Pulmonary Thromboembolism — Update
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Excerpt
To the Editor.— The article by Viamonte et al, entitled "Pulmonary Thromboembolism—Update" (243:2229, 1980), provides an excellent approach to the diagnosis of pulmonary thromboembolism (PTE). In their brief discussion of treatment, however, the authors advise that anticoagulation for acute PTE "may be unnecessary in patients with minimal PTE who have impaired ventilation, no antecedent pulmonary parenchymal disease, a normal heart, and no peripheral venopathy."
This statement suggests that some patients may not be at risk for repeated PTE. The authors did not elaborate on the distinguishing characteristics of this group, nor did they speculate on the source of embolism in persons without evidence of peripheral venopathy.
If untreated, one in four patients who have experienced PTE can be expected to die of recurrent pulmonary embolism.1 Heparin therapy substantially reduces the mortality for PTE. The occurrence of hemorrhagic complications with heparin therapy can be minimized by avoiding anticoagulation of
Footnotes
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Edited by John D. Archer, MD, Senior Editor.
