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==Pulmonary embolism pathophysiology overview==
{{Pulmonary embolism}}
 
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'''''Synonyms and keywords:''''' PE
'''''Synonyms and keywords:''''' PE


Pulmonary embolism (PE) is a common illness that can cause death and significant disability. PE occurs when there is an acute obstruction of the pulmonary artery (or one of its branches). Most often this is due to a venous thrombus (blood clot from a vein), which has been dislodged from its site of formation and embolizes to the arterial blood supply of one of the lungs. This process is termed thromboembolism.


Patients present with a wide array of symptoms and signs. These may include difficulty breathing, pain in the chest during breathing, and in more severe cases collapse, circulatory instability and sudden death. PE treatment requires rapid and accurate risk stratification before haemodynamic decompensation and the development of cardiogenic shock. Therapeutic application most often consists of an anticoagulant medication, such as heparin and warfarin, and rarely (in severe cases) with thrombolysis or surgery. In other, rarer forms of pulmonary embolism, material other than a blood clot is responsible; this may include fat or bone (usually in association with significant trauma), air (often when diving), clumped tumor cells, and amniotic fluid (affecting mothers during childbirth).
==Pathophysiology==
 
Pulmonary embolism and deep vein thrombosis (DVT) should be considered part of the same spectrum of pathophysiology. Most pulmonary emboli result from thromboemboli in the deep veins of the lower extremities, but can also originate in the pelvic, renal, and upper extremity veins, as well as in the right heart. Almost 40% of patients with DVT and no symptoms of pulmonary embolus have evidence of PE on ventilation perfusion scanning (which itself is not 100% sensitive). Approximately 30% of patients with pulmonary embolus have evidence of deep vein thrombosis on ultrasound (U/S) of the lower extremities

Revision as of 18:34, 19 July 2011

Pulmonary Embolism Microchapters

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Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Pulmonary Embolism from other Diseases

Epidemiology and Demographics

Risk Factors

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Natural History, Complications and Prognosis

Diagnosis

Diagnostic criteria

Assessment of Clinical Probability and Risk Scores

Pulmonary Embolism Assessment of Probability of Subsequent VTE and Risk Scores

History and Symptoms

Physical Examination

Laboratory Findings

Arterial Blood Gas Analysis

D-dimer

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Ventilation/Perfusion Scan

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IVC Filter

Pulmonary Embolectomy

Pulmonary Thromboendarterectomy

Discharge Care and Long Term Treatment

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Risk calculators and risk factors for Pulmonary embolism pathophysiology

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Associate Editors-in-Chief: Ujjwal Rastogi, MBBS [2]

Synonyms and keywords: PE


Pathophysiology

Pulmonary embolism and deep vein thrombosis (DVT) should be considered part of the same spectrum of pathophysiology. Most pulmonary emboli result from thromboemboli in the deep veins of the lower extremities, but can also originate in the pelvic, renal, and upper extremity veins, as well as in the right heart. Almost 40% of patients with DVT and no symptoms of pulmonary embolus have evidence of PE on ventilation perfusion scanning (which itself is not 100% sensitive). Approximately 30% of patients with pulmonary embolus have evidence of deep vein thrombosis on ultrasound (U/S) of the lower extremities