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Tag: Pulmonary Embolism

REBEL Cast Episode 30: The PESIT Trial – Do All Patients with 1st Time Syncope Need a Pulmonary Embolism Workup?

Background: Syncope is a very frustrating chief complaint for many in the medical field.  There is no gold standard test and no validated decision instrument. It represents about 3 – 5% of ED visits, 1 – 6% of hospital admissions, …

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Thoracic and Respiratory

Catheter Directed Thrombolysis: The Magic Bullet for Submassive Pulmonary Embolism?

Background: When evaluating therapeutic options for PE, there are three categories in my mind: Subsegmental, Submassive, and Massive. For simplicity sake lets just say subsegmental PEs get treated with anticoagulation and massive PEs get treated with thrombolysis. The submassive category …

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Thoracic and Respiratory

Update on Age-Adjusted D-Dimer

D-dimer has been shown to increase with age, which can cause a lower specificity (i.e. more false positive tests) in older patients. The result of this would be that older patients would often have more diagnostic imaging or downstream testing, …

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Hematology and Oncology

Rivaroxaban for Treatment of Symptomatic Pulmonary Embolism

Typically, the treatment of acute pulmonary embolism consists of administration of unfractionated heparin or low molecular weight heparin (i.e. enoxaparin) overlapped with vitamin K antagonists (i.e. warfarin).  This can be a very effective treatment regimen, but also very complex.  New direct …

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Thoracic and Respiratory

Age Adjusted D-Dimer Testing

D-dimer testing is sensitive for thrombus formation, and in patients who are not high risk, this test is used to rule-out venous thromboembolism. D-dimer has been shown to increase with age, which can cause a lower specificity (i.e. more false …

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Hematology and Oncology

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