Tromboembolismo pulmonar: abordagem prática
Palavras-chave:
tromboembolismo pulmonar, diagnóstico, terapêutica, trombóliseResumo
Introdução: O tromboembolismo pulmonar é uma situação frequente, com mortalidade elevada e de diagnóstico difícil. Nos últimos anos, surgiram alguns novos dados importantes para a sua abordagem diagnóstica e terapêutica.
Objectivos: Os autores procuraram rever o estado da arte desta patologia, incorporando os novos dados numa abordagem prática, diagnóstica e terapêutica, a dois tempos (no serviço de urgência e na enfermaria).
Resultados e conclusões: A abordagem diagnóstica no serviço de urgência desta situação deverá incidir sobre uma clínica, que é altamente sensível, embora pouco específica. A confirmação diagnóstica baseia-se em exames complementares, alguns deles realizáveis no serviço de urgência, mas outros só possíveis em segundo tempo. A terapêutica anticoagulante deverá ser iniciada de imediato, no serviço de urgência e mesmo antes da confirmação diagnóstica. A fibrinólise, nos casos específicos em que está indicada, diminui a mortalidade e a morbilidade.
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