Podcast
Questions and Answers
What is the annual incidence of pulmonary embolism (PE) in the USA?
What is the annual incidence of pulmonary embolism (PE) in the USA?
Which of the following is NOT a recognized risk factor for pulmonary embolism?
Which of the following is NOT a recognized risk factor for pulmonary embolism?
In the pathophysiology of a massive pulmonary embolism, what primarily leads to right ventricular failure?
In the pathophysiology of a massive pulmonary embolism, what primarily leads to right ventricular failure?
Which imaging method is commonly used for diagnosing pulmonary embolism?
Which imaging method is commonly used for diagnosing pulmonary embolism?
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What type of blood thinner is commonly administered via intravenous or subcutaneous route for PE treatment?
What type of blood thinner is commonly administered via intravenous or subcutaneous route for PE treatment?
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What symptom is typically associated with pulmonary embolism?
What symptom is typically associated with pulmonary embolism?
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Which of the following pulmonary embolism treatments is classified as surgical?
Which of the following pulmonary embolism treatments is classified as surgical?
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Which laboratory test is important for assessing clot presence in suspected pulmonary embolism cases?
Which laboratory test is important for assessing clot presence in suspected pulmonary embolism cases?
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Study Notes
Pulmonary Embolism
- Pulmonary embolism (PE) is a condition where a blood clot blocks a pulmonary artery in the lungs.
- 50,000 individuals die from PE each year in the USA.
- The incidence of PE in the USA is 500,000 per year.
Objectives
- Prevalence
- Risk Factors
- Clinical Features
- Pathophysiology
- Diagnostic Workup
- Treatment
Risk Factors
- General anesthesia
- Lower limb or pelvic injury/surgery
- Congestive heart failure
- Prolonged immobility
- Pregnancy and postpartum
- Oral contraceptives
- Malignancy
- Thrombophilia
- Prior DVT/PE
Clinical Features
Symptoms
- Sudden onset dyspnea
- Pleuritic chest pain
- Syncope
- Hemoptysis
- Palpitations
- Lower limb swelling/pain
Signs
- Tachypnea
- Tachycardia
- Cyanosis
- Hypotension
- Fever
- DVT signs (swelling, tenderness, redness)
Pathophysiology
- Thromboembolism: Blood clots originate from deep vein thrombosis (DVT). Possible sources of clots are in lower limb veins, pelvic veins, abdominal veins, and upper limb veins.
- Fat embolism: Can arise from broken long bones.
- Tumor embolism
- Air embolism Often caused by iatrogenic (medical) procedures or suicidal behavior.
- Amniotic fluid embolism: Rare, occurs from pregnancy complications.
- Pathophysiology of massive PE: Increased pulmonary vascular resistance, right ventricular outflow obstruction. leading to increased RV pressure, RV failure, decreased left ventricular preload, and reduced cardiac output.
Diagnosis
- Bedside: ECG, blood pressure
- Blood tests: CBC, coagulation profile, renal and liver profile, D-dimer, Cardiac enzymes (troponin), ABG, thrombophilia screen
- Imaging: CXR, CT pulmonary angiogram, V/Q scan, echocardiogram (echo), US Doppler
Treatment
Medical
- General supportive management
- Blood thinners (anticoagulation): Heparin IV/SC, Warfarin, DOAC
- Clot dissolvers (thrombolytics): Higher risk of bleeding
Surgical/Interventional Radiology
- Vein filter
- Catheter-directed thrombectomy
- Embolectomy
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Description
Explore the critical aspects of pulmonary embolism (PE), a serious condition resulting from blood clots blocking pulmonary arteries. This quiz covers prevalence, risk factors, clinical features, pathophysiology, diagnostic workup, and treatment options for PE. Test your understanding of this life-threatening condition and its management.
