Plicní embolie - stále ještě Popelka akutní kardiologie?

Jan Bělohlávek

Interv Akut Kardiol 2011; 10(Suppl. A): 4-5  

Severe pulmonary embolism

Jan Bělohlávek, Vladimír Dytrych, Aleš Král, Ondřej Šmíd, Aleš Linhart

Interv Akut Kardiol 2011; 10(Suppl. A): 6-13  

Pulmonary embolism is a relatively common condition with considerable mortality, however, well manageable when diagnosed early. Early adequate treatment is usually effective, when initiated without delay. The severity of pulmonary embolism is primarily determined by its haemodynamic impact on right ventricular function and preservation of adequate forward cardiac output and organ functions. However, the severity of this condition may also be affected by the potential development of other complications, such as recurrence of embolism, embolization of free-floating thrombi to the pulmonary or systemic vascular beds, development of respiratory...

Thrombolytic therapy of pulmonary embolism with a mobile thrombus in the right heart

Zdeněk Monhart, Jan Sedláček, Milan Konvička

Interv Akut Kardiol 2011; 10(Suppl. A): 14-16  

The incidence of mobile thrombi in the right heart in pulmonary embolism is not very high, with the ICOPER registry reporting their presence in 4 % of patients with pulmonary embolism. Mobile thrombi are more common in haemodynamically unstable patients. In initially haemodynamically stable patients, their presence was associated with a higher mortality rate when the patients were treated with heparin only. The therapeutic options include either thrombolytic therapy or surgical embolectomy. A case report presents a haemodynamically stable patient with bilateral pulmonary embolism with a mobile thrombus in the right heart. Thrombolytic therapy...

The crucial role of echocardiography in acute pulmonary embolism

Vladimír Dytrych, Jan Bělohlávek, Aleš Král, Aleš Linhart

Interv Akut Kardiol 2011; 10(Suppl. A): 17-19  

Echocardiography is among the principal methods in the diagnostic algorithm of acute pulmonary embolism (APE). It is of particular significance in the risk stratification of the disease as well as in the differential diagnosis of other acute conditions in cardiology. In terms of risk stratification and overall haemodynamic impact of APE, it can provide much more information than is used in routine clinical practice. The investigation should be performed in every patient, within the shortest possible time from the suspicion or confirmation of diagnosis.

Aggressive approach in thrombolytic therapy of massive pulmonary embolism

Viktor Talafa, Dalibor Pastucha

Interv Akut Kardiol 2011; 10(Suppl. A): 20-22  

Pulmonary embolism (PE) is a relatively frequent condition, particularly in elderly and at-risk patients. The incidence ranges from 0.8 to 2 cases per 1,000 population and year. Most commonly, it results from a sudden obstruction of part of pulmonary vascular bed by a thromboembolus originating in the deep venous system of the lower extremities. The treatment of patients with acute PE depends on several factors with the patient’s haemodynamic condition being the most important. In the presence of circulatory instability, alteplase, a thrombolytic agent, is the first-choice drug but it is necessary to take into account absolute contraindications....