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    Pulmonary Embolism

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    noureldintamereisa2004
    Pulmonary embolism (PE) is the occlusion of pulmonary circulation caused by various types of emboli, with pulmonary thromboembolism being the focus of this document. Key risk factors include previous clots, older age, and certain medical conditions, while symptoms can range from swelling and pain to shortness of breath and chest pain. Diagnosis involves imaging techniques like CT pulmonary angiography and treatment options include anticoagulation and surgical interventions for high-risk patients.

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    Pulmonary Embolism

    Uploaded by

    noureldintamereisa2004
    0 views15 pages
    Pulmonary embolism (PE) is the occlusion of pulmonary circulation caused by various types of emboli, with pulmonary thromboembolism being the focus of this document. Key risk factors include previous clots, older age, and certain medical conditions, while symptoms can range from swelling and pain to shortness of breath and chest pain. Diagnosis involves imaging techniques like CT pulmonary angiography and treatment options include anticoagulation and surgical interventions for high-risk patients.

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    Pulmonary embolism (PE) is the occlusion of pulmonary circulation caused by various types of emboli, with pulmonary thromboembolism being the focus of this document. Key risk factors include previous clots, older age, and certain medical conditions, while symptoms can range from swelling and pain to shortness of breath and chest pain. Diagnosis involves imaging techniques like CT pulmonary angiography and treatment options include anticoagulation and surgical interventions for high-risk patients.

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    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    0 views15 pages

    Pulmonary Embolism

    Uploaded by

    noureldintamereisa2004
    Pulmonary embolism (PE) is the occlusion of pulmonary circulation caused by various types of emboli, with pulmonary thromboembolism being the focus of this document. Key risk factors include previous clots, older age, and certain medical conditions, while symptoms can range from swelling and pain to shortness of breath and chest pain. Diagnosis involves imaging techniques like CT pulmonary angiography and treatment options include anticoagulation and surgical interventions for high-risk patients.

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    PU L M O N A R Y

    EM BO L I S M
    MMED AB DELKADER
    BY : BASMA MOHA
    DEFENITION
    • OCCLUSION OF PULMONARY CIRCULATION WHICH MAY
    CAUSED BY:
    1. THROMBI
    2. FAT EMBOLI
    3. AIR EMBOLI
    4. BACTEIAL / SEPTIC EMBOLI
    5. AMNIOTIC FLUID EMBOLI
    6. TUMOR EMBOLI
    AND OUR TOPIC
    TODAY IS PULMONARY
    THROMBO EMBOLISM
    PATHOPHYSIOL
    OGY ;
    • VIRCHOW’S TRIAD :
    • VASCULAR INJURY
    • HYPERCOAGULABILITY
    • BLOOD STASIS
    CLASSIFICATION
    RISK FACTORS
    PREVIOUS HISTORY OF CLOTS AS DEEP VENOUS THROMBOSIS
     OLDER AGE.
    CANCER AND CANCER THERAPY.
     CERTAIN MEDICAL CONDITIONS, SUCH AS HEART FAILURE, CHRONIC
    OBSTRUCTIVE PULMONARY DISEASE (COPD), HIGH BLOOD PRESSURE, STROKE,
    AND INFLAMMATORY BOWEL DISEASE.
    SURGERY AND BED RIDDEN
    Symptoms of acute onset
    • LL. swelling , pain
    • Shortness of breath
    • Chest pain (pleuritic, typical]
    CLINICAL •
    •
    Palpitations
    hemoptysis
    PRESENTAT
    ION Signs
    • Tachypnea
    • Sinus tachycardia
    • Hypoxia
    • Ll tenderness, hottness , edema
    • Shock state and collapse in massive
    PE
    • DIAGNOSIS OF PE IS MISSED MORE THAN MADE IN THE SAME TIME IT IS ONE OF THE
    MOST CAUSES OF UNEXPECTED DEATHES WORLDWIDE.

    • ECG ;
    SINUS TACHYCARDIA
    SIGNS OF RV STRAIN : RBBB , S1Q3T3 , RIGHT AXIS DEVIATION

    • ABG ;
    MOSTLY ASSOCIATED WITH RESPIRATORY ALKALOISIS ‘ UNLESS SHOCKED PATIENT MAY

    DIAGNOSIS
    •
    BE ASSOCIATED WITH METABOLIC ACIDOSIS ‘
    XRAY ;
    A NORMAL X RAY DOESN'T EXCLUDE PULMONARY EMBOLISM
    SOME SIGNS MAY BE SEEN : WEDGE SHAPED INFARCT , HAMPTON’S HUMP ,
    WESTERMARK SIGN , ATELECTATIC BANDS

    • CT PULMONARY ANGIOGRAPHY ;
    IT IS THE RECOMMENDED IMAGING MODALITY AND THE GOLD STANDARD FOR PULMONARY
    EMBOLISM DIAGNOSIS
    LABORATORY INVESTIGATIONS
    1. D DIMER
    2. CBC :
    THROMBOPHILIIA
    POLYTHYSEMIA

    3. CARDIAC ENZYMES :
    TROPNONIN
    BNP

    4. RENAL FUNCTIONS :
    CREATININE
    UREA

    5. COAGULATION PROFILE
    6. DIAGNOSIS OF CAUSE [ COLLAGEN PROFILE, THROMBOPHILIA]
    COMPLICATIONS
    • OBSTRUCTIVE SHOCK AND DEATH
    • ARRHYTHEMIA
    • RESPIRATORY FAILURE
    • PULMONARY HYPERTENSION
    • PLEURAL EFFUSION
    • COMPLICATIONS OF TREATMENT
    • CORPULMONALE
    • CHRONIC THROMBOEMBOLIC PULMONARY HYPERTENSION
    DIFFRENTIAL DIAGNOSIS
    PE HAS A WIDE DD WHICH MUST BE CONSIDERED

    • DD OF ACUTE DYSPNEA WITH OR • DD OF HEMOPTYSIS :


    WITHOUT CHEST PAIN: • BRONCHOGENIC CANCER
    1. MYOCARDIAL INFARCTION • CONGESTIVE HEART FAILURE
    2. PNEUMOTHORAX
    3. PULMONARY EDEMA • DD OF PLEURITIC CHEST PAIN
    4. AORTIC DISSECTION • PNEUMONIA
    5. CARDIAC TAMPONADE • RIB FRACTURE
    • PNEUMOTHORAX
    • PERICARDITIS
    TREATMENT
    PROPHYLACTIC : THERAPUTIC :

    • IF THE PATIENT IN HIGH RISK “SHOCKED” : REPERFUSION


    MUST BE DONE
    A- ELECTIVE ANTI COAGULATION MEDICALLY BY THROMBOLYTIC THEARPY OR

    B-ELASTIC STOKING SURGICALLY BY CATHETER DIRECTED THERAPY OR PULMONARY


    END ARTERIECTOMY “IF MEDICAL TTT IS CONTRAINDICATED “
    C- EARLY POST OPERATIVE
    AMBULATION
    D-ELECTRIC STIMULATION OF CALF • IF THE PATIENT IS NON HIGH RISK PATIENT :
    MEDICAL TREATMENT BY ANTICOAGULANT AGENTS “
    MUSCLES BY GALVANIC CURRENT
    UNFRACTIONATED HEPARINE , LMWH , OACS “

    • SURGICAL TREATMENT BY IVC FILTER FOR RECURRENT


    THROMBOEMOLISM
    THANK YOU

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