Recording-2025-03-04 Pulm

Pulmonary Embolism and Vagal Constriction

• Pulmonary Embolism Effects:

  • Results in collapse of affected lung segments.

  • Causes pulmonary edema.

  • Management includes anticoagulants like Lovenox.

    • Lovenox is a significant treatment in this context.

    • Other anticoagulants can be used, but Coumadin is seldom used for prevention.

Vena Cava Filters

• Filter Types:

  • Filters can be placed in the vena cava, often referred to as a 'bird's nest'.

  • Deployment is performed through the groin.

  • Purpose: To catch clots before they reach the right atrium and right ventricle.

• Risks:

  • Greenfield filters are last resort options due to potential injury to the inferior vena cava.

Thrombolysis and Surgical Retrieval

• Thrombolysis:

  • Directly targets clots, but carries risks of complications.

• Surgical Retrieval:

  • An alternative method to extract blood clots.

Pulmonary Hypertension

• Normal Pressure Ranges:

  • Normal pulmonary circulation should not exceed 18 mmHg.

  • Above 25 mmHg indicates severe hypertension and can lead to right heart failure.

Lung Cancer Types and Prognosis

Tumors Around Bronchial Tubes

• Symptoms:

  • May be asymptomatic; chest pain may occur.

• Treatment:

  • Surgical resection recommended as first-line treatment.

Large Cell Carcinoma

• Characteristics:

  • Also known as undifferentiated carcinoma.

• Prognosis:

  • Poor outcomes expected; primarily managed for palliation.

Small Cell Carcinoma

• Commonly Known As:

  • Oat cell carcinoma.

• Prognosis:

  • Worst prognosis among lung cancers; first signs may include paraneoplastic syndrome.

• Metastasis:

  • Stage four lung cancer indicates mediastinal lymph node involvement and spread below the diaphragm is associated with very limited survival chances.

Treatment Innovations

• Microwave Ablation:

  • New radiofrequency coils are delivered via catheters known as a "microwave on a stick."

  • Technique involves inserting into tumor and using heat to destroy malignant cells.