Pulmonary Embolism Paper

The clinical picture of acute pulmonary embolism (PE) is not similar from various aspect of its pathophysiological course presenting from minimal symptoms to variety of severity of disease like severe hypoxia, hypotension, right heart failure and death1. Massive pulmonary embolism is defined as obstruction of blood flow to a lobe or multiple segments of the lung, or for unstable hemodynamics, i.e. failure to maintain blood pressure without supportive measures.” This case highlights about aggressiveness of treatment and role of thrombolytic therapy for a severely hemodynamic unstable patient2.

Coumadin (non specific name: warfarin) is an anticoagulant, or blood diminishing drug, that is endorsed to numerous patients who are at danger for creating blood clusters that could bring about heart assaults or strokes. Warfarin is near the most astounding purpose recently and simultaneous investigations of medications that provoke ER visits and occurring an expansion in healing center based offices with the affirmation of patients. Anticoagulation treatment stances perils to patients and over and over prompts unfavorable solution events in light of complex dosing, fundamental ensuing watching, and clashing patient consistence. As a result, various patients who meet current evidence based principles for warfarin treatment are not being managed

Venous thromboembolism refers to the formation of a blood clot in a blood vessel. While clots can form in an artery or a vein, this article focuses only on clots that occur in a vein ("," 2015). Critically ill patients are at an increased risk of a venous thromboembolism (VTE) due to VTE can manifest as a deep venous thrombosis (DVT) or a pulmonary embolism (PE). Risk factors include venous stasis, vascular injury, and hypercoagulable disorders. A majority of ICU patients carry at least one risk factor for VTE; additional risk factors are considered to have a cumulative effect…it is impossible to predict which patients will experience a

Thromboembolism the two primary complications include arterial thromboembolism and pump thrombosis. Thrombi forms due to low blood flow to certain areas (aortic valve, dilated ventricle) and infection this can lead to stroke. Hypotension can be an early sign of sepsis, hypovolemia, decreased cardiac output, filling pressure, hypovolemia, right ventricular failure, tamponade, arrhythmias, or device related complications. Hemorrhage or bleeding a major complication that can be caused either by underlying bleeding disorders

Venous Thromboembolism (VTE) is a disease that embodies both pulmonary embolism (PE) and deep vein thrombosis (DVT). On the side of research, VTE is the most common preventable cause of hospital-associated mortality and is both the second most common medical complication and cause of excess length of hospital stay (LOS). Furthermore, with appropriate evidence-based prophylactic measures, the occurrence of hospital-associated VTE (HA-VTE) can be reduced by as much as seventy percent. Subsequently, there are approximately between 200,000 and 300,000 VTE-related deaths annually, which is greater than the yearly rate of mortality for breast cancer,

A pulmonary embolism occurs when a blood vessel in your lung becomes blocked by a blood clot that travels to your lungs from another part of your body, usually your leg.A pulmonary embolism can be fatal. So, it's important to be on the lookout for signs and symptoms of a pulmonary embolism and seek medical attention if they occur. A common complication that can occur after deep vein thrombosis is a condition known as postphlebitic syndrome, also called post thrombotic syndrome. This syndrome is used to describe multiple signs and symptoms like edema, leg pains, skin sores, and skin discoloration. This syndrome is caused by the damage to your veins from a blood clot. This damage lowers blood flow in the affected areas. The symptoms might not occur until a few years after the

Konstantinides, S., & Goldhaber, S. (2012). Pulmonary embolism: Risk assessment and management. European Heart Journal, 33(24), 3014-3022.

Pulmonary embolism is defined as a blood clot or blockage in the lungs. A pulmonary embolism can be small or massive. Either small or massive can cause serious complications in an individual. Breathlessness, chest pain, coughing up blood (hemoptysis), a mildly raised body temperature, tachycardia, and sometimes no symptoms at all are all acute symptoms of a pulmonary embolism. Severe breathlessness, chest pain, feeling faint, and some cases cardiac arrest are all symptoms of a chronic pulmonary embolism (Hartree, 2014).

