Pulmonary Embolism Flashcards
Define pulmonary embolism.
Pulmonary embolism (PE) is a consequence of thrombus formation within a deep vein of the body, most frequently in the lower extremities. Approximately 51% of DVT will embolise to the pulmonary embolus which results in a PE.
Explain the aetiology/risk factors of pulmonary embolism.
Sitting for long periods of time without movement
Smoking
Increased age
Broken bones (fat embolus)
Clotting disorders which cause clots to form more easily.
Summarise the epidemiology of pulmonary embolism.
In the UK, 47,594 cases of PE were reported in the 1-year period between 2013 and 2014. Incidence increases with increased age.
Recognise the presenting symptoms of pulmonary embolism.
SOB
Chest pain
Cough
Recognise the signs of pulmonary embolism on physical examination.
Tachycardia
Tachypnoea
Swelling in leg
Haemoptysis
Identify appropriate investigations for pulmonary embolism and interpret the results.
Wells criteria/Geneva score
Multiple-detector computed tomographic pulmonary angiography (CTPA)
Ventilation-perfusion (V/Q) scan
Coagulation studies
Urea and creatinine
FBC
Pulmonary Embolism Rule-Out Criteria (PERC)
D-dimer test
Generate a management plan for pulmonary embolism.
- Respiratory support
- Intravenous fluids
- Vasoactive agents
- Anticoagulation
- Thrombolysis or embolectomy or catheter-directed therapy
Adjunct:
Venous filter
Identify the possible complications of pulmonary embolism and its management.
Acute bleeding during treatment
Pulmonary infarction
Cardiac arrest/death
Chronic thromboembolic pulmonary
Heparin-associated thrombocytopenia (HIT)
Recurrent venous thromboembolic event
Summarise the prognosis for patients with pulmonary embolism.
Patients in the high-risk category have a short-term mortality of 10.9%, while patients in the low-risk category have 30-day mortality of 1%.
