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