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Lungenembolie und akutes Cor pulmonale

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Klinische Kardiologie
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Zusammenfassung

Die Lungenembolie ist als meist thrombembolisch bedingte Verlegung einer oder mehrerer Pulmonalarterien mit der Folge einer plötzlich einsetzenden Gasaustauschstörung und einer akuten Druckbelastung des rechten Ventrikels definiert. Steigt der systolische Druck in der A. pulmonalis auf über 30 mmHg oder der Mitteldruck auf über 20 mmHg an, so spricht man vom akuten Cor pulmonale.

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Literatur

  • Beasley R, Raymond N, Hill S et al. (2003) eThrombosis: the 21st century variant of venous thromboembolism associated with immobility. Eur Respir J 21: 374–376

    Article  PubMed  CAS  Google Scholar 

  • Belle A van, Buller HR, Huisman MV et al. for the Christopher Study Investigators (2006) Effectiveness of managing suspected pulmonary embolism using an algorithm combining clinical probability, D-dimer testing, and computed tomography. JAMA 295: 172–179

    Google Scholar 

  • Buller HR, Davidson BL, Decousus H et al. (2003) Subcutaneous fondaparinux versus intravenous unfractionated heparin in the initial treatment of pulmonary embolism. N Engl J Med 349: 1695–1702

    Article  PubMed  CAS  Google Scholar 

  • Buller HR, on behalf on the EINSTEIN Investigators (2009) Once daily oral rivaroxaban versus placebo in the treatment of recurrent symptomatic venous thromboembolism. The Einstein Extension Study (Abstract). American Society of Hematology 2009 Meeting, 8.12.2009, New Orleans, LA

    Google Scholar 

  • Cohen AT, Tapson VF, Bergmann JF et al. (2008) Venous thromboembolism risk and prophylaxis in the acute hospital care setting (ENDORSE study): a multinational cross-sectional study. Lancet 371: 387–394

    Article  PubMed  Google Scholar 

  • Daniel KR, Courtney DM, Kline JA (2001) Assessment of cardiac stress from massive pulmonary embolism with 12-lead ECG. Chest 120: 474–481

    Article  PubMed  CAS  Google Scholar 

  • Decousus H, Leizorovicz A, Parent F et al. (1998) A clinical trial of vena caval filters in the prevention of pulmonary embolism in patients with proximal deep-vein thrombosis. N Engl J Med 338: 409–415

    Article  PubMed  CAS  Google Scholar 

  • Eriksson BI, Kakkar AK, Turpie AG et al. (2009) Oral rivaroxaban fort he prevention of symptomatic venous thromboembolism after elective hip and knee replacement. J Bone Joint Surg Br 91: 636–644

    Article  PubMed  CAS  Google Scholar 

  • Francis CW (2007) Clinical practice. Prophylaxis for thromboembolism in hospitalized medical patients. N Engl J Med 356: 1438–1444

    Article  PubMed  CAS  Google Scholar 

  • Geibel A, Zehender M, Kasper W et al. (2005) Prognostic value of the ECG on admission in patients with acute major pulmonary embolism. Eur Respir J 25: 843–848

    Article  PubMed  CAS  Google Scholar 

  • Goldhaber SZ, Visani L, De Rosa M (1999) Acute pulmonary embolism: clinical outcomes in the International Cooperative Pulmonary Embolism Registry (ICOPER). Lancet 353: 1386–1389

    Article  PubMed  CAS  Google Scholar 

  • Grady D, Wenger NK, Herrington D et al. (2000) Postmenopausal hormone therapy increases risk for venous thromboembolic disease. The Heart and Estrogen/progestin Replacement Study. Ann Intern Med 132: 689–696

    PubMed  CAS  Google Scholar 

  • Hull R, Hirsh J, Jay R et al. (1982) Different intensities of oral anticoagulant therapy in the treatment of proximal-vein thrombosis. N Engl J Med 307:1676–1681

    Article  PubMed  CAS  Google Scholar 

  • Interdisziplinäre S2-Leitlinie (2005) Diagnostik und Therapie der Bein- und Beckenvenenthrombose und der Lungenembolie. Vasa 34(S66): 15– 24

    Google Scholar 

  • Jerjes-Sanchez C, Ramirez-Rivera A, Lourdes Garcia M de (1995) Streptokinase and heparin vs. heparin alone in massive pulmonary embolism: a randomized controlled trial. J Thromb Thrombolysis 2: 227–229

    PubMed  CAS  Google Scholar 

  • Kasper W, Konstantinides S, Geibel A et al. (1997) Management strategies and determinants of outcome in acute major pulmonary embolism: results of a multicenter registry. J Am Coll Cardiol 30: 1165–1171

    Article  PubMed  CAS  Google Scholar 

  • Kniffin WD, Baron JA, Barett J et al. (1994) The epidemiology of diagnosed pulmonary embolism and deep venous thrombosis in the elderly. Arch Intern Med 154:861–866

    Article  PubMed  Google Scholar 

  • Konstantinidis S, Geibel A, Olschewski M et al. (1997) Association between thrombolytic treatment and the prognosis of hemodynamically stable patients with major pulmonary embolism: results of a multicenter registry. Circulation 96: 882–888

    Google Scholar 

  • Lapostolle F, Surget V, Borron SW et al. (2001) Severe pulmonary embolism associated with air travel. N Engl J Med 345: 779–783

    Article  PubMed  CAS  Google Scholar 

  • Meaney JF, Weg JG, Chenevert TL et al. (1997) Diagnosis of pulmonary embolism with magnetic resonance angiography. N Engl J Med 336: 1422–1427

    Article  PubMed  CAS  Google Scholar 

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

    PubMed  CAS  Google Scholar 

  • Nordstrom M, Lindblad B (1998) Autopsy-verified venous thromboembolism within a defined urban population – the city of Malmo, Sweden. APMIS 106: 378–384

    Article  PubMed  CAS  Google Scholar 

  • Oger E (2000) Incidence of venous thromboembolism: a community-based study in Western France. EPI-GPTBP Study Group. Groupe d'Etude de la Thrombose de Bretagne Occidentale. Thromb Haemost 83: 657– 660

    PubMed  CAS  Google Scholar 

  • Oudkerk M, Beek EJ van, Wielopolski P et al. (2002) Comparison of contrastenhanced magnetic resonance angiography and conventional pulmonary angiography for the diagnosis of pulmonary embolism: a prospective study. Lancet 359: 1643–1647

    Article  PubMed  Google Scholar 

  • Parkin L, Skegg DC, Wilson M et al. (2000) Oral contraceptives and fatal pulmonary embolism. Lancet 355: 2133–2134

    Article  PubMed  CAS  Google Scholar 

  • Pengo V, Lensing AW, Prins MH et al. (2004) Incidence of chronic thromboembolic pulmonary hypertension after pulmonary embolism. N Engl J Med 350: 2257–2264

    Article  PubMed  CAS  Google Scholar 

  • Perrier A, Desmarais S, Miron MJ et al. (1999) Non-invasive diagnosis of venous thromboembolism in outpatients. Lancet 353: 190–195

    Article  PubMed  CAS  Google Scholar 

  • 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: 2753–2759

    Google Scholar 

  • Quinlan DJ, McQuillan A, Eikelboom JW (2004) Low-molecular-weight heparin compared with intravenous unfractionated heparin for treatment of pulmonary embolism: a meta-analysis of randomized, controlled trials. Ann Intern Med 140: 175–183

    PubMed  CAS  Google Scholar 

  • Raschke RA, Reilly BM, Guidry JR et al. (1993) The weight-based heparin dosing nomogram compared with a »standard care« nomogram. A randomized controlled trial. Ann Intern Med 119: 874–881

    PubMed  CAS  Google Scholar 

  • Rosendaal FR, Koster T, Vandenbroucke JP, Reitsma PH (1995) High risk of thrombosis in patients homozygous for factor V Leiden (activated protein C resistance). Blood 85: 1504–1508

    PubMed  CAS  Google Scholar 

  • Rosendaal FR, Helmerhorst FM, Vandenbroucke JP (2002) Female hormones and thrombosis. Arterioscler Thromb Vasc Biol 22: 201–210

    Article  PubMed  CAS  Google Scholar 

  • Rosenkranz S (2007) Pulmonary hypertension: current diagnosis and treatment. Clin Res Cardiol 96: 527–541

