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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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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...
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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...
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Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
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Acute Coronary Syndrome I: Introduction01:30

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Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
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Cardiac catheterization is an invasive diagnostic technique used to identify and evaluate structural and functional diseases of the heart and major blood vessels. This technique diagnoses congenital heart disease, coronary artery disease, valvular heart disease, and coronary spasms and assesses ventricular function. It helps guide treatment decisions, including the need for revascularization procedures like percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) and...
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Massive Embolism: Knife versus PCI.

Scarlett Tohme1,2, Joshua S Newman1,2, Christopher Gasparis2

  • 1Department of Cardiovascular and Thoracic Surgery, North Shore University Hospital, Northwell Health, Manhasset, New York.

The International Journal of Angiology : Official Publication of the International College of Angiology, Inc
|September 26, 2022
PubMed
Summary
This summary is machine-generated.

Pulmonary embolism (PE) is a common cause of sudden death. This review covers evolving management strategies for hemodynamically unstable PE patients, including anticoagulation, catheter-based, and surgical options.

Keywords:
ECMOcatheter-based embolectomycatheter-directed thrombolysisextracorporeal membrane oxygenationpulmonary embolismsurgical pulmonary embolectomy

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Area of Science:

  • Cardiovascular Medicine
  • Pulmonary Medicine
  • Interventional Cardiology

Background:

  • Pulmonary embolism (PE) ranks as the third leading cause of cardiovascular death.
  • A significant percentage of PE patients (up to 25%) experience sudden mortality.
  • Current management guidelines are evolving, particularly for hemodynamically unstable PE patients.

Purpose of the Study:

  • To review current recommendations for pulmonary embolism (PE) management.
  • To discuss evolving therapeutic options for hemodynamically unstable PE patients.
  • To compare surgical and catheter-based interventions for PE management.

Main Methods:

  • Literature review of current guidelines and therapeutic approaches for PE.
  • Comparative analysis of anticoagulation, catheter-based interventions, and surgical options.
  • Focus on management strategies for submassive and massive pulmonary embolism.

Main Results:

  • Anticoagulation remains a cornerstone for hemodynamically stable PE.
  • Catheter-based and surgical interventions provide effective alternatives for unstable patients.
  • Both invasive approaches carry distinct benefits and risks that require careful consideration.

Conclusions:

  • Management of pulmonary embolism is multifaceted, especially in unstable patients.
  • Surgical and catheter-based interventions offer crucial options when anticoagulation is insufficient or contraindicated.
  • A comprehensive understanding of all available treatment modalities is essential for optimal patient outcomes.