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Related Concept Videos

Pulmonary Embolism I: Introduction01:29

Pulmonary Embolism I: Introduction

7
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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Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care01:29

Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care

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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 III: Nursing Management01:27

Pulmonary Embolism III: Nursing Management

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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...
15
Venous Thrombosis I: Introduction01:30

Venous Thrombosis I: Introduction

11
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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Radiological Investigation III: Pulmonary Angiogram and PET Scan01:13

Radiological Investigation III: Pulmonary Angiogram and PET Scan

97
Radiological investigations are paramount in the diagnosis and management of various pulmonary diseases. Two essential investigations are the Pulmonary Angiogram and the Positron Emission Tomography (PET) Scan.
Pulmonary Angiogram
A Pulmonary Angiogram is an invasive procedure involving injecting a contrast medium through a catheter threaded into the pulmonary artery or the right side of the heart to visualize the pulmonary vasculature. Computed Tomography (CT) scans have mainly replaced this...
97
Pulmonary Hypertension: Classification and Pathogenesis01:30

Pulmonary Hypertension: Classification and Pathogenesis

194
Pulmonary hypertension (PH) is a severe health condition in which the mean pulmonary arterial pressure increases to 25 mmHg or more, even when the body is at rest. This high pressure in the blood vessels that transport blood from the heart to the lungs can cause various symptoms, including shortness of breath, can lead to right heart failure, and significantly affect the overall quality of life.
There are various classifications for PH, each relating to different underlying causes and also...
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A Porcine Model of Acute Autologous Pulmonary Embolism
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Subsegmental Pulmonary Embolism.

Christine Baumgartner1, Tobias Tritschler1, Drahomir Aujesky1

  • 1Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

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|October 23, 2023
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Subsegmental pulmonary embolism (SSPE) management is uncertain. A recent study found untreated low-risk patients had higher venous thromboembolism recurrence, highlighting the need for more research.

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Area of Science:

  • Pulmonary Medicine
  • Radiology
  • Cardiovascular Research

Background:

  • Subsegmental pulmonary embolism (SSPE) diagnosis is increasing due to advanced CTPA technology.
  • Distinguishing SSPE from imaging artifacts presents diagnostic challenges.
  • SSPE is often considered more benign than proximal pulmonary embolism, questioning the necessity of anticoagulation.

Purpose of the Study:

  • To evaluate the risk-benefit ratio of anticoagulation in low-risk patients with SSPE.
  • To address the unclear optimal management strategy for selected SSPE patients.
  • To determine the need for randomized trials in SSPE management.

Main Methods:

  • Review of diagnostic challenges and current management guidelines for SSPE.
  • Analysis of a large prospective study on untreated low-risk SSPE patients.
  • Assessment of venous thromboembolism (VTE) recurrence risk in SSPE.

Main Results:

  • A large prospective study on untreated low-risk SSPE patients was prematurely stopped due to unacceptable VTE recurrence risk.
  • Indirect evidence and small studies suggested SSPE might be benign, but recent findings challenge this.
  • The precise risk-benefit balance of anticoagulation for low-risk SSPE remains undetermined.

Conclusions:

  • Current guidelines suggest considering no anticoagulation for low-risk SSPE patients if proximal deep vein thrombosis is excluded.
  • The optimal management strategy for low-risk SSPE patients requires further investigation.
  • Randomized controlled trials are essential to clarify the role of anticoagulation in SSPE management.