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Pulmonary Embolism I: Introduction

Pulmonary Embolism I: Introduction

Pulmonary embolism (PE) occurs when a thrombus, fat or air embolus, amniotic fluid, or tumor tissue blocks one or more pulmonary arteries. These blockages originate in the venous system or the right side of the heart.EtiologyPE primarily arises from deep vein thrombosis (DVT) and other hypercoagulable states, such as inherited thrombophilias. Additional etiological factors include venous stasis, commonly seen in obesity, and endothelial injury from surgery and trauma. Less common causes include...

Pulmonary Embolism III: Nursing Management

Pulmonary Embolism III: Nursing Management

A pulmonary embolism occurs when a thrombus, amniotic fluid, tumor tissue, fat, or air embolus blocks one or more pulmonary arteries. Effective nursing management and patient education are crucial for improving outcomes and preventing recurrence.Nursing management starts with obtaining a comprehensive patient history, particularly noting any history of deep vein thrombosis (DVT). Assess for clinical manifestations, including dyspnea, chest pain, crackles, heart murmurs, and signs of right-sided...

Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care

Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care

Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...

Venous Thrombosis I: Introduction

Venous Thrombosis I: Introduction

Venous thrombosis, the most common disorder of the veins, involves the formation of a thrombus or blood clot associated with vein inflammation. It can be classified as either superficial vein thrombosis or deep vein thrombosis.Superficial Vein Thrombosis: This involves the formation of a thrombus in a superficial vein, usually the greater or lesser saphenous vein. Though less severe than deep vein thrombosis (DVT), SVT can lead to complications if untreated.Deep Vein Thrombosis (DVT): This...

Peripheral Artery Disease I: Introduction

Peripheral Artery Disease I: Introduction

Peripheral artery disease (PAD) predominantly results from atherosclerosis, which involves the accumulation of fatty deposits, or plaques, within the walls of arteries. This causes them to narrow and harden, significantly reducing blood flow. PAD predominantly affects the legs, particularly the arteries supplying the thighs and calves. In rare cases, it may involve other arteries, including those in the arms.Etiology of PAD:The principal cause of PAD is atherosclerosis, which results from fatty...

Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies

Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies

The key difference between Superficial Vein Thrombosis (SVT) and Deep Vein Thrombosis (DVT) lies in their location and severity.Clinical ManifestationsSVT typically presents with localized pain, tenderness, and redness along the course of a superficial vein, often accompanied by a palpable, cord-like structure under the skin. This condition is usually less dangerous than DVT but can be uncomfortable and may lead to complications such as cellulitis or, rarely, a clot extension into the deep...

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Thromboembolic disease and breathlessness.

¹Clinical Reader in Palliative Medicine, Cardiff University, Wales, UK.

Current Opinion in Supportive and Palliative Care

|June 28, 2016

Summary

Venous thromboembolism (VTE) management is challenging in advanced illness. New oral anticoagulants and individualized care are improving treatment for deep vein thrombosis and pulmonary embolism.

Area of Science:

Palliative Care
Hematology
Oncology

Background:

Venous thromboembolism (VTE), including deep vein thrombosis and pulmonary embolism, presents a significant symptom burden in supportive care settings.
VTE is often unrecognized, and its management is complicated by clinical trial populations unrepresentative of advanced disease patients.

Purpose of the Study:

To review challenges in VTE management within supportive and palliative care.
To discuss new oral anticoagulants (NOACs) and their role in VTE treatment.
To address VTE management in situations with limited evidence.

Main Methods:

Literature review focusing on VTE management in supportive and palliative care.
Analysis of recent developments in anticoagulation therapies.

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Examination of patient-centered approaches and comorbidity considerations.

Main Results:

Recent advancements include new oral anticoagulants and a greater understanding of the patient experience with VTE.
Individualized VTE treatment plans are crucial, considering patient comorbidities.
Evidence gaps exist for managing VTE in specific advanced disease populations.

Conclusions:

Effective VTE management requires addressing challenges in supportive care and adapting treatments for complex patient groups.
NOACs offer new therapeutic options, but careful consideration of individual patient factors is essential.
Further research is needed to guide VTE treatment where evidence is currently lacking.