Diagnosis:
Pulmonary Thromboemboli
• There are numerous risk factors for deep venous thrombosis and resultant pulmonary embolism.
• Strong risk factors for deep venous thrombosis include lower extremity fractures, major general surgery (especially lower extremity orthopedic operations), and spinal cord injury.
• Moderate risk factors include hormonal therapy, paralytic stroke, malignancy, chemotherapy, history of venous thrombosis, congestive heart failure etiologies, and postpartum period.
• Weak risk factors include inactivity owing to prolonged sitting, obesity, varicose veins, and peripartum period.
• Virchow described three risk factors for thrombosis that are known as Virchow triad—endothelial injury, stasis, and hypercoagulability.
• With the advent of genetic tests, heritable thrombophilias may be definitively diagnosed.
• For deaths resulting from pulmonary embolism, postmortem blood samples may be analyzed for mutations in factor V Leiden and prothrombin, the most common causes of thrombophilic coagulation disorders.
• The mortality rate of patients with acute untreated pulmonary embolism is 30% to 35%.
Andrew TA, Fairweather R:
Prothrombin G20210A mutation and sudden death. Am J Forensic Med Pathol 2003;24(4):377-380.
