PE Flashcards
Why do we treat DVT
to prevent PE
when does PE occur
when venous thrombus embolize to the pulmonary artery
pathophysiology
thrombi formed in the deep veins of the legs or pelvis detaches and flows via inferior vena cave to the right atrium and ventricle into the pulmonary artery and occludes it
the larger the thrombus
the more proximal the occlusion and the greater the hemodynamic effects
two immediate effects of occlusion
reduced perfusion in pulmonary circulation–hypoxia
reduced preload in LV and reduced cardiac output–cardiac arrest
venous thromboembolism is the (number) leading cause of death behind
3rd behind stroke and MI
risk factors
Virchow’s triad
venous stasis
vessel wall injury
hypercoagulable state
presentation
extremely variable–the great masquerader
asymptomatic
dyspnea
pleuritic CP
cough/hemoptysis
PE findings
tachypnea
tachycardia
hypotension
rales
distended jugular vein
signs of DVT
the highest incidence of recognized PE occurs in
hospitals
diagnostic tests
d-dimer
CBC
electrolytes
INR
BUN/creatinine
CXR
spiral CT with contrast
EKG
Tx
anticoagulation- LMW heparin/heparin
fibrinolytics- tPA when acute PE is hypotensive and low risk bleeding
pulmonary embolectomy
