خطة علاج الصمة الرئوية PE

we had a pt with PE yesterday.
i will give u the tips and u till me what happened with her:
in this algorithm u have to ask several questions (from top to bottom), here r the answers
-First question: No
-Second Question:Confirmed
Third question:Yes-
-Fourth Question: No
-Fifth Question: Yes
Now u tell me the story (to memorize them, use them, here is ur chance)

Severe PE case without contraindication to give thrmobolytics, you gave him thrombolytics beside LMWH and the case got better. Ofcourse first of all you stabilized the patinet case.

SOB
tachypnea
tachycardia
severe symptoms, serious case
classic ECG signs (can u mention them?)
bilateral DVT

she got thrombolytics, they worked as magic, exactly as if u turn off the switch of the light. she improved dramatically

I didn't study ECG till now, I only know that it's acute right failure ECG findings.

Electrocardiogram (ECG) abnormalities exist in many patients with PE who do not have preexisting cardiovascular disease. However, ECG abnormalities are also common in patients without PE, limiting the diagnostic usefulness of the ECG [24-26] . In one prospective study, 70 percent of patients had ECG abnormalities, most commonly nonspecific ST-segment and T-wave changes [27] .

Electrocardiographic abnormalities historically considered to be suggestive of PE (S1Q3T3 pattern, right ventricular strain, new incomplete right bundle branch block) are actually infrequent with PE [28] . However, they are common in patients with massive acute PE and cor pulmonale [29] . The presence of T-wave inversion in the precordial leads may correlate with more severe right ventricular dysfunction [25] .

The following ECG abnormalities have been associated with poor prognosis [24,25] :

Atrial arrhythmias
Right bundle branch block
Inferior Q-waves
Precordial T-wave inversion and ST-segment changes
ECG-based scoring systems have been developed to correlate ECG findings with the extent of vascular occlusion, but the clinical utility of this strategy remains speculative [30,31] .