Oxygenation: Pulmonary Embolism, Pulmonary Hypertension, and Cor Pulmonale

Vocabulary flashcards covering key definitions, diagnostic tests, treatments, and clinical concepts related to pulmonary embolism, pulmonary hypertension, and cor pulmonale.

Pulmonary Embolism (PE)

A blockage of blood flow to the pulmonary artery caused by a clump of material such as a blood clot, fat clot, or air embolism, resulting in decreased blood supply and impaired gas exchange in the alveoli.

Saddle Embolism

A large pulmonary embolism located at the bifurcation of the pulmonary artery that affects both lungs, leading to increased pressure in the right atrium and right ventricle.

CT Angiogram with Contrast

The fastest diagnostic test used to detect a pulmonary embolism, requiring a large-bore IV line.

Pulmonary Angiogram

The most sensitive diagnostic test for pulmonary embolism, performed via catheter insertion through the groin or wrist with contrast dye to determine the exact location of a clot.

V/Q Scan

A diagnostic nuclear scan performed without contrast dye to evaluate ventilation and perfusion in patients suspected of PE who have kidney failure or are intubated or combative.

D-Dimer

A blood test that measures blood clot fibrin to confirm deep vein thrombosis (DVT); it lacks sensitivity and cannot differentiate between a DVT and a PE.

Thrombolytic Therapy (tPA or TNK)

Medication administered intravenously or via an interventional radiology catheter directly into a clot to treat severe PE or DVT, carrying a high risk of bleeding and requiring strict bed rest.

Pulmonary Embolectomy

A surgical procedure performed to remove a massive or life-threatening pulmonary embolism.

Inferior Vena Cava (IVC) Filter

A vascular filter surgically placed in the inferior vena cava to trap emboli before they can enter the lungs in patients with chronic or high-risk PE.

Pulmonary Hypertension (PHTN)

A chronic condition characterized by pathologically high blood pressure in the pulmonary vasculature due to capillary thickening and arterial narrowing.

Normal Pulmonary Artery Pressure

The physiological baseline pressure in the pulmonary artery, normally ranging from $15\text{--}30 / 4\text{--}12\text{ mmHg}$.

Diagnostic Threshold for Pulmonary Hypertension

A resting pulmonary artery systolic pressure greater than $30\text{ mmHg}$, measured invasively using an arterial line or Swan-Ganz (right heart) catheter.

Atrial Septostomy

A surgical procedure for severe pulmonary hypertension that creates a small hole between the right and left atria to reduce pressure on the right side of the heart.

Cor Pulmonale

Enlargement and hypertrophy of the right ventricle resulting from a primary pulmonary disorder such as COPD or pulmonary hypertension.

Inotropic Effect

A pharmacological or physiological effect influencing the force of muscular contractions of the heart; positive inotropes (e.g., digoxin) increase force, whereas negative inotropes decrease it.

Chromotropic Effect

An effect influencing heart rate; positive chromotropes (e.g., epinephrine) increase heart rate, while negative chromotropes (e.g., beta-blockers) decrease it.

Dromotropic Effect

An effect relating to the conduction velocity of electrical impulses through the heart's conduction system.

Heparin Monitoring Labs

Laboratory tests used to monitor continuous intravenous heparin therapy, specifically PTT and Heparin Xa.

Warfarin (Coumadin) Monitoring Labs

Laboratory values used to monitor oral warfarin therapy, specifically PT and INR, which require frequent monitoring due to interaction with Vitamin K (its antidote).

Lovenox (Enoxaparin)

A low molecular weight heparin utilized for outpatient and home management of small pulmonary embolisms.