Pulmonary Embolism Flashcards
What is a Pulmonary embolism
Blockage of a pulmonary artery by an embolism
What is a PE usually a result of
Of a DVT
How can atrial fibrillation cause PE
Blood clots from in the atria due to stasis and then embolism to the pulmonary arteries
What are symptoms for PE
Dyspnoea - often acute onset
Pleuritic chest pain
Symptoms of DVT
Collapse
Fever
Haemoptysis
What are signs of PE
Tachycardia
Hypoxia
Cyanosis
Low BP
What do you perform if Wells score indicates a PE is likely
CTPA
What do you perform if Wells score indicates a PE is unlikely
D-dimer if positive then perform CTPA
When would you use a V/Q scan as an alternative to a CTPA
Renal impairment
Contrast allergy
At risk from radiation
Pregnant People
When would a CXR be performed
Early on in PE
When would a ultrasound be used
If radiation should be avoided or
DVT suspected
What other test might indicate a PE
ECG - Tachycardia
Troponin - may be raised
ABG - Type 1 response failure
Investigate underlying cause
What are investigations for underlying causes
Ultrasound
Cancer screen
Autoantibodies
Thrombophilia screen
What is the first line acute treatment
Anticoagulation - apixaban or rivaroxaban
What is used if neither apixaban or rivaroxaban are suited
LMWH followed by dabigatran or edoxaban
LMWH followed by vitamin K antagonist
What is recommended as a first line treatment for massive PE where there is circulatory treatment
Thrombolysis
