scholarly journals Escore de Wells e Tromboembolismo pulmonar em pacientes com COVID-19 na residência de clínica médica: Um relato de experiência / Wells Score and pulmonary Thromboembolism in patients with COVID-19 in the medical clinic residence: An experience report

2021 ◽  
Vol 7 (12) ◽  
pp. 119349-119355
Author(s):  
Rafael Felipe Carvalho Canuto ◽  
Thiago dos Santos Vieira
2014 ◽  
Vol 2 (8) ◽  
pp. 21 ◽  
Author(s):  
Ebtesam Islam ◽  
Victor J. Test

This paper reviews the most current literature on the diagnosis of pulmonary thromboembolism.  The epidemiology and symptomology of this disorder, including common symptoms such as fever, chest pain, dyspnea, edema, and syncope, are reviewed.  The utility of basic and easily available testing, such as electrocardiography and chest radiography, is evaluated. The literature on determining the pretest probability of venous thromboembolism with scoring systems, such as the Wells Score, the Geneva Scoring System, and the Pulmonary Embolism Rule Out Criteria, is appraised.  As the evaluation of pulmonary embolism has evolved, multiple imaging techniques has been developed and studied.  Ultrasonography, computed tomography with angiography, magnetic resonance angiography, ventilation perfusion lung scanning, and SPECT ventilation-perfusion lung imaging are discussed.  In conclusion, the diagnosis of pulmonary embolism remains complicated.  Clinical suspicion and stratification should guide a diagnostic strategy for the comprehensive evaluation and diagnosis of patients with this disorder.


2020 ◽  
Vol 58 (3) ◽  
pp. 385-390
Author(s):  
Michele Domenico Spampinato ◽  
Simone Bucci ◽  
Maria Teresa Migliano ◽  
Maria Adelina Ricciardelli ◽  
Andrea Strada ◽  
...  

2020 ◽  
Vol 93 (1113) ◽  
pp. 20200407
Author(s):  
Lorenzo Monfardini ◽  
Mauro Morassi ◽  
Paolo Botti ◽  
Roberto Stellini ◽  
Luca Bettari ◽  
...  

Objectives: To present a single-centre experience on CT pulmonary angiography (CTPA) for the assessment of hospitalised COVID-19 patients with moderate-to-high risk of pulmonary thromboembolism (PTE). Methods: We analysed consecutive COVID-19 patients (RT-PCR confirmed) undergoing CTPA in March 2020 for PTE clinical suspicion. Clinical data were retrieved. Two experienced radiologists reviewed CTPAs to assess pulmonary parenchyma and vascular findings. Results: Among 34 patients who underwent CTPA, 26 had PTE (76%, 20 males, median age 61 years, interquartile range 54–70), 20/26 (77%) with comorbidities (mainly hypertension, 44%), and 8 (31%) subsequently dying. Eight PTE patients were under thromboprophylaxis with low-molecular-weight heparin, four PTE patients had lower-limbs deep vein thrombosis at ultrasound examination (performed in 33/34 patients). Bilateral PTE characterised 19/26 cases, with main branches involved in 10/26 cases. Twelve patients had a parenchymal involvement >75%, the predominant pneumonia pattern being consolidation in 10/26 patients, ground glass opacities in 9/26, crazy paving in 5/26, and both ground glass opacities and consolidation in 2/26. Conclusion: COVID-19 patients are prone to PTE. Advances in knowledge: PTE, potentially attributable to an underlying thrombophilic status, may be more frequent than expected in COVID-19 patients. Extension of prophylaxis and adaptation of diagnostic criteria should be considered.


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