SlideShare a Scribd company logo

Pulmonary embolism

Pulmonary embolism

1 of 17
Download to read offline
Pulmonary Embolism
• Pulmonary embolism (PE) refers to the obstruction of the pulmonary
artery or one of its branches by a thrombus (or thrombi) that
originates somewhere in the venous system or in the right side of the
heart
Types
• Most commonly, PE is due to a blood clot or thrombus.
• However, there are other types of emboli: air, fat, amniotic fluid, and
septic (from bacterial invasion of the thrombus).
Risk Factors
Venous Stasis (slowing of blood flow in veins)
• Prolonged immobilization (especially postoperative)
• Prolonged periods of sitting/traveling
• Varicose veins
• Spinal cord injury
Hypercoagulability (due to release of tissue thromboplastin after
injury/surgery)
• Injury
• Tumor (pancreatic, GI, GU, breast, lung)
• Increased platelet count (polycythemia, splenectomy)
Venous Endothelial Disease
• Thrombophlebitis
• Vascular disease
• Foreign bodies (IV/central venous catheters)

More Related Content

What's hot (20)

Pulmonary thromboembolism
Pulmonary thromboembolismPulmonary thromboembolism
Pulmonary thromboembolism
 
Pulmonary embolism
Pulmonary embolism   Pulmonary embolism
Pulmonary embolism
 
Pulmonary Embolism
Pulmonary EmbolismPulmonary Embolism
Pulmonary Embolism
 
Pulmonary embolism1
Pulmonary embolism1Pulmonary embolism1
Pulmonary embolism1
 
Empyema
EmpyemaEmpyema
Empyema
 
Empyema
EmpyemaEmpyema
Empyema
 
Pulmonary embolism ( PE)
Pulmonary embolism ( PE)Pulmonary embolism ( PE)
Pulmonary embolism ( PE)
 
Pneumothorax
PneumothoraxPneumothorax
Pneumothorax
 
Cor pulmonale
Cor pulmonaleCor pulmonale
Cor pulmonale
 
Pulmonary thromboembolism
Pulmonary thromboembolismPulmonary thromboembolism
Pulmonary thromboembolism
 
Acute respiratory distress syndrome
Acute respiratory distress syndromeAcute respiratory distress syndrome
Acute respiratory distress syndrome
 
Pulmonary embolism
Pulmonary embolismPulmonary embolism
Pulmonary embolism
 
Pleural effusion
Pleural effusionPleural effusion
Pleural effusion
 
Cor pulmonale
Cor pulmonaleCor pulmonale
Cor pulmonale
 
Pulmonary embolism (PE)
Pulmonary embolism (PE)Pulmonary embolism (PE)
Pulmonary embolism (PE)
 
Pleural empyema dr.tinku joseph
Pleural empyema  dr.tinku josephPleural empyema  dr.tinku joseph
Pleural empyema dr.tinku joseph
 
Pneumothorax PPT
Pneumothorax PPTPneumothorax PPT
Pneumothorax PPT
 
Lung abscess
Lung abscessLung abscess
Lung abscess
 
Pleural effusion
Pleural effusionPleural effusion
Pleural effusion
 
Pulmonary embolism
Pulmonary embolism Pulmonary embolism
Pulmonary embolism
 

Similar to Pulmonary embolism

pulmonaryembolismppt-150625153914-lva1-app6891.pptx
pulmonaryembolismppt-150625153914-lva1-app6891.pptxpulmonaryembolismppt-150625153914-lva1-app6891.pptx
pulmonaryembolismppt-150625153914-lva1-app6891.pptxadityapatidar34
 
Plural effusion, PE & lung abscess, pneumothorax_014402.pptx
Plural effusion, PE & lung abscess, pneumothorax_014402.pptxPlural effusion, PE & lung abscess, pneumothorax_014402.pptx
Plural effusion, PE & lung abscess, pneumothorax_014402.pptxShubhrimaKhan
 
