Turkish Journal of Geriatrics 2003 , Vol 6, Issue 3
PULMONARY THROMBOEMBOLISM IN THE ELDERLY
Hanife KARAKAYA KABUKÇU, Vildan ULUSAN
Akdeniz Üniversitesi Tıp Fakültesi Anesteziyoloji ve Reanimasyon Anabilim Dalı, Uzm.Dr., Antalya
Süleyman Demirel Üniversitesi Tıp Fakültesi Anesteziyoloji ve Reanimasyon Anabilim Dalı, Yrd.Doç. Dr., Antalya
The incidence of pulmonary embolism rises with age, however, as doses pulmonary embolism mortality. The diagnosis of pulmonary embolism is diffucult and frequently missed because elderly patients may attribute nonspecific symptoms to underlying cardiyopulmonary disease or to age itself. Routine laboratory examinations are also nonspecif. D-dimer concentrations are useful when low,but are commonly elevated in the elderly. Lung scanning remains the most common initial study to diagnose pulmonary embolism, although spiral CT is as sensitive and specific. Pulmonary angiography should always be considered when the initial studies are nondiagnostic and clinical suspicion is high. Treatment for pulmonary embolism with anticoagualation reduces the mortality rate and should be administered in all elderly patients without contraindications. Trombolisis should be considered for all hemodynamically unstable patients with pulmonary embolism. Vena caval filters are warranted when anticoagulation is contraindicated. Keywords : Elderly, Pulmonary tromboembolism, Heparine, Anticoagulant therapy