Pulmonary Embolism

Question 1

What is the cause of pulmonary embolism?

Answer 1

Virchows triad:

1. stasis
2. coagulation
3. damaged epithelial lining

Question 2

Where do emboli typically come from?

Answer 2

They usually come from the pelvis or the abdomen and sometimes from DVT’s but rarely from the right heart itself

Question 3

What are some of the risk factors/predisposing factors leading to the development of DVT’S?

Answer 3

1. Surgery/immobilisation
2. pregnancy/hormonal pills
3. congestive cardiac failure
4. Pelvic/lower limb fractures
5. inherited hypercoaguability-factor v leiden
   6.

Question 4

What is the clinical picture of amassive pulmonary embolism?

Answer 4

1. sudden collapse of the lung acute obstruction
2. Shocked
3. Pale
4. Sweating
5. tachypnea
6. tachycardia
7. Low BP
8. Syncope, confusion, death
9. right heart failure (JVP)

Question 5

What are the clinical features of moderate pulmonary embolism?

Answer 5

1. mixture of massive and mild. Right heart failure

Question 6

What are the clinical features of mild pulmonary embolism?

Answer 6

1. Pleuritic pain
2. dyspnea
3. cough
4. haemoptysis
5. pleural effusion
6. friction rubs

Question 7

What is the differential of pulmonary embolism?

Answer 7

1. cardiac: angina, myocardial infarction, pericarditis
2. Respiratory: Pneumonia, asthma, penumothorax
3. Other: costochrondritis, panic attack, rib fracture

Question 8

How do we diagnose pulmonary embolism?

Answer 8

1. X-ray: mostly normal/ pleural effusion/wedge-shaped opacification/decreased blood flow in a distal zone, volume loss with raised hemidiaphragm