Pulmonary Thromboembolism/embolism (PE)
Major cause of morbidity – causes 10% of hospital deaths; part if same pathophysiological process as deep vein thrombosis (DVT);
Aetiology:
Due to thrombus from leg (up to 80%) or pelvis (up to 16%) – others from amniotic fluid, air, fat, septic emboli (endocarditis) or tumour cells
Risk factors – immobilisation; surgery; fractures; cardiac and respiratory disorders; malignancy; pregnancy; obesity; oral contraceptives
Clinical features:
Massive thromboembolism – usually have predisposing event (eg surgery); central chest pain; acute dyspnoea; syncope; circulatory arrest
Small thromboembolism – pleuritic chest pain; breathlessness; haemoptysis in 50%
Management:
Resuscitation; oxygen
Anticoagulants; thrombolytic
Surgical embolectomy
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