Pulmonary Embolism Flashcards
Embolus that occlude the main pulmonary artery, impact across the bifurcation
Saddle embolus
Embolus that passes through an interventricular defect to gain access to systemic circulation
Paradoxical embolism
Most common source of embolism
Isolated calf vein thrombi (DVT)
The great masquerade
Pulmonary embolism
Most common history
Unexplained breathlessness
Most common symptom
Dyspnea
Most common sign
Tachypnea
Dyspnea, syncope, hypotension, cyanosis
Massive pulmonary embolism
Most common preventable cause of death among hospitalized patients
Pulmonary Embolism
Signs and symptoms of small pulmonary embolism
Pleuritic pain, cough, hemoptysis
Cramp in lower calf that persist for several days and becomes more uncomfortable
Deep vein thrombosis
Most common abnormality in ECG
T wave inversion in lead V1-V4 (anteroseptal)
Gold standard
Contrast venography
Focal oligemia
Westermark’s sign
Peripheral wedge shaped density above the diaphragm
Hampton’s hump
Enlarged right descending pulmonary artery
palla’s sign
Principal imaging test for diagnosis for PE
Chest CT with IV contrast
Pathognomonic ECG sign
S1Q3T3 sign (S in lead I, Q in lead III, inverted T in lead III)
Second line diagnostic test for PE
Lung scanning
Hypokinesis of RV free wall with normal motion of RV apex in echocardiography
McConnell’s sign
Definitive diagnosis of PE visualization of an intraluminal filling defect in more than 1 projection
Pulmonary angiography
Diagnostic test for suspected DVT
Contrast plebography
Binds to and accelerates the activity of antithrombin preventing formation and permits endogenous fibrinolytic mechanism to lyse clot that formed
Unfractionated heparin
Oral anticoagulant
Warfarin
Direct thrombin inhibitor for prevention of VTE after total hip and knee replacement
dabigatran
Most serious adverse effect of anticoagulation
Hemorrhage
Antidote for Heparin or LMWH
Protamine sulfate
Anticoagulant for patients with renal insufficiency
Argatroban
Anticoagulant for patients with hepatic failure
Lepirudin
Common complication of IVC filter
Caval thrombosis with marked bilateral leg swelling
2 principal indication for IVC filter insertion
- active bleeding that precludes anticoagulation
- recurrent venous thrombosis despite intensive anticoagulation
