Pulmonary Embolism and HTN Flashcards
Signs of pulmonary embolism
Rales, wheezing RR>20 HR>100 Accentuated 2nd heart sound Fever Signs of DVT
Symptoms of pulmonary embolism
Acute onset dyspnea cough, hemoptysis Chest pain, palpitations Syncope, apprehension Leg swelling
How does a PE look like on a CXR?
Normal most of the time Can have: Pleural effusion Atelactasis Ham-toms hump***
How does PE look like on an ECG?
Sinus tachy
Non specific ST/TW changes
S1Q3T3
RV strain pattern
What is a D-dimer test?
Holds negative predictive value to determining whether or not there is a PE.
- > tells if there is a thrombus (byproduct of a thrombus being broken down), but is non specific
- > if neg, then no thrombus -> no PE
How does the ABG test look like for PE?
Respiratory alkalosis
Hypoxemia
Increased A-a gradient
Normal MPAP. Elevated?
12 - 16 mmHg
> 25 mmHg
Signs of pulmonary HTN
Loud S2, high JVP
Tricuspid regurg, louder upon inspiration
Peripheral edema
Symptoms of pulmonary HTN
Gradual onset Exertional dyspnea and lightheadedness, syncope Chest pain Fatigue, decreased appetite Underlying dz symptoms
Pulmonary HTN CXR
Look for enlarged pulm trunk or artery
Pulmonary HTN ECG
Signs for RVH Right axis deviation R:S >1 in VI Bigger p wave in lead II (RA enlargement) RBBB
Pulmonary HTN Echo
Can see tricuspid regurg
RVH and IVS pushed to LV
Pulmonary HTN Treatment
Diuretics if retaining fluid
Anticoagulants for certain PAH patients and CTEPH patients
O2 for hypoxemia