were introduced over three years ago, they promised to revitalise the management of conditions such as atrial fibrillation (AF), venous thromboembolism (VTE) and thromboprophylaxis after major joint replacement surgery. Rivaroxaban is currently available in multiple indications, including (but not limited to): prevention of stroke and systemic embolism in adult patients with non-valvular AF, treatment of deep vein thrombosis (DVT) and pulmonary embolism (PE), and the prevention of recurrent DVT and PE in adults. For decades anticoagulant therapy in these conditions had relied on the vitamin K antagon

NICE updates A new ‘Evidence Update’ has been produced by the National Institute for Health and Clinical Excellence (NICE), which summarises selected new evidence relevant to the NICE guideline on the management of chronic heart failure (CHF) in adults in primary and secondary care (clinical guideline 108).NICE says “Whilst Evidence Updates do not replace current accredited guidance, they do highlight new evidence that might generate a future changes in practice.”  It says it will welcome feedback from societies and individuals in developing this service. The update is available from www.evidence.nhs.uk/evidence-update-2. New guides