Pulmonary embolism refers to the obstruction of a pulmonary artery by a substance that has travelled from elsewhere in the body. The most common emboli are:
Thrombus - responsible for the majority of cases and usually arises in a distant vein.
Fat – following a bone fracture or orthopaedic surgery.
Air – following cannulation in the neck.
The effect of a pulmonary embolism is a reduction in lung perfusion. This results in decreased blood oxygenation, and the accumulation of blood in the right ventricle of the heart.
Clinical features include:
Dyspnoea, chest pain, cough, haemoptysis and tachypnoea. In clinical medicine, the Wells’ score is used to assess the probability of pulmonary embolism.
Definitive treatment:
This involves anticoagulation and thrombolytic therapy which play a role in reducing the size of the embolus, and preventing further clotting.
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