Pulmonary Emboli Flashcards
(17 cards)
Pathophysiology
Detached intravascular mass carried to lungs by blood
Cause
DVT
Risk factors
Abnormal blood flow
Hypercoaguable blood (post MI, cancer treatment)
recent surgery
Investigations
1st - CTPA or V/Q scan (if renal issues present)
ECG
D-dimer
chest X-ray
What would be present on the ECG?
Acute R strain
What would the d-dimer test show?
Raised D-dimers
Treatment
LMW heparin or fondaparinux for 5 days or until INR>20 for 24hrs
Warfarin for 3 months or other Vitamin K antagonist
Treatment (large PE)
Thrombolysis if haemodynamically unstable
What is associated with a large PE?
Circulatory failure (e.g hypotension)
What is associated with PE
Pleural effusion
Describe a pleural effusion that accompanies a PE
small and blood stained
Patients with PE may enter what?
Respiratory alkalosis
Symptoms
severe chest pain
dyspnoea
haemoptysis
what investigation would be used in a pregnant patient with suspected PE
V/Q scan
a well’s score of what makes PE unlikely
< or = 4
a well’s score of what makes PE likely
> 4
when would IVC filter be offered
if PE remains despite anticoagulation after considering increasing LMWH
