Pulmonary Embolism Flashcards
1
Q
What is the brief pathophysiology of a pulmonary embolism?
A
- Venous thrombi, breaks off and blocks blood flow in pulmonary circulation
- Embolus obstructs right ventricular outflow = increased vascular resistance and acute RHF
- Lung tissue ventilated but not perfused
2
Q
What are the risk factors for a PE?
A
- DVT
- Recent surgery, especially abdominal / pelvic or hip / knee replacement
- Thrombophilia
- Leg fracture / immobilisation
- Malignancy
- Pregnancy / post partum
- Combined oestrogen pill / hormone replacement therapy
- Previous PE
3
Q
How would you generally describe the symptoms of a PE?
A
Non specific
4
Q
Give a couple of signs of a PE?
A
- Pyrexia
- Cyanosis
- Tachycardia
- Hypotension
- Raised JVP
5
Q
Give a couple of symptoms of a PE?
A
- Breathlessness
- Pleuritic chest pain
- Haemoptysis
- Syncope
- Dizziness
- Calf pain (sign of a DVT)
6
Q
What investigations would you perform in a suspected PE?
A
- CT pulmonary angiography
- FBC, U&E, baseline clotting, D-dimers
- ABG
- CXR
- ECG
7
Q
What might you see on an ABG in a PE?
A
may show decreased PaO2 and decreased PaCO2
8
Q
What might you see on the CXR in someone with a PE?
A
May be normal or show hypovolaemia of affected segment
9
Q
What is the immediate management for a PE?
A
- Oxygen if hypoxic
- Morphine with anti-emetic if needed
- IV access and LMWH
10
Q
What is the long term management for a PE?
A
- Commence LMWH
- Long term anticoagulants - either DOAC (eg rivaroxaban) or warfarin (refer to DVT)
