Pulmonary Emboli Masquerading as Asthma

Olazábal, Francisco; Román-Irizarry, Luis A.; Oms, Jorge D.; Conde, L Valdivieso; Marchand, Ernesto J.

doi:10.1056/nejm196805022781807

Cited by 17 publications

(2 citation statements)

References 7 publications

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“…Previous follow-ups of patients with acute PE have shown abnormal exercise capacity of cardiopulmonary origin in up to 50% and severe cardiopulmonary limitation in up to 15% of the patients [23,24]. A few studies also suggested that acute PE and repeated PEs over longer time can lead to episodes of shortness of breath and be diagnosed and/or treated as asthma [9,[25][26][27][28][29]. In our study we cannot provide any underlying pathophysiological "causative" explanation of our findings as no cardiopulmonary exercise testing or other detailed examinations were performed.…”

Section: Discussionmentioning

confidence: 99%

Venous thromboembolism associated with severe dyspnoea and asthma in 102 792 adults

Nilausen,

Landt,

Al-Shuweli

et al. 2023

ERJ Open Res

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BackgroundThe most recent guideline on acute pulmonary embolism (PE) indicates possible long-term sequelae such as dyspnoea and chronic thromboembolic pulmonary hypertension after a PE event. However, effects on lung function or asthma risk have not been evaluated in the general population.MethodsWe tested whether individuals with a venous thromboembolism (VTE) encompassing PE and deep vein thrombosis (DVT) have reduced lung function, or greater risks of dyspnoea and asthma using data from 102 792 adults from the Copenhagen General Population Study. Diagnoses of PE, DVT, and asthma were collected from the national Danish Patient Registry. Factor V Leiden and prothrombin G20210A gene variants were determined by TaqMan assays.ResultsPrevalence of PE, DVT, and VTE were 2.2%, 3.6%, and 5.2%, respectively. Individuals with VTE had FEV1% predicted of 92% compared with 96% in individuals without VTE (p<0.001). Individuals with VTEversusthose without had adjusted odds ratios for light, moderate, and severe dyspnoea of 1.4 (95%CI: 1.2–1.6), 1.6 (1.4–1.8), and 1.7 (1.5–1.9), respectively. Individuals with VTEversusthose without had an adjusted odds ratio for asthma of 1.6 (1.4–1.8). Factor V Leiden and prothrombin G20210A genotype also associated with increased risk of asthma (p for trend=0.002). Population attributable fractions of severe dyspnoea and asthma due to VTE were 3.5% and 3.0% in the population.ConclusionIndividuals with VTE have worse lung function and higher risks of severe dyspnoea and asthma, and may account for 3.5% and 3.0% of people with severe dyspnoea and asthma in the general population.

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Section: Discussionmentioning

confidence: 99%

Venous thromboembolism associated with severe dyspnoea and asthma in 102 792 adults

Nilausen,

Landt,

Al-Shuweli

et al. 2023

ERJ Open Res

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“…Clinical experience suggests that an initial bolus of 10,000-15,000 units of heparin (the precise dose depending on the condition, age and weight of the patient) should be given promptly when embolism is suspected and not delayed by time-consuming diagnostie tests. Experimental studies have shown that airway constriction and pulmonary vasoconstriction which accompany thromboembolism in animals [20,47,48] and probably in man [47,[49][50][51][52] are inhibited by a large dose of heparin probably by interferring with thrombin-platelet interaction [19,20,53]. Smaller doses do not have this effect [20].…”

Section: Warfarinmentioning

confidence: 99%

Guidelines for the Management of Anticoagulant Therapy

Gurewich¹

2008

Semin Thromb Hemost

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Pulmonary embolus in acute myelocytic leukemia

Wiernik

Serpick

1969

Cancer

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Seven incidences of clinically significant pulmonary embolus in severely granulocytopenic and thrombocytopenic patients with acute myelocytic leukemia are reported. Each patient had received multiple platelet concentrate transfusions but showed no rise in post‐transfusion platelet count. The possible roles of granulocytopenia and ineffective platelet transfusion in facilitating pulmonary embolus are discussed. It is concluded that severe thrombocytopenia offers no protection against pulmonary embolus.

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Pulmonary Emboli Masquerading as Asthma

Cited by 17 publications

References 7 publications

Venous thromboembolism associated with severe dyspnoea and asthma in 102 792 adults

Venous thromboembolism associated with severe dyspnoea and asthma in 102 792 adults

Guidelines for the Management of Anticoagulant Therapy

Pulmonary embolus in acute myelocytic leukemia

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