Enfermedad tromboembólica venosa: embolia pulmonar aguda

  1. Oblitas, C.M. 1
  2. Demelo Rodríguez, P. 2
  3. Galeano Valle, F. 1
  4. Andueza Lillo, J.A. 3
  1. 1 Unidad de Enfermedad Tromboembólica Venosa, Servicio de Medicina Interna, Hospital General Universitario Gregorio Marañón, Madrid, España Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, España Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España
  2. 2 Unidad de Enfermedad Tromboembólica Venosa, Servicio de Medicina Interna, Hospital General Universitario Gregorio Marañón, Madrid, España Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, España Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España Facultad de Medicina, Universidad CEU San Pablo, Madrid, España
  3. 3 Facultad de Medicina, Universidad Complutense de Madrid, Madrid, España Servicio de Urgencias, Hospital General Universitario Gregorio Marañón, Madrid, España
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Revista:
Medicine: Programa de Formación Médica Continuada Acreditado

ISSN: 0304-5412

Año de publicación: 2023

Título del ejemplar: Urgencias (II):Urgencias respiratorias torácicas

Serie: 13

Número: 88

Páginas: 5196-5207

Tipo: Artículo

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Otras publicaciones en: Medicine: Programa de Formación Médica Continuada Acreditado

Resumen

La enfermedad tromboembólica venosa (ETV) es una enfermedad crónica, siendo la tercera causa de enfermedad vascular después de la cardiopatía isquémica y la enfermedad cerebrovascular. La ETV incluye principalmente la embolia de pulmón (EP) y la trombosis venosa profunda (TVP). La etiopatogenia de la ETV está relacionada con la tríada de Virchow (estasis venosa, daño o disfunción endotelial y estados de hipercoagulabilidad), participando el sistema de hemostasia y el sistema inmunitario (inmunotrombosis). La ETV continúa siendo, actualmente, un reto diagnóstico para el clínico. El diagnóstico de la ETV se basa en tres pilares: la probabilidad clínica pretest (PCP), la determinación de valores de dímero D y la realización de una prueba de imagen solo en aquellos casos en los que la PCP sea probable y/o presenten valores de dímero D elevados. El tratamiento anticoagulante es la piedra angular del tratamiento de la ETV y podemos dividirlo en tres fases: la fase aguda (los primeros 5-10 días), la fase de mantenimiento (los primeros 3-6 meses) y la fase extendida (o crónica) a partir del sexto mes. Su objetivo es prevenir la mortalidad precoz y la recurrencia de ETV, evaluando periódicamente el riesgo hemorrágico.

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Fuente de los datos: Dialnet