Pulmonary Embolisms - What are they?

It's been a while since we've left you with a blog post, so hopefully this one was worth the wait. In this post, we are going to cover pulmonary embolisms. Through our initial education programs, I feel like we've had this elusive and deadly "phenomenon" drilled into our heads from a signs and symptoms perspective along with the "diesel bolus," but we often don't dive too deep into them as a whole.

In this post, we hope to do the following:

•Review the physiological effects of the pulmonary embolism.

•Understand where most pulmonary emboli originate and why.

•Discuss the “stereotypical” increased risk factors associated with pulmonary emboli.

•Discuss the correlation between pulmonary embolisms and the transgender community.

THE STATS

237,000 non-fatal pulmonary embolisms occur in the US each year

294,000 fatal pulmonary embolisms occur in the US each year

These numbers should jump off the page and grab you...as it's not often that we encounter something that kills more patients than it spares.

THE PATHOPHYSIOLOGY

Obstruction of the pulmonary artery or one of its branches by a thrombus that originates somewhere in the venous system or in the right side of the heart. Most commonly, a pulmonary embolism (PE) begins as a deep vein thrombosis (DVT) = thrombus formation in the deep veins, typically the calf or thigh, but can occur in the arm.

This leads to a V:Q mismatch (ventilation:perfusion). Arterial hypoxemia is compensated by "blowing off" more CO2 than is necessary (increasing the respiratory rate).

TYPES OF CLOTS

VIRCHOW'S TRIAD - DVT PREDISPOSITION