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Harrison's Principles of Internal Medicine, 18e
| Part 11. Disorders of the Respiratory System > Section 2. Diseases of the Respiratory System > |
Chapter 262. Deep Venous Thrombosis and Pulmonary Thromboembolism
Sections: Deep Venous Thrombosis and Pulmonary Thromboembolism: Introduction, Further Readings.
Topics Discussed: deep vein thrombosis; pulmonary embolism; thromboembolism; thromboembolism, pulmonary; venous thromboembolism.
Excerpt:"Venous thromboembolism (VTE), which encompasses deep venous thrombosis (DVT) and pulmonary embolism (PE), is one of the three major cardiovascular causes of death, along with myocardial infarction and stroke. VTE can cause death from PE or, among survivors, chronic thromboembolic pulmonary hypertension and postphlebitic syndrome. The U.S. Surgeon General has declared that PE is the most common preventable cause of death among hospitalized patients. Medicare has labeled PE and DVT occurring after total hip or knee replacement as unacceptable "never events" and no longer reimburses hospitals for the incremental expenses associated with treating this postoperative complication. New nonprofit organizations have begun educating health care professionals and the public on the medical consequences of VTE, along with risk factors and warning signs.Thrombophilia contributes to the risk of venous thrombosis. The two most common autosomal dominant genetic mutations are factor V Leiden, which causes resistance to activated protein C (which inactivates clotting factors V and VIII), and the prothrombin gene mutation, which increases the plasma prothrombin concentration (Chaps. 58 and 117). Antithrombin, protein C, and protein S are naturally occurring coagulation inhibitors...."
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