massive pulmonary embolism

massive pulmonary embolism



 MASSIVE ACUTE MASSIVE EMBOLIA
We speak of acute acute pulmonary embolism when at least 2 branches are affected.
CAUSES

Risk factors for deep vein thrombosis are:
Female sex
Aged greater than 40 years
Obesity
Cigarette smoke
Fractures of the lower limbs
Pulmonary, gastrointestinal and genitourinary neoplasms
Pregnancies
Contraceptive therapy
Extended immobilizations
Diabetes mellitus.
DIAGNOSIS

The diagnosis is made with:
Accurate physical examination evaluating the patient's general condition, deep palpation pain in the calf (sign of Bauer), pain in the calf during the dorsiflexion of the foot (sign of Homan) and calf pain during the cough (sign of Laurel),
Blood chemistry tests showing the increase in D-dimer (product of fibrin plasma lysis),
Emogas analysis that shows a hypoxemia (partial pressure of oxygen less than 80 mmHg) and hypocapnia (partial pressure of carbon dioxide less than 40 mmHg),
Chest radiograph to exclude the presence of other diseases (pneumonia, acute pulmonary edema, pneumothorax),
Electrocardiogram showing sinus tachycardia, P-lung waves and right-sided right-bundle branch block,
Venous echocolordoppler of the limbs, which documents and confirms the deep venous thrombosis,
Pulmonary angiography, the most important test for the diagnosis of pulmonary embolism. This allows us to view the pulmonary vessels radiographically after injection of a radiopaque contrast agent.
THERAPY

The therapy involves the administration of:
Anticoagulant drugs which prevent the formation of new thrombi
Fibrinolytic drugs that have the function of rapidly dissolving the thrombus
Surgery to remove a very large embolus using a flexible tube inserted into the blood vessels.