Pulmonary Embolism Flashcards
Pulmonary Embolism
Block of pulmonary artery by a blood clot, fat, tumour or air.
How does PE cause pulmonary infarction?
Blood flow & oxygen supply to lung tissues is compromised => lung tissue may die.
Cause
Usually arise from DVT in pelvis or legs
How does DVT cause PE
Clots break off & pass through veins & right side of the heart.
Classification ation
Massive (with shock or syncope), Major (with RV dysfunction), Major (with normal RV function), Minor.
DVT Classification ficaion
Proximal (Ile-femoral) & distal (popliteal)
Proximal (Ileo-Femoral)
Most likely to embolise & lead to chronic venous insufficiency & venous lung ulcers.
What DVT is more likely to embolise
Proximal: Ileo-femoral.
Risk Factors
Surgery, immobility (long-haul flight), oral contraceptive, pregnancy, pelvic obstruction, trauma, thrombophilia, malignancy, obesity, pulmonary hypertension, IV drug users, vascularise.
Virchow ‘s Triad
- Factors in vessel wall.
- Abnormal blood flow.
- Hypercoagulable blood.
Side effects of anticoagulants
Increased risk of bleeding.
Symptoms: General
Acute SOB, collapse, pleuritic, chest pain, haemoptysis, sudden death.
Signs: General
Tachycardia, tachypnoea, cyanosis, fever, low BP, crackles, pleural rub, signs of pleural effusion.
Symptoms/Signs: Large
CV shock, low BP, central cyanosis, sudden death, sustained systolic <90, sever hypoxaemia.
Symptoms/Signs: Medium
Pleuritic pain, haemoptysis, dyspnoea
Symptoms/Signs: Small/Recurrent
Progressive dyspnoea, pulmonary hypertension, right heart failure.
