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Fig. 5 | Insights into Imaging

Fig. 5

From: Cardiothoracic CT: one-stop-shop procedure? Impact on the management of acute pulmonary embolism

Fig. 5

a The clinical management of hemodynamically stable patients in pulmonary embolism. After establishing the diagnosis of PE, RV function should be determined, followed by the markers of myocardial injury. If there are signs of RVD and an elevation of troponin or fatty acid binding proteins, thrombolysis could be the next step. If there is only RVD or an elevation in the markers of myocardial injury, then the patient could be admitted to the medical ward. Outpatient treatment is the option in the absence of RVD or signs of myocardial injury. PE = pulmonary embolism, RV = right ventricle, RVD = right ventricular dysfunction, MDCT = multi detector computed tomography, BNP = brain natriuretic peptides, H-FABP’s = fatty acid binding proteins, ICU = intensive care unit. b After establishing the diagnosis of PE, the cardiac biomarkers are first taken into consideration. Outpatient treatment can only be considered if the cardiac biomarkers reveal no abnormalities. If these biomarkers are abnormal, RV function should be monitored. In case of RVD, only two options are left: admission to the medical ward in the absence of RVD or admission to ICU in combination with thrombolysis in the presence of RVD. PE = pulmonary embolism, BNP = brain natriuretic peptides, H-FABP’s = fatty acid binding proteins, RV = right ventricle, MDCT = multidetector computed tomography, ICU = intensive care unit

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