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Editorials |

Pulmonary Embolism: Another Piece of the Puzzle?

C. Gregory Elliott, MD; Lynette M. Brown, MD, PhD
Author and Funding Information

Correspondence to: C. Gregory Elliott, MD, Intermountain Medical Center, Department of Medicine, PO Box 577000, Eccles OP, Suite 307, Murray, UT 84157-7000; e-mail: Greg.elliott@imail.org

Affiliations: Dr. Elliott is Chairman, Department of Medicine, Intermountain Medical Center and Professor (with tenure) and Associate Chairman, Department of Internal Medicine, University of Utah School of Medicine. Dr. Brown is Associate Director of the Pulmonary Hypertension Program at Intermountain Medical Center and Assistant Professor of Medicine at the University of Utah School of Medicine.


Financial/nonfinancial disclosures: The authors have reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/site/misc/reprints.xhtml).


© 2009 American College of Chest Physicians


Chest. 2009;136(5):1193-1194. doi:10.1378/chest.09-1452
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Acute pulmonary embolism is a common, serious, and often fatal disorder.1 Each year, approximately 300,000 US residents die from pulmonary emboli,2 and many more survive after diagnosis and the initiation of effective treatment. For survivors, the prognosis is generally good, although approximately 2 to 5% of patients who survive an acute pulmonary embolism will die from recurrent pulmonary emboli during the initial 3 to 6 months of anticoagulant treatment,3 and approximately 3% will have symptomatic, chronic thromboembolic pulmonary hypertension diagnosed during the next year.4 Recurrent pulmonary emboli are more likely when the initial emboli are unprovoked (ie, occur in the absence of major surgery or trauma). Prior pulmonary emboli, idiopathic pulmonary emboli, larger perfusion defects, and young age at onset are associated with an increased risk for chronic thromboembolic pulmonary hypertension.4 Recognition of chronic thromboembolic pulmonary hypertension is important because pulmonary endarterectomy can reverse severe pulmonary hypertension and right heart failure.5

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