Midnapore medical College and hospital,MBBS
West Bengal University of health sciences
Pulmonary embolism
Definition :
a) Exogenous or endogenous material travels in to the lungs and blocks
pulmonary artery or its branches.
b) Embolus material may be of blood clot or air or fat or any other
material.
Causes :
a) Blood clots from deep vein thrombosis (DVT) or septic emboli from
SBE or malignant cells.
b) Fat or air or amniotic fluid or placental bits can also become an
embolus.
Predisposing factors for DVT :
a) Smoking.
b) Pregnancy related causes or extensive surgeries or trauma.
c) Long air travels or presence of malignancy.
Classification :
Pulmonary Embolism Massive (high-risk) :
a)PE accounts for 5–10% of cases and is usually characterized by
systemic arterial hypotension and extensive thrombosis affecting at least
half of the pulmonary vasculature.
b)Dyspnea, syncope, hypotension, and cyanosis
are hallmarks of massive PE.
c)Patients with massive PE may present in cardiogenic shock and can
die from multisystem organ failure.
Sub-massive (intermediate-risk) :
a)PE accounts for 20–25% of patients and
is characterized by RV dysfunction despite normal systemic arterial
pressure. The combination of right heart failure and release of cardiac
biomarkers such as troponin indicates a high risk of clinical deteriora-
