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2017, Número 1

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Acta Med 2017; 15 (1)


Enfoque diagnóstico de la tromboembolia pulmonar

Machado VL, Dimakis RDA

Idioma: Español
Referencias bibliográficas: 86
Paginas: 36-46
Archivo PDF: 187.85 Kb.


RESUMEN

El embolismo pulmonar es una patología de presentación frecuente asociada a tasas de mortalidad elevadas; se caracteriza clínicamente por signos y síntomas altamente inespecíficos. Para su diagnóstico se cuenta con distintas modalidades, que comprenden escalas de predicción clínica (Wells y Ginebra modificadas), dímero-D, angiografía pulmonar por tomografía computarizada, angiografía por resonancia magnética, rayos X, gammagrafía pulmonar de ventilación/perfusión, tomografía computarizada helicoidal, electrocardiograma, ecocardiograma y ecografía venosa. Anteriormente, otras pruebas —tales como la pletismografía de impedancia y la flebografía— resultaban de utilidad en el protocolo diagnóstico de la trombosis venosa profunda y, por ende, del embolismo pulmonar; empero, han sido desplazadas por técnicas que poseen mayor sensibilidad y especificidad. En fechas recientes se han desarrollado múltiples pruebas de laboratorio que cuantifican marcadores biológicos útiles en el diagnóstico del embolismo pulmonar, así como factores pronósticos; entre ellos están el péptido natriurético cerebral, proteína cardiaca de unión a los ácidos grasos, lipocalina asociada con la gelatinasa de los neutrófilos y cistatina C.


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