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Antes Revista del Instituto Nacional de Enfermedades Respiratorias

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2006, Número 1

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Neumol Cir Torax 2006; 65 (1)


Tromboembolia pulmonar

Zavaleta MEO, Morales BJE

Idioma: Español
Referencias bibliográficas: 70
Paginas: 24-39
Archivo PDF: 363.60 Kb.


RESUMEN

La enfermedad tromboembólica venosa (ETV) representa un espectro de una misma entidad que incluye a la tromboembolia pulmonar (TEP) y la trombosis venosa profunda (TVP), se origina como una complicación de varios padecimientos heterogéneos. La principal fuente de origen es la formación de un trombo en el sistema venoso de miembros inferiores que sigue una trayectoria de embolización al corazón derecho, para posteriormente terminar en la circulación arterial pulmonar. La patogenia de la ETV concurre en situaciones adquiridas o congénitas que denominamos factores de riesgo, la identificación de los mismos proporciona un mayor apoyo en el diagnóstico, la probabilidad puede ser estimada de acuerdo a modelos de predicción. La TEP tiene un amplio rango en su presentación, desde no tener importancia clínica hasta condicionar un embolismo masivo con muerte súbita. Los signos y síntomas son inespecíficos, las alteraciones hemodinámicas se relacionan de manera directa al tamaño, número de émbolos, al estado respiratorio y cardiaco preexistente. Se requieren estudios de laboratorio y de gabinete para valorar las condiciones generales del paciente e iniciar una terapéutica correcta. La anticoagulación inicial en niveles terapéuticos correctos influye en la eficacia a corto y largo plazo. El objetivo del tratamiento es evitar los embolismos recurrentes o la propagación del trombo, el pronóstico con el tratamiento de la ETV depende principalmente de las enfermedades coexistentes, tales como enfermedad cardiovascular y la presencia de malignidad.


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