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Pulmonary embolism:a condition in which one or more emboli, usually…
Pulmonary embolism:a condition in which one or more emboli, usually arising from a blood clot formed in the veins, are lodged in and obstruct the pulmonary arterial system, causing severe respiratory dysfunction.
Diagnosis
Other symptoms
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In severe cases, dizziness and/or syncope (due to right ventricular failure).
other symptoms
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Gallop rhythm, a widely split second heart sound, tricuspid regurgitant murmur.
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Hypotension (systolic blood pressure less than 90 mmHg) and cardiogenic shock (rare signs indicating central PE and/or a severely reduced haemodynamic reserve).
Suspect pulmonary embolism (PE) in a person with dyspnoea, tachypnoea, pleuritic chest pain, and/or features of deep vein thrombosis (DVT),
management
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confirmed
Treatment
The parenteral anticoagulants licensed for the treatment of pulmonary embolism are low molecular weight heparins (dalteparin, enoxaparin and tinzaparin). Fondaparinux, a synthetic pentasaccharide that inhibits activated factor X.
Dalteparin administered subcutaneously for PE depends on patients weight -dosage. Treatment should be continued until adequate oral anticoagulation with vitamin K antagonist is established
Enoxaparin subcutaneously in people with low risk of recurrence. 1.5mg/kg every 24 hours until adequate oral anticoagulation is established
Causes/Risk Factors
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Air (arterial gas, nitrogen)
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Investigations
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U&Es, lfts, fbc, PT and APTT
Differentials
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Collapse e.g. vasovagal syncope, postural hypotension, AF, seizures, CVA/TIA
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Cardiac e.g. acute coronary syndrome, acute CHF, dissecting or rupturing AA,unstable angina, MI, pericarditis
Respiratory e.g. pneumothorax, pneumonia, acute bronchitis, acute exacerbation COPD, Asthma, Lung disease,