Podcast
Questions and Answers
What is the patient's primary symptom upon presentation to the emergency department?
What is the patient's primary symptom upon presentation to the emergency department?
What was the patient recently treated for prior to presentation?
What was the patient recently treated for prior to presentation?
What is the patient's heart rate upon presentation?
What is the patient's heart rate upon presentation?
What is the name of the condition suspected in the patient?
What is the name of the condition suspected in the patient?
Signup and view all the answers
What is the patient's oxygen saturation level upon presentation?
What is the patient's oxygen saturation level upon presentation?
Signup and view all the answers
What is the name of the author of the article?
What is the name of the author of the article?
Signup and view all the answers
Where did the authors of the article work?
Where did the authors of the article work?
Signup and view all the answers
What can be inferred about the patient's medical history?
What can be inferred about the patient's medical history?
Signup and view all the answers
What is the patient's Wells score, which indicates the probability of pulmonary embolism?
What is the patient's Wells score, which indicates the probability of pulmonary embolism?
Signup and view all the answers
What is the normal range for creatinine and troponin levels in this patient?
What is the normal range for creatinine and troponin levels in this patient?
Signup and view all the answers
What is the primary concern of the physician based on the patient's assessment?
What is the primary concern of the physician based on the patient's assessment?
Signup and view all the answers
What is the d-dimer level in this patient?
What is the d-dimer level in this patient?
Signup and view all the answers
What is the primary mechanism of pulmonary embolism?
What is the primary mechanism of pulmonary embolism?
Signup and view all the answers
What is the next step in evaluating this patient for pulmonary embolism?
What is the next step in evaluating this patient for pulmonary embolism?
Signup and view all the answers
What is the role of the Wells score in the diagnosis of pulmonary embolism?
What is the role of the Wells score in the diagnosis of pulmonary embolism?
Signup and view all the answers
What is the primary goal of treating pulmonary embolism?
What is the primary goal of treating pulmonary embolism?
Signup and view all the answers
What is the primary benefit of chest imaging in patients with suspected pulmonary embolism?
What is the primary benefit of chest imaging in patients with suspected pulmonary embolism?
Signup and view all the answers
What is the primary goal of anticoagulant therapy in patients with acute pulmonary embolism?
What is the primary goal of anticoagulant therapy in patients with acute pulmonary embolism?
Signup and view all the answers
What is the typical duration of anticoagulant therapy for patients with acute pulmonary embolism?
What is the typical duration of anticoagulant therapy for patients with acute pulmonary embolism?
Signup and view all the answers
What is a common psychological complication associated with pulmonary embolism?
What is a common psychological complication associated with pulmonary embolism?
Signup and view all the answers
What is the primary reason for longitudinal follow-up after an acute pulmonary embolism?
What is the primary reason for longitudinal follow-up after an acute pulmonary embolism?
Signup and view all the answers
What is the classification of pulmonary embolism that can be managed at home with a direct oral anticoagulant?
What is the classification of pulmonary embolism that can be managed at home with a direct oral anticoagulant?
Signup and view all the answers
Study Notes
Pulmonary Embolism
- Pulmonary embolism is a common diagnosis associated with recurrent venous thromboembolism, bleeding due to anticoagulant therapy, chronic thromboembolic pulmonary hypertension, and long-term psychological distress.
Diagnosis and Imaging
- Only a minority of patients evaluated for possible pulmonary embolism benefit from chest imaging (e.g., computed tomography).
Treatment
- Initial treatment is guided by classification of the pulmonary embolism as high-risk, intermediate-risk, or low-risk.
- Most patients have low-risk pulmonary embolism and can be managed at home with a direct oral anticoagulant.
- Patients with acute pulmonary embolism should receive anticoagulant therapy for at least 3 months.
Follow-up and Long-term Care
- Patients should be followed longitudinally after an acute pulmonary embolism to assess for dyspnea or functional limitation, which may indicate the development of post–pulmonary-embolism syndrome or chronic thromboembolic pulmonary hypertension.
- The decision to continue treatment indefinitely depends on whether the associated reduction in the risk of recurrent venous thromboembolism outweighs the increased risk of bleeding and should take into account patient preferences.
Case Study
- A 41-year-old man presents to the emergency department with a 3-week history of breathlessness and awoke with dull pain on the right side of the back on the day of presentation.
- His heart rate is 88 beats per minute, blood pressure 149/86 mm Hg, respiratory rate 18 breaths per minute, temperature 37°C, and oxygen saturation 95% while breathing ambient air.
- The patient's Wells score is 0 (on a scale of 0 to 12.5, with higher scores indicating a higher probability of pulmonary embolism), and the d-dimer level is 2560 ng per milliliter.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
