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7 Cards in this Set
- Front
- Back
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Define PE
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Sudden blockage of the pulmonary artery, usually by a blood clot from a vein in the leg
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Aetiology of PE
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Vessel wall damage: Thrombus formation, at venous valves -trauma, surgery, CV catheterisation
Venous stasis - poor blood flow - immobility etc Hypercoagulability - cancer, obesity, pregnancy, IBD |
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Signs and symptoms
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Risk factors
Chest pain Dyspnoea Tachypnoea Syncope Cough Tachycardia |
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Pathophysiology of PE
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DVT's are dfirectly responsible
They are usually composed of fibrin and trapped erthyrocytes Coag preceeds platelt activation Trapped thrombus causes increases PVR, increasing work on right ventricle. --Inc HR via Frank Starling --|compensation as PVR increased Decrease in RV output leads to decreases in preload. So LV filling and CO decrease, lowering MAP Hypotension and shock Can occur at 5-% or > occlusion |
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Investigations for PE
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CXR - ECG - ABG
D-dimer (if not elevated PE can go home) CTPA V/Q scan MRA Trans Oesophageal Echo |
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Treatment
prophylaxis/log term |
O2
Anticoagulatants Vasopressore therapy LMWH XA inhibitor |
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treatment Acute
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Thrombolysis
t-PA Anticoagulant Vasopressors |
