Pulmonary Embolism Revision Flashcards
What is a PE?
A blockage of the main artery of the lung or one of its branches by a substance that has travelled from elsewhere in the body through the bloodstream (embolism)
What is a PE usually due to?
Embolism of a thrombus from the deep veins in the leg (venous thromboembolism)
What is a small % of PE due to?
the embolisation of air, fat, talc in drugs of intravenous drug abusers or amniotic fluid.
How does the obstruction of blood flow through the lungs due to a PE affect the heart?
Resultant pressure on right ventricle of the heart
Symptoms of PE?
- Sudden onset dyspnoea
- Tachypnoea
- Chest pain of a pleuritic nature (worsened by breathing)
- Cough and haemoptysis
- Palpitations
Clinical signs of PE?
- Low blood O2 sat
- Cyanosis
- Rapid breathing
- Rapid heart rate
What lab tests can be used to diagnose PE?
- D-dimer test
- Imaging
What is the d-dimer test?
A D-dimer test looks for D-dimer in blood.
D-dimer is a protein fragment that’s made when a blood clot dissolves in your body.
What imaging is usually used for PE?
CT pulmonary angiography
Treatment for PE?
anticoagulant medication, including heparin and warfarin
What treatment may severe cases of PE require?
thrombolysis with drugs such as tissue plasminogen activator (tPA) or may require surgical intervention
How do the lungs normally appear during physical examination of PE?
Normal
N.B. a pleural effusion is sometimes present
How may strain on the right ventricle be detected?
- Left parasternal heave
- Loud pulmonary component of the second heart sound
- Raised jugular venous pressure
What causes a parasternal heave?
Usually right ventricular hypertrophy
What is a DVT?
the development of a thrombus in the deep venous system of the lower extremities or, less commonly, the upper extremities.
