Pulmonary Embolism

Question 1

Describe the Patholoohysiology of Pulmonary Embolism.

Answer 1

There is decrease in the cross- sectional area of the pulmonary vascular bed, causing an increase in the pulmonary vascular resistance and RV afterload. [NB] More than half of the pulmonary vascular bed needs to be obstructed to cause an Increase in pulmonary vascular resistance

Mediators from platelets cause vaso and bronchoconstriction.

there is also HYPERVENTILATION as a result of irritant receptors stimulation

Question 2

Describe history or Symptoms for Pulmonary Embolism.

Answer 2

1. Dyspnoea at rest
2. Pleuritic chest pain (pain when breathing)
3. Calf pain or Swelling
4. Cough
5. Wheeze
6. Haemoptysis (haemo-p-ty-sis)
7. Syncope

Question 3

Describe the Treatment of Pulmonary Embolism

Answer 3

General Resuscitation
Oxygenation
Inotropes

Question 4

Describe the Goals and Agents for Parenteral Anticougulation.

Answer 4

Goals
Inhibition of thrombus propagation
Dissolution of exisiting thromboemboli.

Agents
Unfractionated Heparin
Low Molecular Weight Heparin(LMWH)
Fondaparinux (Fonda-pari-nux)