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Venöse Thromboembolie (VTE): Klinik und Diagnose

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DGIM Innere Medizin

Part of the book series: Springer Reference Medizin ((SRM))

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Zusammenfassung

Der Begriff der venösen Thrombembolie umfasst die Krankheitsentitäten der tiefen Venenthrombose und der Lungenarterienembolie, die zwei unterschiedliche Seiten des gleichen pathophysiologischen Geschehens darstellen. Die klinische Präsentation von Lungenarterienembolie und tiefer Beinvenenthrombose ist dabei sehr variabel und oftmals unspezifisch, was die Diagnosestellung erschweren kann. Für beide Krankheitsbilder haben sich diagnostische Algorithmen etabliert, die ein rationelles Vorgehen ermöglichen. Dabei steht am Anfang die Vortestwahrscheinlichkeit, ein wichtiges Konzept zur Verbesserung der Aussagekraft der nachfolgenden Diagnostik.

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Literatur

  • Agnelli G, Becattini C (2010) Acute pulmonary embolism. N Engl J Med 363(3):266–274

    Article  CAS  PubMed  Google Scholar 

  • Bauersachs RM (2012) Venous thromboembolism: advances and controversies clinical presentation of deep vein thrombosis and pulmonary embolism. Best Pract Res Clin Haematol 25:1–9

    Article  Google Scholar 

  • Bauersachs R, Evers EJ (2011) Differential diagnoses in out-patients presenting with suspected deep vein thrombosis, Personal communication

    Google Scholar 

  • Becattini C et al (2011) Multidetector computed tomography for acute pulmonary embolism: diagnosis and risk stratification in a single test. Eur Heart J 32(13):1657–1663

    Article  PubMed  Google Scholar 

  • Ceriani E et al (2010) Clinical prediction rules for pulmonary embolism: a systematic review and meta-analysis. J Thromb Haemost 8(5):957–970

    CAS  PubMed  Google Scholar 

  • Cogo A et al (1998) Compression ultrasonography for diagnostic management of patients with clinically suspected deep vein thrombosis: prospective cohort study. BMJ 316(7124):17–20

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Flanc C et al (1968) The detection of venous thrombosis of the legs using 125-I-labelled fibrinogen. Br J Surg 55(10):742–747

    Article  CAS  PubMed  Google Scholar 

  • Goldhaber S (2008) Deep venous thrombosis and pulmonary thromboembolism. In: Harrison’s principles of internal medicine. Mac Graw Hill Medical, New York/Chicago/San Francisco, 17

    Google Scholar 

  • Grifoni S et al (2000) Short-term clinical outcome of patients with acute pulmonary embolism, normal blood pressure, and echocardiographic right ventricular dysfunction. Circulation 101(24):2817–2822

    Article  CAS  PubMed  Google Scholar 

  • Hach-Wunderle V et al (2010) Interdisziplinäre S2: Leitlinie: Diagnostik und Therapie der Bein- und Beckenvenenthrombose und der Lungenembolie. Vasa 39(Suppl 78):3–24

    Google Scholar 

  • Haeger K (1969) Problems of acute deep venous thrombosis. I. The interpretation of signs and symptoms. Angiology 20(4):219–223

    Article  CAS  PubMed  Google Scholar 

  • Hamadah A et al (2011) Baseline imaging after therapy for unprovoked venous thromboembolism: a randomized controlled comparison of baseline imaging for diagnosis of suspected recurrence. J Thromb Haemost 9(12):2406–2410

    Article  CAS  PubMed  Google Scholar 

  • Huisman MV, Klok FA (2013) Diagnostic management of acute deep vein thrombosis and pulmonary embolism. J Thromb Haemost 11(3):412–422

    Article  CAS  PubMed  Google Scholar 

  • Kasper W et al (1997) Prognostic significance of right ventricular afterload stress detected by echocardiography in patients with clinically suspected pulmonary embolism. Heart 77(4):346–349

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Kearon C et al (2001) Management of suspected deep venous thrombosis in outpatients by using clinical assessment and D-dimer testing. Ann Intern Med 135(2):108–111

