Pulmonary embolism

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[edit] Discussion

  • Partial or complete obstruction of one or more pulmonary arterial branches by a thrombus.
  • More than 90% of all emboli arise from deep vein thromboses.

[edit] Etiologies

Virchow's Triad

  • Venous stasis
  • Vessel wall damage
  • Hypercoagulability


[edit] Imaging Findings

[edit] Plain film

  • Chest radiographs are abnormal in most cases of PE, but the findings are nonspecific and include atelectasis, pleural effusion, parenchymal opacities, and elevation of a hemidiaphragm.
  • Classic radiographic findings of pulmonary infarction (infrequently observed)

[edit] CT

  • Acute PE
    • Thrmobus is located centrally within the vascular lumen or occludes the vessel (vessel cutoff sign)
    • Commonly causes distention of the involved vessel.
  • Chronic PE
    • Eccentric and contiguous with the vessel wall
    • Reduces the arterial diameter by more than 50%
    • Evidence of recanalization within the thrombus
    • Arterial web is present

[edit] Images

Patient #1: Shortness of breath

Patient #2: Acute RBBB


[edit] External Links

[edit] References