Protocolo de diagnóstico y tratamiento de la enfermedad tromboembólica venosa

Venous thromboembolism (VTE) is the third most common cause of death from cardiovascular disease after heart attack and stroke. Sequelae after VTE include chronic pulmonary hypertension and post-thrombotic syndrome. The diagnosis of VTE is based on models of clinical probability, plasma D dimer and noninvasive imaging modalities (compression ultrasound or chest CT). Most patients will respond to anticoagulation with parenteral unfractionated heparin or low molecular weight heparins, followed by oral vitamin K antagonists (sintrom or warfarin) during 3-6 months with coagulation monitoring of INR in the therapeutic range. Several novel oral anticoagulants are in development (dabigatran rivaroxaban, apixaban) which could replace vitamin K antagonists, since they are prescribed in fixed doses and do not need any coagulation monitoring.