Pulmonaryedema 160624071007
Pulmonaryedema 160624071007Pulmonaryedema 160624071007
Pulmonaryedema 160624071007OM VERMA
 
cardiactamponade-210728145806-1.pptx
cardiactamponade-210728145806-1.pptxcardiactamponade-210728145806-1.pptx
cardiactamponade-210728145806-1.pptxmousaderhem1
 
Pulmonary embolism
Pulmonary embolismPulmonary embolism
Pulmonary embolismNitaKarki2
 
Acute pulmonary edema
Acute pulmonary edemaAcute pulmonary edema
Acute pulmonary edemaKhurram Wazir
 
Pericardial effusion
Pericardial effusionPericardial effusion
Pericardial effusionTanvir Adnan
 
Approach to chest pain
Approach to chest pain Approach to chest pain
Approach to chest pain Ewei Voon
 
Approach to chest pain
Approach to chest painApproach to chest pain
Approach to chest paindrwaque
 
Chest trauma (Emergency Medicine)
Chest trauma (Emergency Medicine)Chest trauma (Emergency Medicine)
Chest trauma (Emergency Medicine)kalyan ram
 
2 hyperemia-congestion
2 hyperemia-congestion2 hyperemia-congestion
2 hyperemia-congestionPrasad CSBR
 
pte-170215074434.pptx
pte-170215074434.pptxpte-170215074434.pptx
pte-170215074434.pptxAshraf Shaik
 
Physiology of laparoscopic surgery
Physiology of laparoscopic surgery  Physiology of laparoscopic surgery
Physiology of laparoscopic surgery Ravi Kumar
 
Pulmonary embolism 1-
Pulmonary embolism 1-Pulmonary embolism 1-
Pulmonary embolism 1-Maged Hemaid
 
PULMONARY VALVE DISEASES (2).pptx
PULMONARY VALVE DISEASES (2).pptxPULMONARY VALVE DISEASES (2).pptx
PULMONARY VALVE DISEASES (2).pptxSYED ALI AFRIN
 
Congestive cardiac failure
Congestive cardiac failureCongestive cardiac failure
Congestive cardiac failureSudeep Kashyap
 

Similar to Pulmonary embolism (20)

pulmonaryembolismppt-150625153914-lva1-app6891.pptx
pulmonaryembolismppt-150625153914-lva1-app6891.pptxpulmonaryembolismppt-150625153914-lva1-app6891.pptx
pulmonaryembolismppt-150625153914-lva1-app6891.pptx
 
Plural effusion, PE & lung abscess, pneumothorax_014402.pptx
Plural effusion, PE & lung abscess, pneumothorax_014402.pptxPlural effusion, PE & lung abscess, pneumothorax_014402.pptx
Plural effusion, PE & lung abscess, pneumothorax_014402.pptx
 
Pulmonaryedema 160624071007
Pulmonaryedema 160624071007Pulmonaryedema 160624071007
Pulmonaryedema 160624071007
 
Hemoptysis.pptx
Hemoptysis.pptxHemoptysis.pptx
Hemoptysis.pptx
 
cardiactamponade-210728145806-1.pptx
cardiactamponade-210728145806-1.pptxcardiactamponade-210728145806-1.pptx
cardiactamponade-210728145806-1.pptx
 
Pulmonary embolism
Pulmonary embolismPulmonary embolism
Pulmonary embolism
 
Acute pulmonary edema
Acute pulmonary edemaAcute pulmonary edema
Acute pulmonary edema
 
Pulmonary edema
Pulmonary edemaPulmonary edema
Pulmonary edema
 
Pericardial effusion
Pericardial effusionPericardial effusion
Pericardial effusion
 
Approach to chest pain
Approach to chest pain Approach to chest pain
Approach to chest pain
 
Approach to chest pain
Approach to chest painApproach to chest pain
Approach to chest pain
 
Cardiac tamponade
Cardiac tamponadeCardiac tamponade
Cardiac tamponade
 
Valvular heart disease
Valvular heart disease Valvular heart disease
Valvular heart disease
 
Chest trauma (Emergency Medicine)
Chest trauma (Emergency Medicine)Chest trauma (Emergency Medicine)
Chest trauma (Emergency Medicine)
 