    Article  CAS  PubMed  Google Scholar 

  • Konstantinides S et al (2014) 2014 ESC guidelines on the diagnosis and management of acute pulmonary embolism. Kardiol Pol 72(11):997–1053

    Article  PubMed  Google Scholar 

  • Kruip MJ et al (2003) Diagnostic strategies for excluding pulmonary embolism in clinical outcome studies. A systematic review. Ann Intern Med 138(12):941–951

    Article  PubMed  Google Scholar 

  • Lualdi JC, Goldhaber SZ (1995) Right ventricular dysfunction after acute pulmonary embolism: pathophysiologic factors, detection, and therapeutic implications. Am Heart J 130(6):1276–1282

    Article  CAS  PubMed  Google Scholar 

  • Miniati M et al (1999) Accuracy of clinical assessment in the diagnosis of pulmonary embolism. Am J Respir Crit Care Med 159(3):864–871

    Article  CAS  PubMed  Google Scholar 

  • Perrier A et al (2005) Multidetector-row computed tomography in suspected pulmonary embolism. N Engl J Med 352(17):1760–1768

    Article  CAS  PubMed  Google Scholar 

  • Remy-Jardin M et al (2007) Management of suspected acute pulmonary embolism in the era of CT angiography: a statement from the Fleischner Society. Radiology 245(2):315–329

    Article  PubMed  Google Scholar 

  • Sampson FC et al (2007) The accuracy of MRI in diagnosis of suspected deep vein thrombosis: systematic review and meta-analysis. Eur Radiol 17(1):175–181

    Article  PubMed  Google Scholar 

  • Schellong SM, Eichinger S (2013) Rezidivthrombose. Hamostaseologie 33(3):191

    Article  PubMed  Google Scholar 

  • Schouten HJ, Geersing GJ, Koek HL, Zuithoff NP, Janssen KJ, Douma RA, van Delden JJ, Moons KG, Reitsma JB (2013) Diagnostic accuracy of conventional or age adjusted D-dimer cut-off values in older patients with suspected venous thromboembolism: systematic review and meta-analysis. BMJ 3:346:f2492

    Google Scholar 

  • Sostman HD et al (2008) Sensitivity and specificity of perfusion scintigraphy combined with chest radiography for acute pulmonary embolism in PIOPED II. J Nucl Med 49(11):1741–1748

    Article  PubMed  Google Scholar 

  • Stein PD, Henry JW (1997) Clinical characteristics of patients with acute pulmonary embolism stratified according to their presenting syndromes. Chest 112(4):974–979

    Article  CAS  PubMed  Google Scholar 

  • Stein PD et al (1996) Arterial blood gas analysis in the assessment of suspected acute pulmonary embolism. Chest 109(1):78–81

    Article  CAS  PubMed  Google Scholar 

  • Stein PD et al (2007) Clinical characteristics of patients with acute pulmonary embolism: data from PIOPED II. Am J Med 120(10):871–879

    Article  PubMed Central  PubMed  Google Scholar 

  • The PIOPED Investigators (1990) Value of the ventilation/perfusion scan in acute pulmonary embolism. Results of the prospective investigation of pulmonary embolism diagnosis (PIOPED). JAMA 263(20):2753–2759

    Article  Google Scholar 

  • Thomas SM et al (2008) Diagnostic value of CT for deep vein thrombosis: results of a systematic review and meta-analysis. Clin Radiol 63(3):299–304

    Article  CAS  PubMed  Google Scholar 

  • Torbicki A et al (2008) Guidelines on the diagnosis and management of acute pulmonary embolism: the Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC). Eur Heart J 29(18):2276–2315

    Article  CAS  PubMed  Google Scholar 

  • van Belle A et al (2006) Effectiveness of managing suspected pulmonary embolism using an algorithm combining clinical probability, D-dimer testing, and computed tomography. JAMA 295(2):172–179

    Article  PubMed  Google Scholar 

  • Wells PS et al (1995) Accuracy of clinical assessment of deep-vein thrombosis. Lancet 345(8961):1326–1330

    Article  CAS  PubMed  Google Scholar 

  • Wells PS et al (2001) Excluding pulmonary embolism at the bedside without diagnostic imaging: management of patients with suspected pulmonary embolism presenting to the emergency department by using a simple clinical model and d-dimer. Ann Intern Med 135(2):98–107

    Article  CAS  PubMed  Google Scholar 

  • Wells PS et al (2003) Evaluation of D-dimer in the diagnosis of suspected deep-vein thrombosis. N Engl J Med 349(13):1227–1235

    Article  CAS  PubMed  Google Scholar 

  • Wicki J et al (2001) Assessing clinical probability of pulmonary embolism in the emergency ward: a simple score. Arch Intern Med 161(1):92–97

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Klinikum Darmstadt, Medizinische Klinik IV – Max-Ratschow-Klinik für Angiologie, Grafenstr. 9, 64283, Darmstadt, Deutschland

    Bernd Krabbe

  2. Gefäßzentrum, Klinikum Darmstadt, Medizinische Klinik IV, Max-Ratschow-Klinik für Angiologie, Grafenstr. 9, 64283, Darmstadt, Deutschland

    Rupert M. Bauersachs

Authors
  1. Bernd Krabbe
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  2. Rupert M. Bauersachs
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Corresponding author

Correspondence to Bernd Krabbe .

Editor information

Editors and Affiliations

  1. Medizinische Klinik I, Universitätsklinikum Schleswig-Hoslstein, Campus Lübeck, Lübeck, Schleswig-Holstein, Germany

    Hendrik Lehnert

  2. TU Dresden Universitätsklinikum Carl Gustav Carus, Dresden, Germany

    Sebastian M. Schellong

  3. FB Gastroenterologie und Hepatologie, Universitätsklinikum Leipzig Medizinische Klinik und Poliklinik II, Leipzig, Sachsen, Germany

    Joachim Mössner

  4. Krankenhaus Barmherzige Brüder, Regensburg, Germany

    Cornel C. Sieber

  5. Nürnberg, Bayern, Germany

    Walter Swoboda

  6. Universitätsklinikum Giessen und Marburg Klinik für Innere Medizin, Marburg, Hessen, Germany

    Andreas Neubauer

  7. Interdisziplinärer Schwerpunkt für Hämos, Universitätsklinikum Gießen und Marburg, Gießen, Germany

    Bettina Kemkes-Matthes

  8. Klinik für Gastroenterologie,Hepatologie, Medizinische Hochschule Hannover, Hannover, Germany

    Michael P. Manns

  9. Sektion für Molekulare und Klinische Inf, Universitätsklinikum Schleswig-Holstein,, Lübeck, Germany

    Jan Rupp

  10. Abt. Kardiologie und Pneumologie, Universitätsklinikum Göttingen Herzzentrum Göttingen, Göttingen, Germany

    Gerd Hasenfuß

  11. Abt. Nephrologie und Klinische Immunologie, Univ.Klinikum Aachen Medizinische Klinik II, Aachen, Germany

    J. Floege

  12. Universitätsklinikum Köln Klinik I für Innere Medizin, Köln, Germany

    Michael Hallek

  13. Klinik für Pneumologie, Medizinische Hochschule Hannover (MHH) Zentrum Innere Medizin, Hannover, Germany

    Tobias Welte

  14. Klinik u. Poliklinik für Innere Medizin, Universitätsmedizin Greifswald, Greifswald, Germany

    Markus Lerch

  15. Dr.-Horst-Schmidt-Kliniken GmbH, Wiesbaden, Germany

    Elisabeth Märker-Hermann

  16. Klinische Toxikologie, Giftinformation, Universitätsklinikum Mainz II. Medizinische Klinik und Poliklinik, Mainz, Germany

    Ludwig Sacha Weilemann

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Krabbe, B., Bauersachs, R.M. (2015). Venöse Thromboembolie (VTE): Klinik und Diagnose. In: Lehnert, H., et al. DGIM Innere Medizin. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-54676-1_349-1

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  • DOI: https://doi.org/10.1007/978-3-642-54676-1_349-1

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Online ISBN: 978-3-642-54676-1

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