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Fibrinolysis for Pulmonary Embolism

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Antithrombotic Drug Therapy in Cardiovascular Disease

Part of the book series: Contemporary Cardiology ((CONCARD))

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Abstract

Morbidity and mortality associated with pulmonary embolism (PE) remain high despite important advances in cardiovascular diagnosis and treatment. It is generally estimated that 10% of all patients with PE die during the acute phase of the disease. Overall, 1% of patients admitted to the hospital die of acute PE, and 10% of all hospital deaths are PE-related. Fibrinolytic therapy remains the treatment of choice for those patients at the highest risk of mortality without obvious contraindications. While a consensus opinion exists regarding the management of patients with PE and associated hypotension, controversy surrounds the use of fibrinolysis for the management of normotensive patients with non-massive PE. There is increasing awareness of the need for risk stratification of normotensive patients and the search for an intermediate-risk group. The use of imaging methods to assess for right ventricular dysfunction and the use of cardiac biomarkers may identify the patient with non-massive PE who will benefit from fibrinolysis. Ongoing investigation will hopefully facilitate further risk stratification of patients with PE in order to provide them with optimal therapies which will improve their overall outcome.

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Authors and Affiliations

  1. Department of Cardiology and Pulmonary Medicine, Georg August University of Goettingen, Goettingen, Germany

    Stavros V. Konstantinides MD

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  1. Stavros V. Konstantinides MD
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Editors and Affiliations

  1. Western Reserve Heart Care, Corporate Dr. 1335, Hudson, 44236, U.S.A.

    Arman T. Askari

  2. Dept. Cardiovascular Medicine, Cleveland Clinic, Euclid Ave. 9500, Cleveland, 44195, U.S.A.

    A. Michael Lincoff

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Konstantinides, S.V. (2010). Fibrinolysis for Pulmonary Embolism. In: Askari, A., Lincoff, A. (eds) Antithrombotic Drug Therapy in Cardiovascular Disease. Contemporary Cardiology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-60327-235-3_18

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  • DOI: https://doi.org/10.1007/978-1-60327-235-3_18

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