Pulmonary Embolism Flashcards
What is the most common presenting symptom of a pulmonary embolism (PE)
Sudden-onset dyspnea (shortness of breath).
What are the hallmark cardiovascular symptoms of a PE?
Tachycardia, chest pain, syncope, hypotension (in massive PE), and accentuated pulmonic heart sound.
What respiratory symptoms may occur with a PE?
Tachypnea, hemoptysis, crackles, wheezing, pleuritic chest pain, and cough.
What are severe or life-threatening signs of a massive PE?
Sudden hypotension, mental status change, feeling of impending doom, and cardiopulmonary arrest.
Where do most pulmonary emboli originate?
Deep vein thrombosis (DVT), usually from the lower extremities
What are risk factors for PE?
Immobility, recent surgery, cancer, pregnancy, oral contraceptives, smoking, clotting disorders, and prolonged travel.
What is a “saddle embolus”?
large thrombus lodged at the bifurcation of the pulmonary arteries.
What is the most common and preferred imaging study for diagnosing PE?
Spiral CT scan (CT pulmonary angiography - CTA).
What test is done if the patient cannot tolerate contrast dye?
Ventilation-perfusion (V/Q) scan.
What lab test detects clot degradation and is used to screen for PE
D-dimer test
What ECG and chest x-ray findings might be present in PE?
ECG: Nonspecific ST segment and T wave changes
.
CXR: Atelectasis or pleural effusion (not diagnostic).
What is the priority intervention for PE?
Oxygen therapy and continuous monitoring of cardiopulmonary status.
What anticoagulants are used in acute PE treatment?
Low-molecular-weight heparin (LMWH) (e.g., enoxaparin, dalteparin).
Unfractionated IV heparin (for high-risk patients).
Warfarin (started early for long-term therapy).
What is the duration of anticoagulant therapy for PE
At least 3 months, longer for recurrent PEs or chronic risk factors
What medication is used for massive PE if anticoagulation is not enough
fibrinolytic therapy (e.g., tPA, alteplase).
What are surgical options for severe PE?
Pulmonary embolectomy (for unstable patients) and
inferior vena cava (IVC) filter placement (for recurrent PEs when anticoagulation is contraindicated).
What lifestyle changes can help prevent PE recurrence?
Early ambulation, leg exercises, compression stockings, weight loss, smoking cessation, and avoiding prolonged immobility.
What safety precautions should patients take while on anticoagulant therapy?
Monitor for signs of bleeding (bruising, nosebleeds, hematuria, melena).
Avoid contact sports and high-risk activities.
Use a soft toothbrush and electric razor.
When should a patient seek immediate medical attention?
Sudden shortness of breath, chest pain, hemoptysis, or signs of DVT (leg swelling, redness, pain).
