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Pulmonary Embolism

Pulmonary Embolism is a topic covered in the 5-Minute Emergency Consult.

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Basics

Description

  • The majority of pulmonary embolisms (PEs) arise from thrombi in the deep veins of the lower extremities and pelvis.
  • Thrombi also originate in renal and upper extremity veins.
  • After traveling to lungs, the size of the thrombus determines signs and symptoms.

Etiology

  • Most patients with PE have identifiable risk factor:
    • Recent surgery
    • Pregnancy
    • Previous deep vein thrombosis (DVT)/PE
    • Stroke or recent paraplegia
    • Malignancy
    • Age >50 yr
    • Obesity
    • Smoking
    • Oral contraceptives
    • Major trauma
  • Hematologic risk factors:
    • Factor 5 Leiden
    • Protein C or S deficiency
    • Antithrombin III deficiency
    • Antiphospholipid antibody syndrome
    • Lupus anticoagulant

Pediatric Considerations
  • Thromboembolic disease is quite rare.
  • Risk factors in children:
    • Presence of central venous catheter
    • Immobility
    • Heart disease
    • Trauma
    • Malignancy
    • Surgery
    • Infection

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Citation

Rosen, Peter, et al., editors. "Pulmonary Embolism." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307411/all/Pulmonary_Embolism.
Pulmonary Embolism. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307411/all/Pulmonary_Embolism. Accessed April 20, 2019.
Pulmonary Embolism. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307411/all/Pulmonary_Embolism
Pulmonary Embolism [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 20]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307411/all/Pulmonary_Embolism.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Pulmonary Embolism ID - 307411 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307411/all/Pulmonary_Embolism PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -