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Embolia pulmonar asintomática frecuente en pacientes con trombosis venosa profunda
K M Moser1, P F Fedullo, J K LitteJohn
1Department of Medicine, University of California, School of Medicine, San Diego.
JAMA
|January 19, 1994
Resumen
Casi el 40% de los pacientes con trombosis venosa profunda sin síntomas tenían embolia pulmonar. Esto pone de relieve que el tromboembolismo venoso es una condición única, lo que subraya la necesidad de un diagnóstico y tratamiento integral.
Área de la Ciencia:
- Cardiología Cardiología.
- Pulmonología Pulmonología.
- La medicina vascular es una medicina vascular.
Sus antecedentes:
- La trombosis venosa profunda (TVP) y la embolia pulmonar (EP) son manifestaciones del tromboembolismo venoso (TEV).
- La frecuencia de la EP asintomática en pacientes diagnosticados con TVP no está bien establecida.
- Comprender la relación entre la TVP y la EP es crucial para un manejo eficaz de los pacientes.
Objetivo del estudio:
- Para determinar la incidencia de embolia pulmonar (EP) en pacientes ingresados para el tratamiento de la trombosis venosa profunda (TVP).
- Investigar la relación entre la TVP y la EP asintomática.
Principales métodos:
- Un estudio abierto, multicéntrico y de dosis variadas que involucró a cinco hospitales de atención terciaria.
- Los pacientes con TVP o EP confirmada se sometieron a imágenes de diagnóstico (venogramas, angiogramas pulmonares, exploraciones pulmonares, roentgenogramas de tórax) antes y después del tratamiento.
- Todos los pacientes recibieron activador de plasminógeno de tipo tisular seguido de terapia con heparina.
Principales resultados:
- Casi el 40% de los pacientes con TVP y sin síntomas de EP mostraron evidencia de embolia pulmonar en las exploraciones de ventilación y perfusión y en las radiografías de tórax.
- Estos hallazgos se basaron en los resultados de exploración de alta probabilidad, lo que sugiere una incidencia mínima.
Conclusiones:
- La alta frecuencia de EP asintomática en pacientes con TVP indica que el tromboembolismo venoso debe ser visto como un solo proceso de enfermedad.
- Estos resultados enfatizan la importancia de considerar la EP en todos los pacientes con TVP, incluso en aquellos sin síntomas evidentes.
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