By American College of Chest Physicians
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A gradual increase in pulmonary vascular resistance occurs in the absence of documented recurrent PE, and it is thought to be related to an increased resistance to flow through the pulmonary arteries that results from the initial obstruction and subsequently from vascular remodeling in small, unobstructed vessels. Risk factors for CTEPH have been identified and include ventriculoatrial shunts, infected Table 2. indd 23 Sensitive for proximal DVT, not commonly used in clinical practice Sensitive/specific for proximal DVT, limited in congestive heart failure setting and previous DVT Sensitive for calf vein thrombosis, not commonly used in clinical practice Sensitive/specific for proximal DVT, operator dependent; clinical “gold standard” Diagnostically equivalent 23 7/10/09 8:03:53 PM pacemakers, splenectomy, previous VTE, recurrent VTE, malignancy, thyroid-replacement therapy, and the antiphospholipid antibody syndrome.
Impact of pregnancy on women with CF. Chest 2006; 129:706– 711 Concern exists about the impact of pregnancy on the health of women with CF. This study suggests that women with CF who become pregnant experience similar respiratory and health trends compared to nonpregnant women with CF. However, pregnant women used a greater number of therapies and received more intense monitoring of their health. Moss RB, Rodman D, Spencer LT, et al. Repeated adeno-associated virus serotype 2 aerosol-mediated CF trans-membrane regulator gene transfer to the lungs of patients with CF: a multicenter, double-blind, placebocontrolled trial.
Am J Respir Crit Care Med 2002; 165:345−348 d-dimer concentration and the accuracy of d-dimer assays are dependent on embolus location; smaller, subsegmental emboli may be missed when d-dimer assays are used as the sole test to exclude PE. Douketis JD, Kearon C, Bates S, et al. Risk of fatal pulmonary embolism in patients with treated venous thromboembolism. JAMA 1998; 279:458−462 Among patients with symptomatic PE or DVT who are treated with anticoagulation therapy for 3 months, the occurrence of fatal PE is rare during and after anticoagulant therapy.
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