22 Pulmonary Embolism Flashcards
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:
- Stasis / turbulence of blood flow
- Blood hypercoagulability
- 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?
20%
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?
