22 Pulmonary Embolism Flashcards Preview

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Flashcards in 22 Pulmonary Embolism Deck (17)
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What is a pulmonary embolism?

Obstruction of a pulmonary artery or one of its branches


Where do pulmonary emboli commonly originate?

Deep veins of lower limb, pelvis or abdomen


What can the embolism be made up of (ie what can embolise)? (6)

Fat embolism due to long bone fracture 


How are fat emboli usually caused?

Fat emboli commonly occur after fractures to the long bones of the lower body


How are cerebral air emboli usually caused?


Where do the majority of pulmonary emboli come from?

90% from DVT in legs

Esp: popliteal vein and pelvic veins


What are the risk factors for a pulmonary embolus?

Same as for DVT:

  1. Stasis / turbulence of blood flow
  2. Blood hypercoagulability 
  3. Endothelial injury 

Vichow Triad


List some risk factors that increase someones risk of developing a thromboembolism (eg pregnancy).


  • Increased age- increased risk (culmination of factors) 
  • HRT
  • Longhaul travel: stasis, dehydration


If someone with a DVT has no identifiable risk factors, what needs to be considered?

Undetected malignancy

  • Eg. Cancer might secrete pro-thrombotic factors 


Give examples of conditions that should be screened for if a patient is in hypercoagulable state.

  • Deficiency of natural blood thinners
    • Antithrombin III deficiency
    • Protein C or Protein S deficiency/resistance  
  • Lupus anticoagulant
  • Homocystinuria
  • Malignancy 


What % of people with pulmonary emboli will suddenly die?



What are the symptoms of a pulmonary embolism?

Patient can look and feel asymptomatic- make sure to check if high risk 


What are the physical signs of a pulmonary embolism?

Diaphoresis= sweating

Thrombophelbitis= (inflammation of a vein due to thrombus) 


If a patient presents with the symptoms of a pulmonary embolism, what might be the diffential diagnoses?

Pleurisy= pleuritis (sharp chest pain) 


What investigations can be done if a patient has a suspected pulmonary embolism? 


Outline the how pulmonary emboli are treated.

  • Oxygen
  • Low molecular weight heparin
    • Stop thmobus propagatin and allows body to lyse thrombus
      • BUT watch out for heparin induced thrombocytopenia
  • Percutaneous catheter- thrombectomy
  • Surgical pulmonary embolectomy


What can we do to prevent the occurence of pulmonary emboli in patients?

  • Manage risk factors (eg HRT, obesity, travelling etc)
  • DVT prophylaxis after surgery/for malignancy