Pulmonary Embolism Flashcards
- Q: What is the first pathological stage of a pulmonary embolism (PE)?
A: Embolus Formation
A thrombus (usually from a DVT) forms in a deep vein.
Triggered by Virchow’s triad: venous stasis, endothelial injury, hypercoagulability.
- Q: What happens during the embolisation stage of PE?
A: Thrombus dislodges and travels to pulmonary circulation
Embolus moves via:
Leg vein → IVC → Right atrium → Right ventricle → Pulmonary artery
Lodges in a pulmonary artery or branch
- Q: What occurs during the vascular obstruction stage of PE?
A: Pulmonary artery is blocked
Blood flow to alveoli is reduced → V/Q mismatch
Leads to hypoxemia and impaired gas exchange
- Q: What are the hemodynamic effects of PE?
A: Increased pulmonary vascular resistance → Right heart strain
Right ventricle struggles against high afterload
May lead to right-sided heart failure, hypotension, or cardiac arrest in massive PE
- Q: What happens in the inflammatory stage of PE?
A: Pulmonary tissue may infarct due to lack of perfusion
Inflammatory response leads to:
Pleuritic chest pain
Hemoptysis
Pleural effusion
- Q: What are the possible outcomes of a PE?
A: Resolution or chronic complications
Fibrinolysis: Embolus is broken down by plasmin
Chronic thromboembolic pulmonary hypertension (CTEPH) may develop if emboli are not resolved
- Q: What is CTEPH and how does it relate to PE?
A: Chronic Thromboembolic Pulmonary Hypertension
• A long-term complication of unresolved or recurrent PE
• Leads to persistent pulmonary hypertension and right heart overload
