Pulmonary Embolism Flashcards
State the signs and symptoms of pulmonary embolism.
Sudden onset dyspnea, pleuritic chest pain, tachypnea, hemoptysis, cough, tachycardia, dizziness or syncope.
What are the cardinal symptoms of pulmonary embolism?
Sudden onset dyspnea and pleuritic chest pain.
What are the most common risk factors for pulmonary embolism?
Recent surgery, prolonged immobility, deep vein thrombosis (DVT), cancer, pregnancy, oral contraceptives, smoking, obesity.
What is the primary diagnostic test for pulmonary embolism?
CT pulmonary angiography (CTPA).
What other diagnostic tests can be used for pulmonary embolism?
V/Q scan, D-dimer (useful in low-probability patients), venous ultrasound (to detect DVT).
What is the initial management for pulmonary embolism?
Anticoagulation therapy (e.g., heparin or LMWH), oxygen therapy, and supportive care.
When is thrombolysis indicated in pulmonary embolism?
In patients with massive PE (hemodynamic instability or shock) or in those with severe hypoxia.
What are the complications of pulmonary embolism?
Chronic thromboembolic pulmonary hypertension (CTEPH), right ventricular dysfunction, death.
What is the role of D-dimer in diagnosing pulmonary embolism?
Elevated D-dimer levels suggest PE, but it is not specific; useful for ruling out PE in low-risk patients.
What is the management for a patient with confirmed pulmonary embolism?
Anticoagulation (e.g., heparin followed by oral anticoagulants), consider thrombolysis or surgery for massive PE, mechanical support if needed.
What is the role of CT pulmonary angiography (CTPA) in diagnosing pulmonary embolism?
CTPA is the gold standard imaging test for PE, providing direct visualization of thrombus in pulmonary arteries.
How does V/Q scanning help in diagnosing pulmonary embolism?
Used when CTPA is contraindicated or unavailable, assesses ventilation and perfusion mismatch.
How long is anticoagulation therapy required for pulmonary embolism?
For at least 3 months, with long-term therapy depending on the presence of risk factors (e.g., malignancy, idiopathic PE).
What is the role of inferior vena cava (IVC) filter in pulmonary embolism?
Used in patients with contraindications to anticoagulation or recurrent PE despite anticoagulation.
What are the signs of right ventricular strain in pulmonary embolism?
Elevated JVP, hypotension, tachycardia, right bundle branch block (RBBB) on ECG.
