Pulmonary Embolism

Question 1

PE Presentation

Answer 1

Non-specific
History is key
-recent history of travel, long bone fracture, immobility, stroke, malignancy, heart failure, postpartum
History of PE is a risk

Question 2

“Classic” PE Presentation

Answer 2

Dyspnea
Tachycardia
Pleuritic chest pain
Neck vein distension
Weakness or malaise

Question 3

PE

Answer 3

blockage of one or more of the pulmonary arteries or their branches by a thrombus or other embolic material that dislodges and enters the pulmonary circulation

Question 4

PE Diagnostics

Answer 4

EKG to rule out cardiac
Chest x-ray to rile out other
V/Q Scan
CT (gold standard)
BNP and D-dimer can rule out, but not confirm

Question 5

Virchow Triad

Answer 5

Venous stasis
Endothelial or vessel wall injury
Hypercoaguability

These three contribute to the cause of a thrombus

Question 6

Treatment

Answer 6

Immediate referral
Initial stabilization - treat hypoxia and hypotension
Anticoagulation with low-molecular weight heparin and start warfarin