Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content ++ Venous thromboembolism (VTE) ++ 415.1 Pulmonary embolism and infarctionAssociated PT diagnoses/treatment diagnoses that may be associated with respiratory disorders780.7 Malaise and fatigue786.0 Dyspnea and respiratory abnormalities786.05 Shortness of breath ++ I26 Pulmonary embolism ++ 6A: Primary Prevention/Risk Reduction for Cardiovascular/Pulmonary Disorders6B: Impaired Aerobic Capacity/Endurance Associated with Deconditioning6C: Impaired Ventilation, Respiration/Gas Exchange, and Aerobic Capacity/Endurance Associated With Airway Clearance Dysfunction6F: Impaired Ventilation and Respiration/Gas Exchange Associated With Respiratory Failure +++ Description ++ Blockage of the artery of the lungThrombus (blood clot), commonly from a deep veins in the legsChest pain with breathingEmbolism can be fat or airIncreased pressure in the right ventricle of the heart +++ Essentials of Diagnosis ++ Sudden onset shortness of breath (dyspnea)CyanosisCirculatory dysfunctionPleural effusion +++ General Considerations ++ Can be life-threatening; sudden death can occurCan damage part of the lungOrgan damage secondary to reduced oxygen levels +++ Demographics ++ For every 10 years older than 60 years old, the risk of PE doubles1Pregnancy increases riskObesity increases risk +++ Signs and Symptoms ++ Chest painCoughingPulmonary component of the second heart soundPain worse with deep breath or coughPalpitationsSweatingLight-headednessSwelling in one legCalf painCyanosisIncreased respiratory rateFatigueSudden deathIncreased heart rateDecreased oxygenation throughout the bodyChest tightnessShoulder raised to allow increased lung air flowShortness of breathTensed muscles from dyspnea +++ Functional Implications ++ Bleeding problems from blood thinner medicationCaution with massage and cross-friction techniques secondary to bruising and bleedingIncreased with bleeding and bruising with minimal activitiesDisabling dyspnea when performing simple tasks (i.e., arm elevation to reach into cabinet)Decreased exercise tolerance +++ Possible Contributing Causes ++ Recent surgeryFracturesHigh blood pressureAir bubble or tumor breaks looseCancerFemale hormone therapyBirth control medicationPregnancyObesityLong-distance air travel/automobile tripEstrogenAcquired thrombophiliaProlonged bed restCongenital malformationVenous clotDeep vein thrombosisVirchow’s triadAlteration of blood flowFactors in the vessel wallFactors affecting the properties of the blood +++ Differential Diagnosis ++ Congestive heart failureInfluenzaAsthmaGastroesophageal reflux diseaseLudwig’s anginaBronchiectasisCystic fibrosisKawasaki diseaseBronchitisGoiterUpper respiratory tract infectionCentral airway obstructionLung tumorTuberculosis +++ Laboratory Tests ++ Blood test, clotting statusArterial blood gasesLung function testsPulse oximetryWells scoreGeneva rulePercussion of the chest/lungs +++ Imaging ++ Pulmonary angiographyChest radiographCTLung ventilation/perfusion scanEchocardiogramUltrasound legs for blood clots ++ Normal D-dimer level can exclude thrombotic PEMcConnell’s ... Your MyAccess profile is currently affiliated with '[InstitutionA]' and is in the process of switching affiliations to '[InstitutionB]'. Please click ‘Continue’ to continue the affiliation switch, otherwise click ‘Cancel’ to cancel signing in. Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Username? Forgot Password? Sign in via OpenAthens Sign in via Shibboleth