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     TOMBOEMBOLISMO

    PULMONARDr. Jorge Yáñez Villaseñor

    Profesor e!ar"a#e$"o #ei%i$a

    i$"er$a UDE&E$fer#eaes res!ira"oriasU$ia %'iaos i$"e$si(os )**B

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     Te#ario

    • Sos!e%+a %l,$i%a

    • E-á#e$es %o#!le#e$"arios e

    i$"er!re"a%i$• Algori"#os iag$s"i%os

    • E$fre$"a#ie$"o "era!/'"i%o

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    0A&TORES DE RIES*O

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    Es%e$arios %l,$i%os

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    E-á#e$es %o#!le#e$"arios

    Radiografía de tórax

    Electrocardiograma

    Enzimas miocárdicas

    Gases en sangre arterial

    Dímero –D

    E%o%ariogra#aPro BNPA$gio"a% e "ra-&i$"igra#a (e$"ila%i$ !erf'si$

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     TEP

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    A$gio TA& e "ra-

    Sensibilidad 97%

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    Ele%"ro%ariogra#a

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    DIMERO 1D

    • Se ele(a e$ 2 – e#3arazo4 ea a(a$zaa4 e$fer#eaes

    i$5a#a"orias gra(es e %'al6'ier orige$4

    "ra'#a"is#o4 %á$%er4 %ir'g,a re%ie$"e4 i$far"o el#io%ario.

     – Valor !rei%"i(o !osi"i(o 3a7o 8 $o soli%i"ar %'a$ola sos!e%+a %l,$i%a es al"a9.

     – Valor !rei%"i(o $ega"i(o al"o 8 Des%ar"ae$fer#ea %'a$o s' res'l"ao es $or#al e$!a%ie$"es %o$ 3a7a !ro3a3ilia %l,$i%a e e#3olia9.

    • .

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    TEP SUBMASIVO

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    &INTI*RAMA V:;

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    Mar%aores e riesgo#or"alia

    • Pro BNP – I$i%aor e +i!o-ia #io%ári%a < s"ress e$

    !are

     –

    Ae%'aa %orrela%i$ %o$ %o#!li%a%io$es

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    EN0RENTAMIENTO&LINI&O

    Pro3a3ilia iag$os"i%aPro3a3ilia e falle%er

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    Algori"#o &+ris"o!+er

    • Si#!li=%a @ells –   #as

     –

    • Pos"erio#e$"e – Di#ero C D

     – A$gio"a% "ora-

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    Sos!e%+a TEP)e#oi$a#ia

    es"a3le

    Ba7a Al"a

    Di#ero C D 819Des%ar"a

    iag$os"i%oA$gioTA&

     TEP 819 TEP 89

    DD 89

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     TEP 2 o'"%o#es•PAS F•Dis#i$'%io$ F##)g !or GH#i$'"os

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     Tra"a#ie$"o

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    &á$%er Tro#3o=lia

     TEP re%'rre$"e

    N'e(os a$"i%oag'la$"esorales

    http://www.google.cl/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&cad=rja&uact=8&docid=NOOXd1uIlC9tMM&tbnid=9rHirOySPLPFPM:&ved=0CAcQjRw&url=http://www.celyontecnica.es/productos/ida-4-plus&ei=OKgsVIPHJ4TeoAS2nIGYCQ&psig=AFQjCNHeVJHCdNuah-cOVyV67hh460nOJw&ust=1412299126549610

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    )e!ari$a soi%a

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    )e!ari$a 3a7o !eso#ole%'lar

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     TROMBOLISIS

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    0ILTRO VENA &AVA

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