Tromboembolismo pulmonar: avances en diagnóstico, tratamiento y prevención Pulmonary thromboembolism: advances in diagnosis, treatment and prevention

• Bratta Castro, Diego ^[1]
  1. [1] Universidad Técnica Particular de Loja

     Universidad Técnica Particular de Loja

     Loja, Ecuador

     
• Localización: GICOS: Revista del Grupo de Investigaciones en Comunidad y Salud, ISSN-e 2610-797X, Vol. 9, Nº. 3 (septiembre-diciembre), 2024, págs. 377-392
• Idioma: español
• Títulos paralelos:
  • Pulmonary thromboembolism: advances in diagnosis, treatment and prevention
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  • español

    El tromboembolismo pulmonar (TEP) es una condición médica grave caracterizada por la obstrucción de las arterias pulmonares por un coágulo sanguíneo, generalmente originado en las venas profundas de las extremidades inferiores. Esta patología representa una causa significativa de morbilidad y mortalidad a nivel mundial. La fisiopatología del TEP involucra una compleja interacción entre factores de coagulación, plaquetas y células inflamatorias. La formación del trombo se inicia con la activación plaquetaria y la cascada de coagulación, potenciada por factores como la estasis venosa y estados de hipercoagulabilidad. El diagnóstico del TEP puede ser desafiante debido a su presentación clínica variable. Los síntomas más comunes incluyen disnea, dolor torácico y taquipnea. Las estrategias diagnósticas actuales, combinan la evaluación clínica, biomarcadores como el dímero D, y técnicas de imagen, siendo la angiografía pulmonar por tomografía computarizada el estándar de oro. El tratamiento se centra en la anticoagulación, con los anticoagulantes orales directos ganando prominencia en los últimos años debido a su eficacia y perfil de seguridad mejorado. En casos severos, pueden ser necesarias terapias de reperfusión como la trombólisis. La prevención del TEP, especialmente en poblaciones de alto riesgo, sigue siendo un área de investigación activa. Estrategias como la tromboprofilaxis en pacientes hospitalizados y la identificación de factores de riesgo individuales son cruciales para reducir la incidencia de esta condición potencialmente mortal. Los avances en la comprensión de la fisiopatología del TEP están abriendo nuevas vías para el desarrollo de terapias dirigidas y estrategias de prevención más efectivas.Pulmonary thromboembolism (PTE) is a serious medical condition characterized by blockage of the pulmonary arteries by a blood clot, usually originating in the deep veins of the legs. This pathology represents a significant cause of morbidity and mortality worldwide. The pathophysiology of PE involves a complex interaction between coagulation factors, platelets and inflammatory cells. Thrombus formation begins with platelet activation and the coagulation cascade, enhanced by factors such as venous stasis and hypercoagulable states. The diagnosis of PE can be challenging due to its variable clinical presentation. The most common symptoms include dyspnea, chest pain, and tachypnea. Current diagnostic strategies combine clinical evaluation, biomarkers such as D-dimer, and imaging techniques, with computed tomography pulmonary angiography being the gold standard. Treatment focuses on anticoagulation, with direct oral anticoagulants gaining prominence in recent years due to their effectiveness and improved safety profile. In severe cases, reperfusion therapies such as thrombolysis may be necessary. Prevention of PTSD, especially in high-risk populations, remains an area of active research. Strategies such as thromboprophylaxis in hospitalized patients and identification of individual risk factors are crucial to reduce the incidence of this potentially fatal condition. Advances in understanding the pathophysiology of PTSD are opening new avenues for the development of targeted therapies and more effective prevention strategies.Recibido: 21-05-2024Aprobado: 02-07-2024Publicado: 01-11-2024

  • English

    Pulmonary thromboembolism (PTE) is a serious medical condition characterized by blockage of the pulmonary arteries by a blood clot, usually originating in the deep veins of the legs. This pathology represents a significant cause of morbidity and mortality worldwide. The pathophysiology of PE involves a complex interaction between coagulation factors, platelets and inflammatory cells. Thrombus formation begins with platelet activation and the coagulation cascade, enhanced by factors such as venous stasis and hypercoagulable states. The diagnosis of PE can be challenging due to its variable clinical presentation. The most common symptoms include dyspnea, chest pain, and tachypnea. Current diagnostic strategies combine clinical evaluation, biomarkers such as D-dimer, and imaging techniques, with computed tomography pulmonary angiography being the gold standard. Treatment focuses on anticoagulation, with direct oral anticoagulants gaining prominence in recent years due to their effectiveness and improved safety profile. In severe cases, reperfusion therapies such as thrombolysis may be necessary. Prevention of PTSD, especially in high-risk populations, remains an area of active research. Strategies such as thromboprophylaxis in hospitalized patients and identification of individual risk factors are crucial to reduce the incidence of this potentially fatal condition. Advances in understanding the pathophysiology of PTSD are opening new avenues for the development of targeted therapies and more effective prevention strategies.