PULMONARY EMBOLISMOLADIPO MOJISOLA1453

• INTRODUCTION• PATHOPHYSIOLOGY• SIGNS AND SYMPTOMS• RISK FACTORS• EPIDEMOLOGY• DIAGNOSIS TREATMENT• SUMMARY• REFERENCE

INTRODUCTION• An embolus is a detached intravascular solid,

liquid, or gaseous mass that is carried by the blood to a site distant from its point of origin most times the embolus is from a dislodged thrombus

• . Pulmonary embolism occurs when a clump of material, most often a blood clot, gets wedged into an artery in your lungs. These blood clots most commonly originate in the deep veins of your legs, but they can also come from other parts of your body. This condition is known as deep vein thrombosis (DVT).

• Pulmonary embolism is a complication principally in patients who are already suffering from some underlying disorder, such as cardiac disease or cancer, factor v leiden mutation, protein c deficiency, or who are immobilized for several days or weeks, those with hip fracture being at high risk

• venous emboli originate from the leg above the level of the knee as described previously. They are carried through progressively larger channels and usually pass through the right side of the heart into the pulmonary vasculature. Depending on the size of the embolus, it may occlude the main pulmonary artery, impact across the bifurcation (saddle emb. olus), or pass out into the smaller, branching arterioles

• Other causes –air bubbles, part of a tumour, fat from the bone marrow of broken long bone

• Frequently, there are multiple emboli, perhaps sequentially or as a shower of smaller emboli from a single large mass

Signs and symptoms• Shortness of breath. This symptom typically appears

suddenly and always gets worse with exertion.• Chest pain. You may feel like you're having a heart

attack. The pain may become worse when you breathe deeply (pleurisy), cough, eat, bend or stoop. The pain will get worse with exertion but won't go away when you rest.

• Cough. The cough may produce bloody or blood-streaked sputum.

• Other signs and symptoms that can occur with pulmonary embolism include:

• Leg pain or swelling, or both, usually in the calf• Clammy or discolored skin (cyanosis)• Rapid or irregular heartbeat• Lightheadedness or dizziness

RISK FACTORS• Some one who has had it before• DVT• Family history- venous blood clot , pulmonary

embolism• Heart diseases• Cancer• Prolonged immobility- bed rest, journey• Surgery• Obesity• Smoking• Pregnancy• Supplemental estrogen

COMPLICATIONS

• INFARCTION• PULMONARY HYPERTENSION• SUDDEN DEATH-COR PULMONALE

DIAGNOSIS

• Pulmonary embolism can be difficult to diagnose, especially in people who have underlying heart or lung disease

• Blood test – D DIMER TEST• chest xray• Ct scan• v/q lung scan• Pulmonary angiogram-MOST DIAGNOSTIC

TEST

EPIDEMOLOGY

• Pulmonary embolism occur in more than 0.6 million people in the United States each year. It results in between 50,000 and 200,000 deaths per year in the United States.The risk in those who are hospitalized is around 1%.The rate of fatal pulmonary emboli has declined from 6% to 2% over the last 25 years in the United States.

• It is the third most common cause of cardiovascular deathin the us (MI cerebrovascular shock)

• IT is usually a silent disease and its discovered in half of hospitalized patients via autopsy

Medications

• Blood thinners (anticoagulants). • Clot dissolvers (thrombolytics)

Other procedures• Clot removal• Vein filters

REFERENCES 1998-2015 Mayo Foundation for Medical Education and Research•  Goldhaber SZ (2005). "Pulmonary thromboembolism". In Kasper DL, Braunwald

E, Fauci AS, et al. Harrison's Principles of Internal Medicine (16th ed.). New York, NY: McGraw-Hill. pp. 1561–65. 

•  Stein PD, Sostman HD, Hull RD, Goodman LR, Leeper KV, Gottschalk A, Tapson VF, Woodard PK (March 2009). "Diagnosis of Pulmonary Embolism in the Coronary Care Unit". Am. J. Cardiol.

• Pregerson DB, Quick Essentials: Emergency Medicine, 4th edition. EMresource.org

•  Jaff, MR; McMurtry, MS; Archer, SL; Cushman, M; Goldenberg, N; Goldhaber, SZ; Jenkins, JS; Kline, JA; Michaels, AD; Thistlethwaite, P; Vedantham, S; White, RJ; Zierler, BK; American Heart Association Council on Cardiopulmonary, Critical Care, Perioperative and, Resuscitation; American Heart Association Council on Peripheral Vascular, Disease; American Heart Association Council on Arteriosclerosis, Thrombosis and Vascular, Biology (Apr 26, 2011). "Management of massive and submassive pulmonary embolism, iliofemoral deep vein thrombosis, and chronic thromboembolic pulmonary hypertension: a scientific statement from the American Heart Association.".Circulation 123 (16): 1788–830. 

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