PE Flashcards
what causes PE?
Usually arise from a venous thrombosis in the pelvis or legs
what are the symptoms of PE? 7
- Acute breathlessness
- pleuritic chest pain
- haemoptysis
- dizziness
- syncope
- ask about risk factors
- fam history of thromoembolism
what are the signs of PE?
- pyrexia
- cyanosis
- tachypnoea
- tachycardia
- hypotension
- raised JVP
- pleural rub
- pleural effusion
what investigations should be done?
- FBC, U&E, baseline clotting, D-dimers .
- ABG
- CTPA
- V/Q scan
- CXR
- ECG
V/Q scan - this is still useful particularly in ___ ______PEs and _______ (perfusion only). It is limited by frequency of inconclusive results.
V/Q scan - this is still useful particularly in small peripheral PEs and pregnancy (perfusion only). It is limited by frequency of inconclusive results.
CXR may be normal, or show _____ of affected segment, dilated _______ ______, linear _______, small _____ ______, _____-_______ opacities or cavitation (rare).
CXR may be normal, or show oligaemia of affected segment, dilated pulmonary artery, linear atelectasis, small pleural effusion, wedge-shaped opacities or cavitation (rare).
ECG may be normal, or show ______, _____ block, right ventricular strain (______ __ __ __). The classical SI QIII TIII pattern (p92) is rare.
ECG may be normal, or show tachycardia, right bundle branch block, right ventricular strain (inverted T in V1 to V4). The classical SI QIII TIII pattern (p92) is rare.
what is the first line imaging modality?
CTPA
CTPA can show clots down to ___ order pulmonary arteries
5th order
what is the main treatment for PE?
see VTE treatment options
when may someone have thrombolysis
If someone has a massive PE and collapse there is strong evidence that thrombolysis is beneficial
Consider pharmacological systemic thrombolytic therapy for patients with PE and ________ ________ - e.g. BP and Pulse weird
Consider pharmacological systemic thrombolytic therapy for patients with PE and haemodynamic instability - e.g. BP and Pulse weird
who should not be offered thrombolytic therapy ?
patients with PE and haemodynamic stability