2 hyperemia-congestion
2 hyperemia-congestion2 hyperemia-congestion
2 hyperemia-congestion
 
pte-170215074434.pptx
pte-170215074434.pptxpte-170215074434.pptx
pte-170215074434.pptx
 
Physiology of laparoscopic surgery
Physiology of laparoscopic surgery  Physiology of laparoscopic surgery
Physiology of laparoscopic surgery
 
Pulmonary embolism 1-
Pulmonary embolism 1-Pulmonary embolism 1-
Pulmonary embolism 1-
 
PULMONARY VALVE DISEASES (2).pptx
PULMONARY VALVE DISEASES (2).pptxPULMONARY VALVE DISEASES (2).pptx
PULMONARY VALVE DISEASES (2).pptx
 
Congestive cardiac failure
Congestive cardiac failureCongestive cardiac failure
Congestive cardiac failure
 

More from Eko Priyanto

Venture planning in nursing
Venture planning in nursingVenture planning in nursing
Venture planning in nursingEko Priyanto
 
Unit 4 methods of data collection
Unit 4 methods of data collectionUnit 4 methods of data collection
Unit 4 methods of data collectionEko Priyanto
 
Introduction to nursing research
Introduction to nursing researchIntroduction to nursing research
Introduction to nursing researchEko Priyanto
 
Ethics in nursingresearch
Ethics in nursingresearchEthics in nursingresearch
Ethics in nursingresearchEko Priyanto
 
Curriculum development
Curriculum developmentCurriculum development
Curriculum developmentEko Priyanto
 
persepective of-nursing-education
persepective of-nursing-educationpersepective of-nursing-education
persepective of-nursing-educationEko Priyanto
 
Master plan of evaluation
Master plan of evaluationMaster plan of evaluation
Master plan of evaluationEko Priyanto
 
Curriculum process
Curriculum process Curriculum process
Curriculum process Eko Priyanto
 
The role of stake holders in curriculum development
The role of stake holders in curriculum development The role of stake holders in curriculum development
The role of stake holders in curriculum development Eko Priyanto
 
Strategies in curriculum evaluation
Strategies in curriculum evaluation Strategies in curriculum evaluation
Strategies in curriculum evaluation Eko Priyanto
 
Process of curriculum change
Process of curriculum change Process of curriculum change
Process of curriculum change Eko Priyanto
 
Nosocomial infection
Nosocomial infectionNosocomial infection
Nosocomial infectionEko Priyanto
 
Introduction rs and hallo
Introduction rs and halloIntroduction rs and hallo
Introduction rs and halloEko Priyanto
 
Self directed learning theory presentation
Self directed learning theory presentationSelf directed learning theory presentation
Self directed learning theory presentationEko Priyanto
 
Programmed instruction my presentation
Programmed instruction my presentationProgrammed instruction my presentation
Programmed instruction my presentationEko Priyanto
 

More from Eko Priyanto (20)

Venture planning in nursing
Venture planning in nursingVenture planning in nursing
Venture planning in nursing
 
Data analysis
Data analysisData analysis
Data analysis
 
Research critic
Research criticResearch critic
Research critic
 
Unit 4 methods of data collection
Unit 4 methods of data collectionUnit 4 methods of data collection
Unit 4 methods of data collection
 
Introduction to nursing research
Introduction to nursing researchIntroduction to nursing research
Introduction to nursing research
 
Ethics in nursingresearch
Ethics in nursingresearchEthics in nursingresearch
Ethics in nursingresearch
 
Curriculum development
Curriculum developmentCurriculum development
Curriculum development
 
persepective of-nursing-education
persepective of-nursing-educationpersepective of-nursing-education
persepective of-nursing-education
 
Unit plan
Unit planUnit plan
Unit plan
 
Master plan of evaluation
Master plan of evaluationMaster plan of evaluation
Master plan of evaluation
 
Curriculum process
Curriculum process Curriculum process
Curriculum process
 
Course plan
Course planCourse plan
Course plan
 
The role of stake holders in curriculum development
The role of stake holders in curriculum development The role of stake holders in curriculum development
The role of stake holders in curriculum development
 
