Pulmonary embolism pathophysiology
Pulmonary Embolism Microchapters |
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Pulmonary Embolism Assessment of Probability of Subsequent VTE and Risk Scores |
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Pulmonary embolism pathophysiology On the Web |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editors-in-Chief: Ujjwal Rastogi, MBBS [2]
Overview
Pulmonary embolism (PE) occurs when there is an acute obstruction of the pulmonary artery (or one of its branches). Most often this is due to a venous thrombus (blood clot from a vein), which has been dislodged from its site of formation and embolizes to the arterial blood supply of one of the lungs. This process is termed thromboembolism.
Iliofemoral veins are the source of most clinically recognized PE. It can cause death and significant disability.
The following video explains the pathophysiology of DVT and its most common complication, PE. <youtube v=gGrDAGN5pC0/>
After traveling to the lung, thrombus, depending on its size, produce variable outcomes.
- Large thrombus: lodge at the bifurcation of the main pulmonary artery or lobar branches, and causes hemodynamic compromise.
- Small thrombus: travel distally and initiate an inflammatory response adjacent to the parietal pleura causing pleuritis and pleuritic chest pain.
Gas exchange abnormalities, if present, happen due to a mix of the following factors:
- Mechanical obstruction of the vascular bed.
- Alterations in the ventilation to perfusion ratio
- Release of inflammatory mediators causing atelectasis and surfactant dysfunction.