Pulmonary Embolism Lecture Review

Question-and-answer flashcards covering definition, symptoms, risk factors, pathophysiology, diagnostics, treatment, and complications of pulmonary embolism.

What is a pulmonary embolism (PE)?

A blockage of one or more pulmonary arteries, most often by a blood clot that has traveled from a deep vein in the legs (DVT).

From which condition do most pulmonary emboli originate?

Deep vein thrombosis (DVT) in the legs.

Pulmonary embolism is the ____ most common cardiovascular disease after MI and stroke.

Third

Which sudden respiratory symptom is most characteristic of PE?

Acute shortness of breath (dyspnea).

How does chest pain associated with PE typically worsen?

It increases with coughing or deep breathing (pleuritic chest pain).

What feeling often described by patients can signal PE-related anxiety?

A sense of impending doom.

Name three classic vital-sign abnormalities seen in PE.

Tachycardia, tachypnea, and hypoxemia (low SpO₂).

Which two lifestyle/medication factors in women increase PE risk?

Oral contraceptive use and hormone replacement therapy.

List at least four major risk factors for developing a pulmonary embolism.

Recent surgery or trauma, prolonged immobility, cancer, pregnancy/post-partum state, obesity, smoking, history of DVT/PE, advanced age (>60), heart disease, diabetes.

What key pathophysiologic change causes hypoxemia in PE?

Ventilation-perfusion (V/Q) mismatch due to blocked pulmonary blood flow.

Why can a large PE lead to right-sided heart failure?

The clot increases pulmonary vascular resistance, straining the right ventricle.

Which blood test is commonly elevated in the presence of a clot?

D-dimer.

What is the imaging gold standard for diagnosing PE?

CT pulmonary angiogram (CTPA).

Which scan can be used when a CT angiogram is contraindicated?

Ventilation–perfusion (V/Q) scan.

On arterial blood gas, what pattern may appear early in PE?

Respiratory alkalosis (due to hyperventilation).

What is the first-line parenteral anticoagulant started for most acute PEs?

Heparin (either unfractionated or low-molecular-weight).

Which oral anticoagulant has long been used for extended PE therapy?

Warfarin.

When are thrombolytic agents indicated in PE management?

In massive or high-risk PE with hemodynamic instability to rapidly dissolve the clot.

Name a surgical or catheter-based option for clot removal in severe PE.

Pulmonary embolectomy (surgical or catheter-directed).

What device may be placed in the vena cava to prevent recurrent emboli when anticoagulation is contraindicated?

Inferior vena cava (IVC) filter.

Give two supportive/preventive measures to reduce PE risk during hospitalization.

Graduated compression stockings and pneumatic compression devices (plus early mobilization and adequate hydration).

List three potential complications of pulmonary embolism.

Pulmonary infarction, recurrent PE, sudden death, chronic thromboembolic pulmonary hypertension, or bleeding from anticoagulants.