BY Bibo Masrawy
1-Patients diagnosed with PE who are deemed appropriate candidates for therapeutic anticoagulation should be treated for an initial period of 3 months.
2-In general, those patients with unprovoked PE or those with persistent risk factors should be considered for indefinite anticoagulation with routine follow-up to assess ongoing benefit.
3-Validated tools exist to quantify risk of recurrent VTE and may be helpful in patients with unprovoked PE who have an intermediate bleeding risk or in those who choose to discontinue anticoagulation.
4-Serial D-dimer testing is a useful tool to detect recurrence and inform the decision to restart anticoagulation after the initial 3-month period in patients with unprovoked PE.
5-Patients with unexplained persistent dyspnea or exercise intolerance merit ongoing anticoagulation while undergoing workup for new onset pulmonary vascular disease such as chronic thromboembolic pulmonary hypertension