IN PULMONARY EMBOLISM AN INTERPRETATION OF SYSTOLIC BLOOD PRESSURE, TROPONIN (AND OTHER IMPORTANT PARAMETERS) DEPENDS ON THEIR PREVIOUS VALUES AND COMORBIDITIES

Abstract

We reviewed several important parameters in pulmonary thromboembolism (PTE) and showed how not only absolute values but also relative are relevant in clinical practice. The vast majority of parameters depend both on previous values and co-morbidities; failure to realize this can result in misclassification of a patient and inappropriate treatment. For example, the absolute value of systolic blood pressure (BP) less than 90 mmHg is crucial for urgent treatment (e.g. thrombolysis); obviously, the same admission systolic BP (sBP) of 87 mmHg may not have the same significance if previous usual sBP was also 87 mmHg or it was 220 mmHg. Moreover, cardiac troponin is also very important for the risk stratification; the same troponin concentration ought not to be interpreted equally if it is due to acute pulmonary thromboembolism or if it is chronic and due to e.g. renal failure. The interpretation of important dichotomous parameters (normal or pathologic values) in PTE does depend on previous values (if available) and co-morbidities. This principle should be recognized and used in clinical practice, while risk-stratifying patients.