Strategies in curriculum evaluation
Strategies in curriculum evaluation Strategies in curriculum evaluation
Strategies in curriculum evaluation
 
Process of curriculum change
Process of curriculum change Process of curriculum change
Process of curriculum change
 
Nosocomial infection
Nosocomial infectionNosocomial infection
Nosocomial infection
 
Introduction rs and hallo
Introduction rs and halloIntroduction rs and hallo
Introduction rs and hallo
 
Rating scale
Rating scaleRating scale
Rating scale
 
Self directed learning theory presentation
Self directed learning theory presentationSelf directed learning theory presentation
Self directed learning theory presentation
 
Programmed instruction my presentation
Programmed instruction my presentationProgrammed instruction my presentation
Programmed instruction my presentation
 

Recently uploaded

Cell locomotion (Ameboid/ciliary/flagellar movement)
Cell locomotion (Ameboid/ciliary/flagellar movement)Cell locomotion (Ameboid/ciliary/flagellar movement)
Cell locomotion (Ameboid/ciliary/flagellar movement)MedicoseAcademics
 
Tolerance Hydra10P Avene trainings blink
Tolerance Hydra10P Avene trainings blinkTolerance Hydra10P Avene trainings blink
Tolerance Hydra10P Avene trainings blinkClinicians
 
Seminario biología molecular Kevin Duque
Seminario biología molecular Kevin DuqueSeminario biología molecular Kevin Duque
Seminario biología molecular Kevin Duquekevinestebanduque
 
Presentation on Cerebral Palsy and its orthotic management
Presentation on Cerebral Palsy and its orthotic managementPresentation on Cerebral Palsy and its orthotic management
Presentation on Cerebral Palsy and its orthotic managementeshasmalik27
 
Staphylococcus.ppt.........ali.rasool.badr
Staphylococcus.ppt.........ali.rasool.badrStaphylococcus.ppt.........ali.rasool.badr
Staphylococcus.ppt.........ali.rasool.badrssuser06f49d
 
Anesthesia Implications in cannabis Users.pptx
Anesthesia Implications in cannabis Users.pptxAnesthesia Implications in cannabis Users.pptx
Anesthesia Implications in cannabis Users.pptxhrowshan
 
GLANDS IN THE SKIN,FUNCTIONS AND ABNORMALITIES ..pptx
GLANDS IN THE SKIN,FUNCTIONS AND ABNORMALITIES ..pptxGLANDS IN THE SKIN,FUNCTIONS AND ABNORMALITIES ..pptx
GLANDS IN THE SKIN,FUNCTIONS AND ABNORMALITIES ..pptxWINCY THIRUMURUGAN
 
Population of India and Family welfare programme.pptx
Population of India and Family welfare programme.pptxPopulation of India and Family welfare programme.pptx
Population of India and Family welfare programme.pptxDr. Dheeraj Kumar
 
How to be a successful physician intrapreneur
How to be a successful physician intrapreneurHow to be a successful physician intrapreneur
How to be a successful physician intrapreneurArlen Meyers, MD, MBA
 
Seminario Biología Molecular - Susana Cano V.pdf
Seminario Biología Molecular - Susana Cano V.pdfSeminario Biología Molecular - Susana Cano V.pdf
Seminario Biología Molecular - Susana Cano V.pdfsusiedapp
 
Psychedelic Interventions for Neurological Conditions [NAN 2022 Poster]
Psychedelic Interventions for Neurological Conditions [NAN 2022 Poster]Psychedelic Interventions for Neurological Conditions [NAN 2022 Poster]
Psychedelic Interventions for Neurological Conditions [NAN 2022 Poster]Brian Peacock
 
Seminario Biología Molecular Manuela Álvarez Ramírez
Seminario Biología Molecular Manuela Álvarez RamírezSeminario Biología Molecular Manuela Álvarez Ramírez
Seminario Biología Molecular Manuela Álvarez Ramírezmanuelaalvarezr
 
