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| __NOTOC__
| | #Redirect [[Pulmonary embolism natural history, complications and prognosis]] |
| {{Pulmonary embolism}}
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| '''Editor(s)-In-Chief:''' {{ATI}}, [[C. Michael Gibson, M.S., M.D.]] [mailto:charlesmichaelgibson@gmail.com]; {{AE}} {{CZ}}
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| ==Recurrence==
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| The PESI and Geneva prediction rules can estimate mortality. They may guide the selection of patients who can be considered for outpatient therapy.<ref name="pmid17625081">{{cite journal |author=Jiménez D, Yusen RD, Otero R, ''et al'' |title=Prognostic models for selecting patients with acute pulmonary embolism for initial outpatient therapy |journal=Chest |volume=132 |issue=1 |pages=24-30 |year=2007 |pmid=17625081 |doi=10.1378/chest.06-2921}}</ref> Right ventricular dysfunction on echocardiography, and higher than normal concentrations of [[troponin]], identify high risk patients who might need escalation of therapy with thrombolysis or embolectomy even if the blood pressure is normal on presentation.
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| After a first PE, the search for secondary causes is usually brief. Only when a second PE occurs, and especially when this happens while still under [[anticoagulant]] therapy, a further search for underlying conditions is undertaken. This will include testing ("thrombophilia screen") for Factor V Leiden mutation, antiphospholipid antibodies, protein C and S, [[antithrombin]] levels, and later prothrombin mutation, MTHFR mutation, Factor VIII concentration and rarer inherited [[coagulation]] abnormalities.
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| When patients are admitted to medical wards or when patients undergo surgery, their physicians should prescribe prophylactic measures to prevent PE. After being discharged from the hospital, prophylaxis should continue for about a month, especially patients at high risk for a [[thromboembolism]].
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| ==References==
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| {{reflist|2}}
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| [[Category:Needs overview]]
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| [[Category:Hematology]]
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| [[Category:Pulmonology]]
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| [[Category:Cardiology]]
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| [[Category:Emergency medicine]]
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| [[Category:Intensive care medicine]]
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| {{WH}}
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| {{WS}}
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