Pulmonary Embolism

• Pulmonary Embolism:

  • blockage of a blood vessel in the pulmonary circulation
  • this is due to a lack of blood flow to a specific area of the lungs which reduces the amount of gaseous exchange in the body
  • risks include immobility, smoking, CVA lines, and age
• Causes:

  • blood clot
  • air bubble
  • fat or amniotic fluid
  • recent surgery
  • currently pregnant/recent birth
  • lower limb fracture, varicose veins
  • reduced mobility
  • previous venous thromboembolism
  • patient is taking combined oral contraceptive pills and HRT
  • obesity
• Signs and symptoms:

  • can be asymptomatic
  • breathlessness
  • pleuritic pain on inspiration
  • cough with bloodstain
  • shock
  • fall in oxygen saturation
• Pathophysiology of Pulmonary Embolism:

  • when a clot (known as an embolus) blocks a blood vessel, all capillaries branching off from that point do not receive blood
  • all alveoli surrounding the capillaries cannot undertake gaseous exchange
  • this results in large sections of the lung not functioning and the body being starved of oxygen, and a build-up of carbon dioxide
• Diagnostic tools:

  • chest x-ray and ECG
  • wells score
  • CTPA (computerised tomography pulmonary angiogram)
  • CT scan of the pulmonary arteries
  • ultrasound scan of leg veins
  • d-dimer and troponin blood tests
  • echocardiogram (ultrasound scan of the heart)