Thromboembolic disease.

Abstract

(1) Thromboembolic disease is a rare condition in physically fit subjects and is, therefore, likely to occur only rarely in aircrew. (2) The clinical diagnosis of both pulmonary embolism and deep venous thrombosis is unreliable. As the occurrence of these conditions has serious implications so far as the future licensing of airmen is concerned, it is of paramount importance to establish the diagnosis beyond doubt. (3) The chance of recurrence after an acute pulmonary embolus is low, particularly in those subjects in whom a definite acute and transient predisposing factor such as recent surgery or trauma can be identified. (4) When there is no definite predisposing factor to an acute pulmonary embolism, careful assessment is needed. The possibility that the embolus was the first sign of some serious sytemic illness, such as malignancy, should be considered and the possibility of rare clotting abnormalities sought. (5) Patients with subacute pulmonary embolism should be regarded as for those with acute pulmonary embolism and no obvious risk factor. A large proportion of these patients will have no predisposing factor and will require long-term oral anticoagulants as part of their routine therapy. Fortunately this condition is very rare. (6) Patients with repeated deep venous thrombosis, usually associated with chronic damage to the venous system of the leg, also may require long-term oral anticoagulants and their condition is likely to be exacerbated by long periods of inactivity.(ABSTRACT TRUNCATED AT 250 WORDS)