Pulmonary Embolism Flashcards
What is the reaccurance rate of a pulmonary embolism
10%
What is a pulmonary embolism
thrombus in pulmonary vessel (artery)
PE are usually caused from
DVTs
Where are these DVTs commonly found
iliac, popliteal, femoral
thrombus can also be caused by
fat (fracture through the bone marrow)
air (iatrogenic)
particles (from amniotic fluid during delivery)
Main patho of a PE
DVT - becomes an embolus - and then becomes a thrombus in the arterial bed of the lungs - causes impaired perfusion - hypoxemia
How does hemodynamic instability occur
platelets degranulate - bronchial/ pulmonary constrictions = hemodynamic instability (inadequate blood pressure)
Why does a decrease CO occur
dt decreased input to the L atrium
What does ischemia cause in an PE
kills the surfactant producing cells - causing atelectasis - and right sided HF dt having to pump against the thrombus
Manifestations
Chest pain (ischemia)
Tachypnea (compensatory)
Dyspnea
Tachycardia
what serum markers are used to diagnosis a pulmonary embolism
serum markers for infarction (LDH3)
lactate dehydrogenase
Describe the lung scan used for diagnosis in pulmonary embolism
uses 131 I-HSA (human serum albumin) to detect thrombus. its a radioactive marker that stops when reaches a thrombus
Other diagnostics for diagnosis
Hx Px ABGs Chest CT pulmonary angiogram (invasive)
Treatment
Stat treatment
Anticoagulants and thrombolytics
maintain cardiopulmonary function to avoid shock