32 Suspected acute pulmonary embolus Flashcards
What is the pathophysiology of an acute PE?
An acute PE can obstruct the vessels in the lungs, increasing pulmonary vascular resistance and decreasing blood flow and increasing blood pressure. This may be exacerbated by the hypoxic vasoconstriction. This can cause PA dilatation, RV dilatation and TR secondary to pressure overload. This can cause an increase in RA pressure and size which can cause IVC dilatation and fixation.
How is an acute PE assessed (signs)?
PA dilatation, RV dilatation, TR, increased RA pressure and IVC dilatation and fixation indicate a PE.
A RVEDD to LVEDD ratio of >0.6 indicates a massive acute PE.
McConnell sign is the presence of an RV which is dilated and hypokinetic at the RV free wall but not the apex (RV free wall akinesis).
The 60/60 sign is a PASP <60mmHg and PAT <60ms.
PE symptoms include dyspnoea, chest pain and haemoptysis.
How is a chronic PE assessed?
A chronic PE can cause group 4 PH.
