Pulmonary Embolism Flashcards
(16 cards)
What is pulmonary embolism?
Blood clot in pulmonary arteries
What is an embolus?
Thrombus that has traveled in the blood, often from DVT
What affect will blood clot have?
Block blood flow to lung tissue and strain right side of the heart
What are the risk factors for PE?
Immobility
Recent surgery
Long haul travel
Pregnancy
HRT with oestrogen
Malignancy
Polycycthaemia
SLE
Thrombophilia
What is used as prophylaxis for VTE?
Low molecular weight heparin
What else can be used as prophylaxis?
Anti-embolism compression stocking (unless peripheral arterial disease)
What is the presentation of PE?
Asymptomatic
SOB
Cough
haemoptysis
Pleuritic chest pain
Hypoxia
Tachycardia
Increased RR
Low grade fever
Haemodynamic instability causing hypotension
What scoring criteria can used in PE?
PERC rule out criteria
Well’s score
How is PERC rule out criteria used?
<15% probability of PE to decide wether further investigation for PE are needed
How is well’s score used?
Predicts possibility of PE
Accounts for risk factors and clinical findings
How are PEs diagnosed?
Chest x-ray clear but rules out other causes
Well’s score for next step:
- likely = CTPA
- unlikely = d-dimer, if +ve = CTPA
Describe d-dimer test
Not specific, causes for a raised d-dimer =
- pneumonia
-malignancy
-HF
-surgery
-pregnancy
What are imaging options in pe?
CTPA
V/Q scan
Planar V/Q scan
What is the management of PE?
Support depends on severity of symptoms:
-admit to hospital if required
-o2 as required
-analgesia if required
-monitor deterioration
Anticoagulants main management
What anticoagulants can be used in PE?
First line = apixaban and rivaroxiban
LMWH main alternative
Should be started immediately in suspected PE
How is a massive PE treated?
Continuous infusion of unfractioned heparin and considered thrombolysis
