Pulmonary Embolism – Signs and Symptoms, Diagnosis, Treatment

Pulmonary embolism (PE) is a form of venous thromboembolism (VTE) that is common and sometimes fatal. The clinical presentation of PE is variable and often nonspecific making the diagnosis challenging. The evaluation of patients with suspected PE should be efficient so that patients can be diagnosed and therapy administered quickly to reduce the associated morbidity and mortality.
Pulmonary embolus (PE) refers to obstruction of the pulmonary artery or one of its branches by material (eg, thrombus, tumor, air, or fat) that originated elsewhere in the body.

Most emboli are thought to arise from lower extremity proximal veins (iliac, femoral, and popliteal) and more than 50% of patients with proximal vein deep venous thrombosis (DVT) have concurrent PE at presentation. Calf vein DVT rarely embolizes to the lung and two–thirds of calf vein thrombi resolve spontaneously after detection. However, if untreated, one-third of calf vein DVT extend into the proximal veins, where they have greater potential to embolize. PE can also arise from DVT in non-lower-extremity veins including renal and upper extremity veins, although embolization from these veins is less common. Most thrombi develop at sites of decreased flow in the lower extremity veins, such as valve cusps or bifurcations. However, they may also originate in veins with higher venous flow including the inferior vena cava, or the pelvic veins, and in non-lower-extremity veins including renal and upper extremity veins.

Understand pulmonary embolism (P.E.) with this clear explanation from Dr. Roger Seheult of http://www.medcram.com.

Part 1

– Includes definition, risk factors, epidemiology, DVT, signs, and symptoms.

Part 2 includes discussion on the diagnosis of pulmonary embolism

– Includes; Arterial blood gasses (ABGs), chest x-ray, Aa gradient, Hampton’s Hump, Westermark Sign, D-Dimer, tachycardia, ultrasound, DVT, EKG, S1Q3T3, and much more.

Part 3 includes further discussion on the diagnosis of P.E.

– Includes Ventilation/perfusion scan (VQ scan), CT pulmonary angiogram (CTPA), pulmonary angiogram, echocardiogram and more.

Part 4 is a discussion on the treatment of pulmonary embolism.

– Includes fast vs. slow anticoagulation treatment, heparin, warfarin, enoxaparin, IVC filters, contraindications to treatment, prevention, factor V leiden, and other workup.

 

Speaker: Roger Seheult, MD
Clinical and Exam Preparation Instructor
Board Certified in Internal Medicine, Pulmonary Disease, Critical Care, and Sleep Medicine

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Produced by Kyle Allred PA-C

Please note: MedCram medical videos, medical lectures, medical illustrations, and medical animations are for medical educational and exam preparation purposes, and not intended to replace recommendations by your health care provider.

 

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