Approach to thrombosis in the emergency room: when to think about PTE and the importance of diagnosis

Abstract

Venous thromboembolism (VTE), comprising acute pulmonary thromboembolism (PTE) and deep vein thromboembolism (DVT), is a serious cardiovascular condition. Effective prevention of VTE in emergency surgeries faces significant challenges due to the lack of clear guidance and complex interpretation of existing guidelines. The aim of this study is to analyze thrombosis in the emergency department, with emphasis on PTE, in order to understand its pathophysiology and clinical signs, aiming at the early identification of suspected patients. Agile assessment strategies are essential to reduce morbidity and mortality. This is a literature review of exploratory qualitative research, carried out in March 2024, using the SciELO and PubMed databases. The search terms used were "Venous Thromboembolism"; pulmonary thromboembolism; "Emergency Rooma", combined by the connective "AND". Original articles in Portuguese, without time restrictions, free of charge and pertinent to the proposed theme were included, excluding repeated or incomplete works and those that did not meet the established criteria. Venous thromboembolism, influenced by several triggering factors, requires a multifaceted approach to its understanding and management. Transient factors, such as surgery and trauma, and persistent factors, such as active cancer, contribute significantly to the risk. Although the exclusion criteria for PTE provide a useful initial approach, their limitations require supplementation with additional diagnostic methods for an accurate assessment. The administration of prophylactic medications requires careful assessment of the balance between clotting and bleeding, highlighting the importance of individualization of treatment. A multidisciplinary and individualized approach is essential to ensure an effective and safe response in the management of pulmonary thromboembolism in the emergency department.