Virtual Conference
Heart 2022 Conference

Irena Mitevska

University Cardiology Clinic, North Macedonia

Title: Treatment of pulmonary embolism in COVID-19 pandemic: Clinical and treatment approaches


Thrombotic complications in patients diagnosed with COVID-19 are important sequelae that contribute to significant morbidity and mortality. In up to 15% of patients, the disease is complicated by severe interstitial pneumonia, which can lead to acute respiratory distress syndrome, multiorgan failure including acute kidney injury, disseminated intravascular coagulation, and death. Early reports suggest incidences of DVT and PE up to 30% in patients with COVID-19 infection. The proposed mechanisms for COVID-19–induced thrombosis include a cytokine-mediated diffuse microvascular damage, disease-specific hypercoagulable state, hypoxia, immobilization, diffuse intravascular coagulation and, in some cases, reactive thrombocytosis. There are several guidance and many ongoing studies concerning the anticoagulant treatment and thromboprophylaxis, however still many treatment challenges remain having in mind also bleeding risk in these patients. The presentations explain the mechanisms of pulmonary embolism in COVID-19 patients, prevalence, guidance and several studies results on anticoagulant treatment and thromboprophylaxis, as well as the importance of individual approach to each patient. Risk stratification for the future thromboembolic events is also presented. Sudden deterioration in respiratory status especially in correlation with high titers of D-dimers in hospitalized patients, should raise suspicion for pulmonary embolism, prompt diagnosis and proper management. 


Irena Mitevska is Associate professor of cardiology at the St. Cyril and Methodius University, Medical Faculty in Skopje, North Macedonia. She ad completed PhD thesis at the University St Cyril and Methodius in Skopje. She works at the University Cardiology Clinic in Skopje. intensive care unit, echocardiography and nuclear cardiology labolatory, also actively involved in clinical research. Dr Mitevska has been included in several ESC Surveys (NSTEMI, Heart Failure III, Diabetes and Heart), multicentric SIGNIFY and ISCHEMIA trial. She is Vice President of the National Society of Cardiology of North Macedonia. Her research interest includes heart failure treatment, acute cardiovascular care, echocardiography, cardiovascular prevention, pulmonary embolism. Dr Mitevska is also involved in medical students, internal medicine and cardiology resident’s education.