Artificial Radionuclide Generators in Medicine Applications in Radiotherapy.pptx
Artificial Radionuclide Generators in Medicine Applications in Radiotherapy.pptxArtificial Radionuclide Generators in Medicine Applications in Radiotherapy.pptx
Artificial Radionuclide Generators in Medicine Applications in Radiotherapy.pptxDr. Dheeraj Kumar
 
USG,CT AND MR IMAGING OF HEPATIC MASS LESIONS.
USG,CT AND MR IMAGING OF HEPATIC MASS LESIONS.USG,CT AND MR IMAGING OF HEPATIC MASS LESIONS.
USG,CT AND MR IMAGING OF HEPATIC MASS LESIONS.vrchk912
 
HEPATIKA 6 Nutritional supplement, six ingredients supported by clinical studies
HEPATIKA 6 Nutritional supplement, six ingredients supported by clinical studiesHEPATIKA 6 Nutritional supplement, six ingredients supported by clinical studies
HEPATIKA 6 Nutritional supplement, six ingredients supported by clinical studiesRichard Clement
 
ABDULRAHMAN AL RAFIQ UPDATED MANAGEMENT OF ACUTE PULMONARY EMBOLISM .pdf
ABDULRAHMAN AL RAFIQ UPDATED MANAGEMENT OF ACUTE PULMONARY EMBOLISM .pdfABDULRAHMAN AL RAFIQ UPDATED MANAGEMENT OF ACUTE PULMONARY EMBOLISM .pdf
ABDULRAHMAN AL RAFIQ UPDATED MANAGEMENT OF ACUTE PULMONARY EMBOLISM .pdfAbdurahmanRafeeq
 
Impact of Early Pregnancy---Lecture-2024
Impact of Early Pregnancy---Lecture-2024Impact of Early Pregnancy---Lecture-2024
Impact of Early Pregnancy---Lecture-2024ERWINPEJI2
 
pediatrics. epilepsy and seizures in children 8.ppt
pediatrics. epilepsy and seizures in children 8.pptpediatrics. epilepsy and seizures in children 8.ppt
pediatrics. epilepsy and seizures in children 8.pptArun170190
 
KOSHTA CONCEPT IN AYURVEDA BY VIJAY R K
KOSHTA CONCEPT IN AYURVEDA  BY  VIJAY R KKOSHTA CONCEPT IN AYURVEDA  BY  VIJAY R K
KOSHTA CONCEPT IN AYURVEDA BY VIJAY R Kvinaykumarrkumabar
 

Recently uploaded (20)

Anti-interferon-gamma autoantibody associated immunodeficiency
Anti-interferon-gamma autoantibody associated immunodeficiencyAnti-interferon-gamma autoantibody associated immunodeficiency
Anti-interferon-gamma autoantibody associated immunodeficiency
 
Cell locomotion (Ameboid/ciliary/flagellar movement)
Cell locomotion (Ameboid/ciliary/flagellar movement)Cell locomotion (Ameboid/ciliary/flagellar movement)
Cell locomotion (Ameboid/ciliary/flagellar movement)
 
Tolerance Hydra10P Avene trainings blink
Tolerance Hydra10P Avene trainings blinkTolerance Hydra10P Avene trainings blink
Tolerance Hydra10P Avene trainings blink
 
Seminario biología molecular Kevin Duque
Seminario biología molecular Kevin DuqueSeminario biología molecular Kevin Duque
Seminario biología molecular Kevin Duque
 
Presentation on Cerebral Palsy and its orthotic management
Presentation on Cerebral Palsy and its orthotic managementPresentation on Cerebral Palsy and its orthotic management
Presentation on Cerebral Palsy and its orthotic management
 
Staphylococcus.ppt.........ali.rasool.badr
Staphylococcus.ppt.........ali.rasool.badrStaphylococcus.ppt.........ali.rasool.badr
Staphylococcus.ppt.........ali.rasool.badr
 
Anesthesia Implications in cannabis Users.pptx
Anesthesia Implications in cannabis Users.pptxAnesthesia Implications in cannabis Users.pptx
Anesthesia Implications in cannabis Users.pptx
 
