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Difference between revisions of "Pulmonary embolism"
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(→Microscopic (VTE): +thrombus) |
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PE usually refers to '''pulmonary venous thromboembolism''', abbreviated '''VTE''', if not otherwise specified. | PE usually refers to '''pulmonary venous thromboembolism''', abbreviated '''VTE''', if not otherwise specified. | ||
==Clinical== | ==General== | ||
===Clinical=== | |||
*Shortness of breath (dyspnea) - classic symptom. | *Shortness of breath (dyspnea) - classic symptom. | ||
*Tachycardia. | *Tachycardia. | ||
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*Venous thrombosis OR~=12 for PE.<ref name=pmid20648405>{{cite journal |author=Reissig A, Haase U, Schulze E, Lehmann T, Kroegel C |title=[Diagnosis and therapy of pulmonary embolism prior to death] |language=German |journal=Dtsch. Med. Wochenschr. |volume=135 |issue=30 |pages=1477–83 |year=2010 |month=July |pmid=20648405 |doi=10.1055/s-0030-1262435 |url=}}</ref> | *Venous thrombosis OR~=12 for PE.<ref name=pmid20648405>{{cite journal |author=Reissig A, Haase U, Schulze E, Lehmann T, Kroegel C |title=[Diagnosis and therapy of pulmonary embolism prior to death] |language=German |journal=Dtsch. Med. Wochenschr. |volume=135 |issue=30 |pages=1477–83 |year=2010 |month=July |pmid=20648405 |doi=10.1055/s-0030-1262435 |url=}}</ref> | ||
==Risks factors (VTE)== | ===Mechanism=== | ||
The classic factors are given by ''Virchow's triad'':<ref name=pmid22345594>{{Cite journal | last1 = Reitsma | first1 = PH. | last2 = Versteeg | first2 = HH. | last3 = Middeldorp | first3 = S. | title = Mechanistic view of risk factors for venous thromboembolism. | journal = Arterioscler Thromb Vasc Biol | volume = 32 | issue = 3 | pages = 563-8 | month = Mar | year = 2012 | doi = 10.1161/ATVBAHA.111.242818 | PMID = 22345594 }}</ref><ref name=pmid20852464>{{Cite journal | last1 = Meetoo | first1 = D. | title = In too deep: understanding, detecting and managing DVT. | journal = Br J Nurs | volume = 19 | issue = 16 | pages = 1021-7 | month = | year = | doi = | PMID = 20852464 }}</ref> | |||
#Hypercoagulability. | |||
#Endothelial dysfunction/injury. | |||
#Stasis. | |||
Note: | |||
*The triad has a limited practical use. Like many questions about mechanism... their greatest utility is pimping medical students and residents. | |||
===Risks factors (VTE)=== | |||
A general mnemonic for hypercoagulable states ''PIANO'':<ref>URL: [http://www.usmle-forums.com/usmle-step-1-mnemonics/252-causes-hypercoagulable-states.html http://www.usmle-forums.com/usmle-step-1-mnemonics/252-causes-hypercoagulable-states.html]. Accessed on: 8 December 2011.</ref> | A general mnemonic for hypercoagulable states ''PIANO'':<ref>URL: [http://www.usmle-forums.com/usmle-step-1-mnemonics/252-causes-hypercoagulable-states.html http://www.usmle-forums.com/usmle-step-1-mnemonics/252-causes-hypercoagulable-states.html]. Accessed on: 8 December 2011.</ref> | ||
*'''P'''regnancy. | *'''P'''regnancy. | ||