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2006, Número 2

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Neumol Cir Torax 2006; 65 (2)


Tromboembolia pulmonar, un enfoque multidisciplinario

Alcocer GMA, González JF, León GS, Castro ME, Romero OMA, Loarca PLM, Carpio MRF, Martínez RJA, Silos GR

Idioma: Español
Referencias bibliográficas: 96
Paginas: 88-100
Archivo PDF: 149.54 Kb.


RESUMEN

La tromboembolia pulmonar (TEP) es un estado patológico debido a la formación de trombos en el sistema venoso que migran y embolizan al árbol pulmonar; dependiendo de la edad del paciente, la localización dentro del territorio pulmonar, la magnitud de la trombosis, el tiempo de evolución, los desencadenantes agudos y patologías asociadas, son algunos de los principales indicadores de la morbimortalidad de los pacientes que presenten TEP. Es considerada una de las 3 principales causas de mortalidad cardiovascular en nuestro medio, es por ello que es de suma importancia el tener un abordaje multidisciplinario para el diagnóstico oportuno, basado en los principios clínicos, diagnóstico diferencial, incluyendo la evaluación hematológica para la búsqueda de estados protrombóticos, la identificación de factores de riesgo, estudios no invasivos, particularmente del ecocardiograma y marcadores séricos, con los cuales se podrá ofrecer la estrategia terapéutica con fines pronósticos más adecuada en forma individualizada, desde el manejo exclusivamente médico, indicaciones de los diferentes fibrinolíticos, uso de dispositivos intervencionistas como los filtros temporales y permanentes en vena cava, dispositivos de fragmentación y extracción de trombos, así como procedimientos quirúrgicos como la endarterectomía pulmonar; haciendo recomendaciones sobre el manejo crónico, ambulatorio y conceptos de la rehabilitación cardiopulmonar.


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