[Features of pulmonary thromboembolism in women].

Pulmonary artery embolism (PAE) is usually a diagnosis of exclusion. Verification of a more common pathology takes time, which may become critical for treatment of pulmonary embolism and saving the patient's life. Since PAE is an acute disease, the time window for medical care largely determines the prognosis. Therefore, the differential diagnostic process should include thromboembolism already at the first visit. It is important to determine risk factors for PAE taking into account the patient's personality and gender. Obtained data may help the physician to determine quickly the expedience of visualizing studies, such as ventilation/perfusion scintigraphy, angiopulmonography, computed tomographic angiopulmonography. For women, it is important to collect specific information, such as the presence of large uterine fibroids, use of combined oral contraceptives or hormonal replacement therapy; to ask how long ago the patient had pregnancy and delivery, whether she has thrombophilia or oncological diseases.

[Estimation of poor prognostic factors in patients with pulmonary artery thromboembolism]. / Otsenka faktorov neblagopriyatnogo prognoza u patsientov s tromboemboliei legochnoi arterii.

AIM: To identify predictors of fatal outcome in hospitalized patients with risk factors (RF) for pulmonary artery thromboembolism (PATE) during its occurrence. SUBJECTS AND METHODS: To determine predictors of fatal outcome in patients with PATE, the data of a 10-year city hospital pulmonary embolism registry were used to analyze RF for PATE (according to European and Russian guidelines), complaints, medical histories, and laboratory and instrumental data, which can be identified at general surgery or general therapy hospital, as well as a nosological entity existing in the patients. RESULTS: According to the existing idea on thrombogenesis, RF for PATE and its fatal outcome, information about used treatment, and autopsy data, 137 parameters were selected in patients with PATE. For estimating the risk of death in patients with PATE, a logistic regression analysis was employed to make a mathematical model encompassing 10 indicators: bed rest; the presence/absence of lung diseases; chronic venous insufficiency; obesity; the symptom complex of cor pulmonale; postinfarction cardiosclerosis of the left ventricle, pericardial effusion; right atrial dilatation; right ventricular dilation; right ventricular systolic pressure >36 mm Hg as evidenced by echocardiography. CONCLUSION: The mathematical model built during the study allows the calculation of a risk for fatal outcome in the development of PATE for a specific patient in terms of its individual characteristics.