Pathophysiology, clinics and diagnostics of non-thrombotic pulmonary embolism

Abstract

Non-thrombotic pulmonary embolism (NTPE) is commonly defined as the partial or total occlusion of the pulmonary circulation caused by a variety of non-thrombotic embolic agents. Although its prevalence is much lower than that of pulmonary thromboembolism, this life-threatening pathology is often underestimated due to the low specificity of signs and symptoms and because it might be frequently overlooked in the differential diagnosis of the chest pain. The main sources of non-thrombotic pulmonary emboli include cancers, fat, infective agents, amniotic fluid, a variety of foreign materials and gases. The diagnosis is particularly challenging. The spectrum of imaging findings using imaging techniques such as computed tomography is unpredictable and typically heterogeneous, whereas laboratory tests can only be helpful for establishing the cause but not the presence of the disease (i.e., D-dimer testing is frequently negative). As such, the clinical history along with the identification a potential underlying disease are the often the mainstay for the differential diagnosis. The aim of this article is to provide an overview of the pathophysiology, clinics and diagnostic approach to NTPE.

Deep vein thrombosis after sodium hyaluronate injection to knee joint: a case report

“…Likewise, deep vein thrombosis and the pulmonary embolisms that develop as a consequence are life-threatening complications following orthopedic surgeries and interventions [9]. Hyaluronic acid is one of the foreign materials accepted as an embolic [10]. Park et al reported a pulmonary embolism case after a cosmetic vaginal procedure with sodium hyaluronate injection.…”

Pulmonary embolism: clinical guidelines of European Society of Cardiology (2014)*

“…Диагностика нетромботической эмболии ЛА может быть сложной [464]. Эмболы небольших раз меров (микроэмболы) не видны при КТ легких.…”

False myths and legends in laboratory diagnostics

“…Under some circumstances, however, non-diagnostic values of D-dimer may be present in patients with DVT and/or PE, essentially when D-dimer is tested too early or too late after the development of VTE, after initiation of anticoagulant therapy, in patients with small and peripheral DVT [43]. Normal D-dimer values are also frequently found in patients with non-thrombotic PE [44].…”