GLANDS IN THE SKIN,FUNCTIONS AND ABNORMALITIES ..pptx
GLANDS IN THE SKIN,FUNCTIONS AND ABNORMALITIES ..pptxGLANDS IN THE SKIN,FUNCTIONS AND ABNORMALITIES ..pptx
GLANDS IN THE SKIN,FUNCTIONS AND ABNORMALITIES ..pptx
 
Population of India and Family welfare programme.pptx
Population of India and Family welfare programme.pptxPopulation of India and Family welfare programme.pptx
Population of India and Family welfare programme.pptx
 
How to be a successful physician intrapreneur
How to be a successful physician intrapreneurHow to be a successful physician intrapreneur
How to be a successful physician intrapreneur
 
Seminario Biología Molecular - Susana Cano V.pdf
Seminario Biología Molecular - Susana Cano V.pdfSeminario Biología Molecular - Susana Cano V.pdf
Seminario Biología Molecular - Susana Cano V.pdf
 
Psychedelic Interventions for Neurological Conditions [NAN 2022 Poster]
Psychedelic Interventions for Neurological Conditions [NAN 2022 Poster]Psychedelic Interventions for Neurological Conditions [NAN 2022 Poster]
Psychedelic Interventions for Neurological Conditions [NAN 2022 Poster]
 
Seminario Biología Molecular Manuela Álvarez Ramírez
Seminario Biología Molecular Manuela Álvarez RamírezSeminario Biología Molecular Manuela Álvarez Ramírez
Seminario Biología Molecular Manuela Álvarez Ramírez
 
Artificial Radionuclide Generators in Medicine Applications in Radiotherapy.pptx
Artificial Radionuclide Generators in Medicine Applications in Radiotherapy.pptxArtificial Radionuclide Generators in Medicine Applications in Radiotherapy.pptx
Artificial Radionuclide Generators in Medicine Applications in Radiotherapy.pptx
 
USG,CT AND MR IMAGING OF HEPATIC MASS LESIONS.
USG,CT AND MR IMAGING OF HEPATIC MASS LESIONS.USG,CT AND MR IMAGING OF HEPATIC MASS LESIONS.
USG,CT AND MR IMAGING OF HEPATIC MASS LESIONS.
 
HEPATIKA 6 Nutritional supplement, six ingredients supported by clinical studies
HEPATIKA 6 Nutritional supplement, six ingredients supported by clinical studiesHEPATIKA 6 Nutritional supplement, six ingredients supported by clinical studies
HEPATIKA 6 Nutritional supplement, six ingredients supported by clinical studies
 
ABDULRAHMAN AL RAFIQ UPDATED MANAGEMENT OF ACUTE PULMONARY EMBOLISM .pdf
ABDULRAHMAN AL RAFIQ UPDATED MANAGEMENT OF ACUTE PULMONARY EMBOLISM .pdfABDULRAHMAN AL RAFIQ UPDATED MANAGEMENT OF ACUTE PULMONARY EMBOLISM .pdf
ABDULRAHMAN AL RAFIQ UPDATED MANAGEMENT OF ACUTE PULMONARY EMBOLISM .pdf
 
Impact of Early Pregnancy---Lecture-2024
Impact of Early Pregnancy---Lecture-2024Impact of Early Pregnancy---Lecture-2024
Impact of Early Pregnancy---Lecture-2024
 
pediatrics. epilepsy and seizures in children 8.ppt
pediatrics. epilepsy and seizures in children 8.pptpediatrics. epilepsy and seizures in children 8.ppt
pediatrics. epilepsy and seizures in children 8.ppt
 
KOSHTA CONCEPT IN AYURVEDA BY VIJAY R K
KOSHTA CONCEPT IN AYURVEDA  BY  VIJAY R KKOSHTA CONCEPT IN AYURVEDA  BY  VIJAY R K
KOSHTA CONCEPT IN AYURVEDA BY VIJAY R K
 