    Article  PubMed  CAS  Google Scholar 

  • Rossouw JE, Anderson GL, Prentice RL et al. (2002) Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women's Health Initiative randomized controlled trial. JAMA 288: 321–333

    Article  PubMed  CAS  Google Scholar 

  • Schulman S, Rhedin AS, Lindmarker P et al. (1995) A comparison of six weeks with six months of oral anticoagulant therapy after a first episode of venous thromboembolism. Duration of Anticoagulation Trial Study Group. N Engl J Med 332:1661–1665

    Article  PubMed  CAS  Google Scholar 

  • Schulman S, Kearon C, Kakkar AK et al., for the RECOVER Study Group (2009) Dabigatran versus warfarin in the treatment of acute venous embolism. N Engl J Med 361: 2342–2352

    Google Scholar 

  • Scridon T, Scridon C, Skali H et al. (2005) Prognostic significance of troponin elevation and right ventricular enlargement in acute pulmonary embolism. Am J Cardiol 96: 303–305

    Article  PubMed  CAS  Google Scholar 

  • Silverstein MD, Heit JA, Mohr DN et al. (1998) Trends in the incidence of deep vein thrombosis and pulmonary embolism: a 25-year population- based study. Arch Intern Med 158: 585–593

    Article  PubMed  CAS  Google Scholar 

  • Stein PD, Henry JW (1995) Prevalence of acute pulmonary embolism among patients in a general hospital and at autopsy. Chest 108: 978–981

    Article  PubMed  CAS  Google Scholar 

  • Stein PD, Terrin ML, Hales CA et al. (1991) Clinical, laboratory, roentgenographic, and electrocardiographic findings in patients with acute pulmonary embolism and no pre-existing cardiac or pulmonary disease. Chest 100: 598–603

    Article  PubMed  CAS  Google Scholar 

  • Stein PD, Hull RD, Patel KC (2004) D-dimer for the exclusion of acute venous thrombosis and pulmonary embolism: a systematic review. Ann Intern Med 140: 589–602

    PubMed  Google Scholar 

  • Stein PD, Beemath A, Olson RE (2005) Trends in the incidence of pulmonary embolism and deep venous thrombosis in hospitalized patients. Am J Cardiol 95: 1525–1526

    Article  PubMed  Google Scholar 

  • Stein PD, Fowler SE, Goodman LR et al. PIOPED II Investigators (2006) Multidetector computed tomography Enr acute pulmonary embolism. N Engl J Med 354: 2317–2327

    Google Scholar 

  • Tapson VF (2008) Acute pulmonary embolism. N Engl J Med 358: 1037– 1052

    Article  PubMed  CAS  Google Scholar 

  • Torbicki A, Perrier A, Konstantinides S et al.(2008) Guidelines on the diagnosis and management of acute pulmonary embolism. Eur Heart J 29: 2276–2315

    Article  PubMed  CAS  Google Scholar 

  • Turpie AG, Lassen MR, Davidson BL et al. (2009) Rivaroxaban versus enoxaparin for thromboprophylaxis after total knee arthroplasty (RECORD4): a randomized trial. Lancet 373: 1673–1680

    Article  PubMed  CAS  Google Scholar 

  • Virchow R (1862) Gesammelte Abhandlungen zur Wissenschaftlichen Medizin, Bd IV: Thrombose und Embolie. G-Hamm-Grotesche Buchhandlung, Berlin, S 219

    Google Scholar 

  • Wan S, Quinlan DJ, Agnelli G, Eikelboom JW (2004) Thrombolysis compared with heparin for the initial treatment of pulmonary embolism: a metaanalysis of the randomized controlled trials. Circulation 110: 744– 749

    Article  PubMed  CAS  Google Scholar 

  • Wells PS, Anderson DR, Rodger M et al. (2000) Derivation of a simple clinical model to categorize patients probability of pulmonary embolism: increasing the models utility with the SimpliRED D-dimer. Thromb Haemost 83: 416–420

    PubMed  CAS  Google Scholar 

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Rosenkranz, S. (2011). Lungenembolie und akutes Cor pulmonale. In: Erdmann, E. (eds) Klinische Kardiologie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-16481-1_10

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  • DOI: https://doi.org/10.1007/978-3-642-16481-1_10

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-16480-4

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