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Cardiac Biomarkers in Pulmonary Embolism

Samuel Z. Goldhaber
Author and Funding Information

Affiliations: Boston, MA
 ,  Dr. Goldhaber is associated with Brigham and Women’s Hospital, Harvard Medical School.

Correspondence to: Samuel Z. Goldhaber, MD, FCCP, Cardiovascular Division, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115; e-mail: sgoldhaber@partners.org



Chest. 2003;123(6):1782-1784. doi:10.1378/chest.123.6.1782
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Pulmonary embolism (PE) encompasses a wide spectrum of illnesses, with diverse prognoses and management strategies. Some PEs, detected serendipitously by chest CT scanning, cause no apparent adverse symptoms or signs. They are anatomically tiny and have minimal clinical impact, at least in patients without concomitant proximal leg deep vein thrombosis. The heparin treatment is required as a “bridge” to warfarin treatment. In this situation, the major debate is about whether to hospitalize the patients for the traditional 5 to 7 days, to abbreviate the hospital stay by using low-molecular-weight heparin in lieu of continuous IV infusion of unfractionated heparin, or even to consider complete outpatient therapy12 with subsequent office follow-up. At the other end of the spectrum are patients who are critically ill and in cardiogenic shock. Their survival will depend on the rapid detection of the PE followed by implementation of the following emergency treatment plan: successful debulking of the clot, either with thrombolysis34 or embolectomy.56

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