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Editor's Correspondence
May 27, 2002

Anticoagulation in Acute Pulmonary Embolism

Arch Intern Med. 2002;162(10):1195. doi:

David Cundiff1 states that patients with pulmonary embolism (PE) who survive to the point of undergoing diagnostic imaging are a selected group with a "relatively benign prognosis." While we agree that their prognosis is better than that of unselected patients with PE, we would argue that survivors of nonmassive PE who have adequate cardiopulmonary reserve in fact consist of 2 distinct subgroups with quite different prognoses in the absence of treatment, based on the likelihood of PE recurrence. This is, in turn, determined by the presence or absence of residual proximal deep vein thrombosis (PDVT).

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