20 PE
- femoral vein: thigh
- popliteal vein: behind knee
- edema from poor venous outflow
Symptoms
- worse with deep breath
- sudden death: so much obstruction of blood flow that dies from shock
Diagnosis
- CT contrast
- thrombus in pulmonary artery
- large PE crossing bifurcation
- saddle emboli
- pt likely to be in shock
- classic EKG
- deep S wave in lead 1, Q wave and inverted T wave in lead III
- pseudo RBBB in V1, lower right: normal
- sign of right heart strain: massive PE
- in clinical practice and ER
- blood clots present and broken down by coagulation system: raise D-dimer
- for ruling out DVT/PE with low Wells score
- inhale nuclear tracer: left
- inject nuclear tracer: right
- see difference in V/Q
Treatment
- similar causes and treatment to PE
- together aka VTE
Fat Embolism
- fat in bone marrow leak out
- triad of symptoms in lung, CNS, skin
- lung: respiratory failure
- looks like ARDS
- pt after trauma present with dyspnea, confusion, petechiae
Amnionic Fluid Embolism
- women shortly after delivering baby develops symptoms
- biopsy shows fetal squamous and keratin debrid
- seizure can be seen in phase 1 or 2
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