Pulmonary Embolism Flashcards
Common signs and symptoms of PE
Pleuritic chest pain, haemoptysis, SOB, cough
Less common signs and symptoms
Rapid/irregular HR, dizziness, sweating, fever, syncope, leg pain or swelling, cyanosis, low BP
Medical risk factors for getting PE
CV disease for clot formation, cancers, clotting disorders, Covid-19, protein S and protein C deficiency
Risk factors for PE
Post-op surgery, prolonged immobility, smoking, overweight, supplemental oestrogen, pregnancy
Types of PE
Massive, moderate or mild
Diagnosis of PE
D dimer, CXR, US, CTPA, V/Q scan, ECG,
Gold standard for PE diagnosis
CTPA - not used in those with poor kidney function
Signs in ECG of PE
Sinus tachycardia, S1Q3T3 pattern of acute cor pulmonale classic (large S wave on lead I, Q wave in lead III and inverted T wave in lead III)
Supportive management of PE
Admission to hosp, oxygen, analgesia and adequate monitoring
Initial management of PE
Apixaban or rivaroxaban
Long term management of PE
Switch to anticoagulation with warfarin, NOAC or LMWH
How long does anticoagulation continue if there is an obvious reversible cause
3 months
How long does anticoagulation continue if there is no clear cause, recurrent VTE and irreversible cause
> 3 months, usually 6 months
How long for anticoagulation in patients with cancer
6 months, with LMWH
What does thrombolysis involve
Injecting a fibrinolytic medication that rapidly dissolves clots
