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Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care01:29

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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...
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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...
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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...
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Cardioembolic Stroke.

Cumara B O'Carroll, Kevin M Barrett

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    Cardioembolic stroke, often caused by atrial fibrillation, is a disabling condition. This review covers its causes, diagnosis, and management, including novel anticoagulants for prevention.

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    Area of Science:

    • Neurology
    • Cardiology
    • Internal Medicine

    Background:

    • Cardioembolic stroke is a significant cause of ischemic stroke, often leading to greater disability compared to other stroke types.
    • The incidence of cardioembolic stroke is projected to increase due to an aging population and the rising prevalence of atrial fibrillation.

    Observation:

    • Diagnosis requires clinical suspicion and comprehensive evaluation, including ECG, echocardiography, brain imaging, and cardiac monitoring.
    • Atrial fibrillation is the primary cause, with anticoagulation recommended; novel oral anticoagulants are increasingly used for stroke prevention.
    • Prolonged cardiac monitoring is crucial for detecting occult atrial fibrillation, while other causes like prosthetic heart valves and aortic arch atherosclerosis are also considered.

    Findings:

    • Risk stratification models aid in decision-making for anticoagulation therapy.
    • Evidence supports patent foramen ovale closure for specific cryptogenic stroke cases.
    • Current management strategies emphasize a tailored approach based on the diverse mechanisms of cardioembolism.

    Implications:

    • Improved diagnostic strategies, particularly prolonged cardiac monitoring, can enhance the detection of atrial fibrillation.
    • The use of novel oral anticoagulants offers effective stroke prevention in patients with atrial fibrillation.
    • A comprehensive, mechanism-specific approach is essential for optimizing the diagnosis, management, and prevention of cardioembolic stroke.