Pulmonary Emboli

Front 1

Pulmonary Emboli: What is it? (pathology?)

Back 1

Pulmonary embolism (PE) is a blockage of the main artery of the lung or one of its branches by a substance that has travelled from elsewhere in the body through the bloodstream (embolism). The obstruction of the blood flow through the lungs and the resultant pressure on the right ventricle of the heart leads to the symptoms and signs of PE. The risk of PE is increased in various situations, such as cancer and prolonged bed rest.

Front 2

Pulmonary Emboli: What is the cause?

Back 2

Usually this is due to embolism of a thrombus (blood clot) from the deep veins in the legs, a process termed venous thromboembolism.
DVT-Deep vein thrombosis

Front 3

Pulmonary Emboli: What risk factors?

Back 3

alterations in blood flow: after surgery, injury or long-distance air travel), pregnancy (also procoagulant), obesity (also procoagulant), cancer (also procoagulant)
factors in the vessel wall: of limited direct relevance in VTE (venous thromboembolism)
factors affecting the properties of the blood
Estrogen-containing hormonal contraception
Genetic thrombophilia (factor V Leiden, prothrombin mutation G20210A, protein C deficiency, protein S deficiency, antithrombin deficiency, hyperhomocysteinemia and plasminogen/fibrinolysis disorders)
Acquired thrombophilia (antiphospholipid syndrome, nephrotic syndrome, paroxysmal nocturnal hemoglobinuria)
Cancer (due to secretion of pro-coagulants)

Front 4

Pulmonary Emboli: Signs & symptoms?

Back 4

Symptoms of PE are sudden-onset dyspnea (shortness of breath),
tachypnea (rapid breathing),
chest pain of a "pleuritic" nature (worsened by breathing),
cough and hemoptysis (coughing up blood).
More severe cases can include signs such as cyanosis (blue discoloration, usually of the lips and fingers),
collapse, and
circulatory instability due to decreased blood flow through the lungs and into the left side of the heart.
About 15% of all cases of sudden death are attributable to PE.
palpitations.
Clinical signs:
low blood oxygen saturation and cyanosis,
rapid breathing,
rapid heart rate.
Severe cases of PE can lead to collapse,
abnormally low blood pressure
sudden death

Front 5

Pulmonary Emboli: Diagnostic tests?

Back 5

The gold standard for diagnosing pulmonary embolism (PE) is pulmonary angiography.
CT pulmonary angiography. CT pulmonary angiogram (CTPA) is a medical diagnostic test that employs computed tomography to obtain an image of the pulmonary arteries. Its main use is to diagnose pulmonary embolism (PE). CT pulmonary angiography (CTPA) is a pulmonary angiogram obtained using computed tomography (CT) with radiocontrast rather than right heart catheterization
D-Dimer: a small protein fragment present in the blood after a blood clot is degraded by fibrinolysis. A normal D-dimer level (shown in a blood test) is enough to exclude the possibility of thrombotic PE
X-ray shows whiteout
Spiral CT (3-dimensional scan)