pulmonary%20thromboembolism
PULMONARY THROMBOEMBOLISM
Pulmonary embolism is the blockage of the blood vessels in the lungs usually due to blood clots from the veins, especially the veins in the legs and pelvis.
Dyspnea, chest pain, syncope or tachypnea (respiratory rate of ≥20/min) occur in most cases of pulmonary embolism.
Pleuritic chest pain with or without dyspnea is one of the most frequent presentations of this disease.
Syncope or shock are the hallmark signs of central pulmonary embolism and usually result in severe hemodynamic repercussions.
Signs of hemodynamic compromise and reduced heart flow are also usually present.

Surgical Intervention

  • Main purpose is to remove the obstructing thrombi from the main pulmonary arteries
  • Preferred for patients w/ contraindications to systemic thrombolysis

Catheter Extraction

  • Catheter extraction involves suction extraction of pulmonary embolism (PE) under fluoroscopy w/ electrocardiogram (ECG) monitoring
  • Reserved for highly compromised patients who cannot receive thrombolytic therapy due to contraindications, as an adjunct when thrombolytic therapy failed to improve circulation, or as alternative to surgery if
  • immediate access to cardiopulmonary bypass is not available

Inferior Vena Cava (IVC) Filter Placement

  • Recommended for patients unresponsive &/or intolerant to anticoagulant/thrombolytic therapy, patients w/ active bleeding complications, & those w/ recurrent acute PE w/ underlying pulmonary hypertension
  • Studies show decreased incidence of PE in patients w/ proximal deep vein thrombosis (DVT) on anticoagulant therapy

Pulmonary Embolectomy

  • Performed in emergency situations when more conservative measures have failed
  • Reserved for patients w/ massive PE (preferably angiographically documented), hemodynamic instability despite Heparin & resuscitation, or failure of thrombolytic therapy or contraindication to its use
  • May be considered in patients w/ submassive acute PE who are hemodynamically unstable, severe worsening lung/RV failure, or cardiac necrosis
Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Respirology - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
Rachel Soon, 16 Aug 2019

On 8 August, the first town hall held by the Ministry of Health (MOH) with members of the pharmacy profession took place in Putrajaya. Over 500 pharmacists from across the country and from different areas of practice—community and hospital, public and private, academy and industry—converged to fill the auditorium for the chance to engage in direct dialogue with MOH.

2 days ago
Cardiac biomarkers are useful for identifying community-acquired pneumonia (CAP) patients with an elevated risk of early and long-term cardiovascular (CV) events, according to a study.
10 hours ago
Tofogliflozin is safe and effective for elderly patients with type 2 diabetes mellitus (T2DM), regardless of insulin and oral antidiabetic drugs, reports a new Japan study.
5 days ago
Pulmonary function has potential predictive value for future increases in arterial stiffness and its progression, as reported in a recent study.