5.Pulmonary Embolism

Question 1

Define Pulmonary embolism?

Answer 1

Blocking of the pulmonary arteries by an embolus.

Question 2

Common etiology of pulmonary embolism?

Answer 2

Deep vein thrombosis (DVT)

Question 3

What are risk factors that contribute to DVT and pulmonary embolism as a result of DVT?

Answer 3

1.History of DVT/PE
2.Trauma
3.Surgery
4.Immobilization
5.Malignancy
6.Pregnancy/giving birth/abortion
7.Heart disease/Heart failure

Question 4

Classification of PE in respect to occlusion of pulmonary artery?

Answer 4

Massive=>50% occlusion
Non-massive=<50% occlusion
Sub-massive= non-massive occlusion subgroup with echocardiogram features of acute RHS failure

Question 5

Classification of PE with respect to the course of the disease?

Answer 5

1.acute
2.chronic
3.with pulmonary infarction
4.without pulmonary infarction

Question 6

Symptoms of pulmonary embolism?

Answer 6

-Dyspnoea, tachypnoea, cyanosis, hemoptysis, cough, pleural pain

-Tachycardia, hypotension, tricuspid regurgitation

-Distended neck veins, Peripheral oedema, anxiety, syncope

Question 7

Diagnosis of Pulmonary embolism?

Answer 7

1.CXR
2.physical examination
3.CT angiography
4.ECG
5.D-Dimer test

Question 8

Treatment of pulmonary embolism?

Answer 8

-Anticoagulants (LMWH), Vitamin K antagonists (warfarin)

• supplemental oxygen for hypoxemia symptoms followed by intubation and mechanical ventilation if severe.
  -IV fluids for hypotension

-inferior vena cava filters
-thrombolectomy