Leiden University Scholarly Publications

Klok, F.A. (2010)

Pulmonary embolism : diagnostic management and prognosis

Doctoral Thesis

This thesis describes the diagnostic management, short term prognosis and long term complications of pulmonary embolism. We have validated a newly derived clinical decision rule, the revised Geneva score, for predicting the pre-test probability of having acute pulmonary embolism. This rule can be used in clinical practice to managge patients with suspected pulmonary embolism. We further found that NT-pro-BNp levels are the best predictors of benign clinical course, when compared to troponin and D-dimer levels, and CT derived maesurements of the right ventricular volume and function. Finally, we demonstrate that although the incidence of chronic thromboembolic pulmonary hypertension after acute pulmonary embolism is very low, the long term clinical course after pulmonary embolism is complicated frequently by mortalitity, recurrent venous thombosis, newly diagnosed maligancies and arterial cardiovascular events.

Arterial cardovascular disease

Chronic thromboembolic pulmonary hypertension

Diagnostic management

Nt-pro-BNP

Prognosis

Pulmonary embolism

All authors

Klok, F.A.

Supervisor

Romijn, J.A.

Co-supervisor

Huisman, M.V.

Qualification

Doctor (dr.)

Awarding Institution

Leiden University Medical Center (LUMC), Leiden University

Date

2010-03-02

ISBN (print)

9789085599173