16.) PE Flashcards
(14 cards)
What is pulmonary thromboembolism (PE)?
PE occurs when a blood clot, typically from a deep vein thrombosis (DVT) in the legs, breaks off and travels to the pulmonary arterial circulation.
What percentage of patients with proximal leg DVT develop PE?
Approximately half of the patients with proximal leg DVT will develop PE, often without symptoms.
What are the common fatal outcomes of PE?
PE can be fatal, commonly due to progressive right ventricular failure.
What is a serious long-term complication of PE?
Chronic thromboembolic pulmonary hypertension.
What are the risk factors for pulmonary thromboembolism?
Risk factors include immobilization, cancer, obesity, smoking, trauma, surgery, pregnancy, and oral contraceptives.
What are the clinical features of PE?
Dyspnea is the most common sign; chest pain, cough, hemoptysis, and syncope can also occur.
What is the Wells score used for?
The Wells score is used to estimate the probability of PE.
What score indicates that PE is likely according to the Wells score?
A score of more than 4 indicates that PE is likely.
What are the physical exam findings in PE?
Tachypnea, tachycardia, low-grade fever, neck vein distention, hypotension, and cyanosis in massive PE.
What lab tests are used in the diagnosis of PE?
D-dimer, arterial blood gas, and troponin tests are used.
What imaging is typically used for diagnosing PE?
Chest X-ray with IV contrast and transesophageal echocardiography when contrast X-ray is not appropriate.
What is the treatment for PE?
Anticoagulate with LMW heparin, then warfarin for a minimum of 3 months aiming for an INR of 2–3. Thrombolysis for massive PE.
What is the prevention strategy for PE?
Heparin for all immobile patients, compression socks, and early mobilization.
Wells score points
Clinical signs of DVT: 3 points
• Alternative diagnosis less likely than PE: 3p
• Heart rate >100: 1.5p
• Immobilization or surgery in the past 4 weeks: 1.5p
• Previous DVT/PE: 1.5p
• Hemoptysis: 1p
• Malignancy (treatment in last 6 months, or palliative): 1p
• Score of more than 4 PE likely, less han 4 PE unlikely.