Pulmonary embolism

  • 2. • Pulmonary embolism (PE) refers to the obstruction of the pulmonary artery or one of its branches by a thrombus (or thrombi) that originates somewhere in the venous system or in the right side of the heart
  • 3. Types • Most commonly, PE is due to a blood clot or thrombus. • However, there are other types of emboli: air, fat, amniotic fluid, and septic (from bacterial invasion of the thrombus).
  • 4. Risk Factors Venous Stasis (slowing of blood flow in veins) • Prolonged immobilization (especially postoperative) • Prolonged periods of sitting/traveling • Varicose veins • Spinal cord injury
  • 5. Hypercoagulability (due to release of tissue thromboplastin after injury/surgery) • Injury • Tumor (pancreatic, GI, GU, breast, lung) • Increased platelet count (polycythemia, splenectomy)
  • 6. Venous Endothelial Disease • Thrombophlebitis • Vascular disease • Foreign bodies (IV/central venous catheters)
  • 7. Certain Disease States (combination of stasis, coagulation alterations, and venous injury) • Heart disease (especially heart failure) • Trauma (especially fracture of hip, pelvis, vertebra, lower extremities) • Postoperative state/postpartum period • Diabetes mellitus • Chronic obstructive pulmonary disease
  • 8. Other Predisposing Conditions • Advanced age • Obesity • Pregnancy • Oral contraceptive use • History of previous thrombophlebitis, pulmonary embolism • Constrictive clothing
  • 9. Pathophysiology thrombus completely or partially obstructs a pulmonary artery The area continue to be ventilated, but receives little or no blood flow. gas exchange is impaired or absent in this area the alveolar dead space is increased V-Q mis match
  • 10. various substances are released from the clot and surrounding area causing regional blood vessels and bronchioles to constrict increase in pulmonary vascular resistance. Increases ventilation–perfusion imbalance.
  • 11. • The hemodynamic consequences are increased pulmonary vascular resistance from the regional vasoconstriction and reduced size of the pulmonary vascular bed. • This results in an increase in pulmonary arterial pressure and, in turn, an increase in right ventricular work to maintain pulmonary blood flow. • When the work requirements of the right ventricle exceed its capacity, right ventricular failure occurs, leading to a decrease in cardiac output followed by a decrease in systemic blood pressure and the development of shock.
  • 12. Clinical Manifestations • Tachypnea • Dyspnea • Anxiety • Chest pain • Hypoxemia may be present depending on the size of embolism • Cough • Syncope (loss of consciousness) • Hemoptysis • Crackles • Fever • edema • cyanosis
  • 13. Diagnostic findings • Physical examination • Pulse oxymetry • ABG analysis • ECG • Lung perfusion scan • CT scan • Pulmonary angiography is the definitive means of diagnosis of PE
  • 14. Medical Management • General measures to improve respiratory and vascular status • Anticoagulation therapy – heparin or warfarin, low mol.wt heparin • Thrombolytic therapy - streptokinase, alteplase, anistreplase, reteplase • Surgical intervention
  • 15. EMERGENCY MANAGEMENT • Nasal oxygen • Intravenous infusion lines • A perfusion scan, hemodynamic measurements, and arterial blood gas determinations are performed. • Hypotension is treated by a slow infusion of dobutamine (Dobutrex) (which has a dilating effect on the pulmonary vessels and bronchi) or dopamine (Intropin).
  • 16. • The ECG is monitored continuously for dysrhythmias and right ventricular failure, which may occur suddenly. • If the patient has suffered massive embolism and is hypotensive, an indwelling urinary catheter is inserted to monitor urinary output. • Small doses of intravenous morphine or sedatives are administered to relieve the patient’s anxiety, to alleviate chest discomfort, to improve tolerance of the endotracheal tube, and to ease adaptation to the mechanical ventilator.
  • 17. SURGICAL MANAGEMENT • Pulmonary embolectomy requires a thoracotomy with cardiopulmonary bypass technique. • Transvenous catheter embolectomy is a technique in which a vacuum- cupped catheter is introduced transvenously into the affected pulmonary artery. Suction is applied to the end of the embolus and the embolus is aspirated into the cup. The surgeon maintains suction to hold the embolus within the cup, and the entire catheter is withdrawn through the right side of the heart and out the femoral vein. • An inferior caval filter is usually inserted at the time of surgery to protect against a recurrence.