Hospital Medicine Alert – September 1, 2006

September 1, 2006

• How Common is Pulmonary Embolism in Patients with COPD Exacerbations?

  In a selected population of patients with known COPD who were hospitalized with acute worsening of respiratory symptoms but did not have usual signs of an infection or other specific process, 25% were found to have pulmonary embolism.

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• Pregnancy and Ischemic Stroke: Is Thrombolysis an Option?

  Pregnancy is a prothrombotic state which is rarely associated with ischemic arterial stroke. However, when a stroke occurs, especially in later pregnancy, the options for therapy may be limited.

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• Door-to-Balloon Time in STEMI

  Time to primary PCI is strongly associated with mortality risk and is important regardless of time from symptom onset to presentation and regardless of baseline risk of mortality.

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• Failed Thrombolysis

  Rescue PCI in the setting of early fibrinolytic failure improves mortality, but this is tempered by a possible increase in the risk of thromboembolic stroke.

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• Risks of Catheter-Related Thrombosis in Cancer Patients

  In a prospective, observational study of 444 patients, there were no cases of symptomatic pulmonary embolus, and postphlebitic syndrome occurred infrequently.

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