DVT is associated with an increased risk for pulmonary embolism when above the knee (popliteal vein and above) 1

Venous thromboembolism (VTE), including both deep venous thrombosis (DVT) and pulmonary embolism (PE), is reognised as the leading cause of preventable in-hospital mortality. DVT is the formation of blood clots in a deep vein- usually the large veins in the leg or pelvis. The most serious complication of a DVT is that the clot could dislodge and travel to the lungs, becoming a life-threatening blood clot in the lungs, pulmonary embolism. When a blood clot breaks loose and travels in the blood, this is called a venous thromboembolism. An inflammatory reaction is usually present mainly in the superficial veins and, for this reason this pathology is often called thrombophlebitis. It is a disorder that can occur in all races and ethnicities, all age groups, and both genders. Despite a marked increase in federal and national efforts to raise awareness and acknowledge the need for VTE prevention, VTE continues to remain as an important and growing public health problem. Unfortunately, VTE recurs frequently and is commonly overlooked, affects both hospitalized and non-hospitalized patients, and results in long-term complications including chronic thromboembolic pulmonary hypertension (CTPH) and the post-thrombotic syndrome (PTS).

Anticoagulant therapy will started according to facility protocol. This therapy will decrease the blood’s ability to clot, and help to prevent the formation of new clots. Anticoagulants used will be warfarin, heparin, or coumadin. In facility therapy will be initiated via IV push according to facility protocol, with continuous monitoring of patient condition.

Clots that develop in the lower extremities are deep vein thrombosis (DVT), if the clot breaks off and journeys to an individual’s lungs, it is then classified as a pulmonary embolism (PE). If no treatment is received DVT can progress to adjacent veins. Venous thromboembolism is a term that incorporates PE and DVT. (Reyes, Grosse, & Grant, 2015)

A Deep Venous Thrombosis (DVT) will propagate when there is either stasis of blood flow, endothelial injury, or if the patient is in a hypercoagulable state. Under physiological conditions, a dislodged DVT can predictably settle in the pulmonary arteries causing a pulmonary embolism. However, a DVT in the presence of a intracardiac shunt or PAVM can paradoxically cause an embolism in branches of the aorta. The pathophysiological mechanism varies depending on the etiology of the paradoxical embolism. For instance, in a paradoxical embolism due to a PFO, a DVT gets dislodged and enters the right atrium where a transient increase in right atrial pressure during a Valsalva maneuver can force the embolism through the PFO and into the left atrium

Pulmonary embolism (PE) is a blockage in a lung artery due to a clot.1 These clots are a result of a condition called deep venous thrombosis (DVT), the clots travel from veins usually in lower extremities through the bloodstream to the lungs, and block an artery.1 If not treated, this condition may lead to death depending on the size of the clot; therefore rapid treatment must be administered.1 The aim of this article is to analyze multiple peer reviewed research studies about the effects of thrombolytic therapy on the mortality and treatment escalation during the management of patients with an acute PE. The assumptive benefit of using thrombolytic therapy is that it can potentially break up clots instead of only preventing them from getting larger and dissolving clots will lead to an improved hemodynamic status in a short time period.2 However the effects of thrombolytic therapy are relatively unclear compared to the standard anticoagulation therapy which is prescribed more often.2

Surgical embolectomy is highly suggested for patients with thrombi in right side of the heart. Embolectomy is the surgical removal of emboli/thrombi (blood clots) which blocking the blood vessel. It is best indicated in patients whom the thrombolytic therapy in contraindicated and a therapeutic option in those who fail fibrinolysis. This procedure can be done surgically or using a catheter. Surgical embolectomy is done by making an incision into the vessels mainly blocked artery by open surgery. It is limited by costs, large medical centers and needs experienced surgeon because it has high mortality rate among elderly. Patients have high risk of developing intracranial hemorrhage due to administration of heparin anticoagulation in extracorporeal