Respiratory
PE Risk Factors:
caused from
most
commonly leg/hip venous thrombus. Surgery, hip/leg fracture
-
sedentary lifestyle
-
Type 1Respiratory Failure via V/Qmismatch.
Pregnancy
·
Causes
-
-
Combined pill, HRT
Presentation: Investigations.
-
Previous PE
Active
Malignancy
-
Sudden Death HTN,
Haemoptysis S1Q3T3 pattern ECG
- -
-
-
on
-
Acute SOB
-
syncope (Right Heart Strain) -
Endocarditis+Tricuspid murmur
Pleuritic C9 Tachycardia positive D-dimer
-
- -
Accompanying DVT Pulmonary Angiogram
-
CT
-
va scan
-
Diagnosis:
After d-dimer is
age 55, usually positive,
·
1) must do
age adjusted d-dimer.
Do Welle score. so
-
If -
4 Do D-dimer D-dimer has high NOV, so exclude PE.
·
can
=
If 4 DO CTPA
=
2) Do D-dimer according to Wells score.
If D-dimer is negative clot is ruled out.
- VOSCAN
If D-dimer is positive Do CTPA. -
3) for definitive
Do CTPA
diagnosis.
IfCTPA
is contraindicated (in
pregnancy or renal failure),
then do va scan.
Management:
Give: -O2 for perfusion
-Analgesia for ventilation
Treatment:
Anticoagulation with DOAC (e.g. Rivaroxiban, Apixaban), LMWA, Warfarin.
· -
-
Thrombolysis 1 Ifhaemodynamically
↑
-
Thrombolectomy unsotable
Contraindications:
Thrombolysis
If
delayed, anticoagulation.
·
imaging is commence
After treatment, anticoagulate for 3 months. -previous haemorrhagic stroke
·
recent ischaemic stroke
-
-recent GI bleed
recent
surgery
-
-active cancer
PE Risk Factors:
caused from
most
commonly leg/hip venous thrombus. Surgery, hip/leg fracture
-
sedentary lifestyle
-
Type 1Respiratory Failure via V/Qmismatch.
Pregnancy
·
Causes
-
-
Combined pill, HRT
Presentation: Investigations.
-
Previous PE
Active
Malignancy
-
Sudden Death HTN,
Haemoptysis S1Q3T3 pattern ECG
- -
-
-
on
-
Acute SOB
-
syncope (Right Heart Strain) -
Endocarditis+Tricuspid murmur
Pleuritic C9 Tachycardia positive D-dimer
-
- -
Accompanying DVT Pulmonary Angiogram
-
CT
-
va scan
-
Diagnosis:
After d-dimer is
age 55, usually positive,
·
1) must do
age adjusted d-dimer.
Do Welle score. so
-
If -
4 Do D-dimer D-dimer has high NOV, so exclude PE.
·
can
=
If 4 DO CTPA
=
2) Do D-dimer according to Wells score.
If D-dimer is negative clot is ruled out.
- VOSCAN
If D-dimer is positive Do CTPA. -
3) for definitive
Do CTPA
diagnosis.
IfCTPA
is contraindicated (in
pregnancy or renal failure),
then do va scan.
Management:
Give: -O2 for perfusion
-Analgesia for ventilation
Treatment:
Anticoagulation with DOAC (e.g. Rivaroxiban, Apixaban), LMWA, Warfarin.
· -
-
Thrombolysis 1 Ifhaemodynamically
↑
-
Thrombolectomy unsotable
Contraindications:
Thrombolysis
If
delayed, anticoagulation.
·
imaging is commence
After treatment, anticoagulate for 3 months. -previous haemorrhagic stroke
·
recent ischaemic stroke
-
-recent GI bleed
recent
surgery
-
-active cancer
