Management of Patients With Venous Thromboembolism After the Initial Treatment Period
Autor: | Richard H. White, Manreet Kanwar, Timothy M. Fernandes |
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Rok vydání: | 2021 |
Předmět: |
medicine.medical_specialty
Deep vein Hemorrhage 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Recurrent thromboembolism medicine Humans Initial treatment 030212 general & internal medicine Intensive care medicine business.industry Public Health Environmental and Occupational Health Anticoagulants Venous Thromboembolism Evidence-based medicine medicine.disease Pulmonary hypertension Thrombosis Pulmonary embolism medicine.anatomical_structure Pulmonary Embolism Family Practice business Venous thromboembolism |
Zdroj: | The Journal of the American Board of Family Medicine. 34:409-419 |
ISSN: | 1558-7118 1557-2625 |
Popis: | Background: Venous thromboembolism (VTE) is a common medical problem seen in primary care settings. The most common long-term adverse sequelae are recurrent thromboembolism and incomplete resolution of the embolic material, which may result in pulmonary hypertension after pulmonary embolism and post-thrombotic changes in the leg after deep vein thrombosis. Although there are detailed guidelines for diagnosing and treating acute VTE, there are few focused articles that provide recommendations for primary care physicians (PCPs) about how to manage VTE patients after completion of the initial period of anticoagulation treatment. Observations: In this article, we highlight several important clinical decisions that must be addressed after the first 3 months of anticoagulation treatment is complete, with a focus on particular management issues for PCPs. Conclusions: The 2 most important decisions the PCP must make are to determine, first, if symptoms of acute VTE have indeed resolved, and second, if they have resolved, to assess the long-term risk of recurrent VTE versus the risk of potential bleeding and decide if anticoagulation should be stopped, or if indefinite anticoagulation treatment is indicated. Among higher-risk patients who may benefit from indefinite anticoagulation, the PCP should discuss both the risks and benefits of anticoagulation treatment, empowering the patient to actively participate in this important shared decision-making process. |
Databáze: | OpenAIRE |
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