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Pulmonary Thromboembolism and Deep-Vein Thrombosis

Pulmonary Thromboembolism and Deep-Vein Thrombosis is a topic covered in the Harrison's Manual of Medicine.

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DEFINITION AND NATURAL HISTORY

Venous thromboembolism includes both deep-vein thrombosis (DVT) and pulmonary thromboembolism (PE). DVT results from blood clot formation within large veins, usually in the legs. PE results from DVTs that have broken off and traveled to the pulmonary arterial circulation. Isolated calf vein thrombi have much lower risk of PE. Although DVTs are typically related to thrombus formation in the legs and/or pelvis, indwelling venous catheters, pacemakers, and internal cardiac defibrillators have increased the occurrence of upper extremity DVT. In the absence of PE, the major complication of DVT is postthrombotic syndrome, which causes chronic leg swelling and discomfort due to damage to the venous valves of the affected leg. In its most severe form, postthrombotic syndrome causes skin ulceration. PE is often fatal, usually due to progressive right ventricular failure. Chronic thromboembolic pulmonary hypertension is another long-term complication of PE.

Some genetic risk factors, including factor V Leiden and the prothrombin G20210A mutation, have been identified, but they account for only a minority of venous thromboembolic disease. Medical conditions that increase the risk of venous thromboembolism include cancer and antiphospholipid antibody syndrome. A variety of other risk factors have been identified, including immobilization during prolonged travel, obesity, smoking, surgery, trauma, pregnancy, oral contraceptives, and postmenopausal hormone replacement.

Massive PE, with thrombosis affecting at least half of the pulmonary vasculature, often includes dyspnea, syncope, hypotension, and cyanosis. Submassive PE includes RV dysfunction in the setting of normal systemic arterial pressure. Low-risk PE, which includes normal RV function and systemic arterial pressure, has an excellent prognosis.

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Citation

Loscalzo, Joseph, et al., editors. "Pulmonary Thromboembolism and Deep-Vein Thrombosis." Harrison's Manual of Medicine, 19th ed., McGraw Hill Inc., 2017. harrisons.unboundmedicine.com/harrisons/view/Harrisons-Manual-of-Medicine/623049/all/Pulmonary_Thromboembolism_and_Deep_Vein_Thrombosis.
Pulmonary Thromboembolism and Deep-Vein Thrombosis. In: Loscalzo J, Jameson JL, Longo DL, et al, eds. Harrison's Manual of Medicine. 19th ed. McGraw Hill Inc.; 2017. https://harrisons.unboundmedicine.com/harrisons/view/Harrisons-Manual-of-Medicine/623049/all/Pulmonary_Thromboembolism_and_Deep_Vein_Thrombosis. Accessed April 23, 2019.
Pulmonary Thromboembolism and Deep-Vein Thrombosis. (2017). In Loscalzo, J., Jameson, J. L., Longo, D. L., Hauser, S. L., Fauci, A. S., & Kasper, D. L. (Eds.), Harrison's Manual of Medicine. Available from https://harrisons.unboundmedicine.com/harrisons/view/Harrisons-Manual-of-Medicine/623049/all/Pulmonary_Thromboembolism_and_Deep_Vein_Thrombosis
Pulmonary Thromboembolism and Deep-Vein Thrombosis [Internet]. In: Loscalzo J, Jameson JL, Longo DL, Hauser SL, Fauci AS, Kasper DL, editors. Harrison's Manual of Medicine. McGraw Hill Inc.; 2017. [cited 2019 April 23]. Available from: https://harrisons.unboundmedicine.com/harrisons/view/Harrisons-Manual-of-Medicine/623049/all/Pulmonary_Thromboembolism_and_Deep_Vein_Thrombosis.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Pulmonary Thromboembolism and Deep-Vein Thrombosis ID - 623049 ED - Loscalzo,Joseph, ED - Jameson,J Larry, ED - Longo,Dan L, ED - Hauser,Stephen L, ED - Fauci,Anthony S, ED - Kasper,Dennis L, BT - Harrison's Manual of Medicine UR - https://harrisons.unboundmedicine.com/harrisons/view/Harrisons-Manual-of-Medicine/623049/all/Pulmonary_Thromboembolism_and_Deep_Vein_Thrombosis PB - McGraw Hill Inc. ET - 19 DB - Harrison's Manual of Medicine DP - Unbound Medicine ER -