Venous Diseases – Pulmonary Embolism

by Joseph Alpert, MD

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    Continuing with Advanced Vascular Medicine, we’re going to talk for a while about pulmonary embolism, the most-dreaded complication of venous thromboembolism. The definition of pulmonary embolism is blockage of a main artery of the lung or one of its branches by an embolus arising in the venous system. Pulmonary embolism results from deep venous thrombosis, that is a blood clot in the deep veins, 90% of the time in the deep veins of the legs. And when the blood clot breaks off from the clot in the leg, it migrates in the circulation up into the lung. The diagnosis again, as I said in previous lectures, can be difficult because the patient may have very non-specific symptoms and usually, in order to make the diagnosis, it requires one of our imaging techniques – a lung scan, with radionuclides, a pulmonary angiogram or MRI angiography or even CT angiography. And I’m going to talk about these in a little greater detail. The lung scan is a nuclear-medicine technique. It consists of two components: a ventilation component and a perfusion component. For the ventilation component, the patient inhales radioactive xenon gas. And what happens there is that the lung fills with radioactivity and we take a scanning picture to see whether the xenon gas gets uniformly throughout the lung. If patients have pneumonia or if they’ve had a lung resection or if they have a tumour in the lung, often you’ll see an area of the lung that doesn’t get xenon gas because it’s been replaced. Normal patients will have a uniform lung ventilation scan and patients with pulmonary embolism will also have a normal ventilation scan. And what’s demonstrated here is a normal ventilation scan with xenon gas. The imaging of the perfusion scan consists of looking at where small particles...

    About the Lecture

    The lecture Venous Diseases – Pulmonary Embolism by Joseph Alpert, MD is from the course Venous Diseases. It contains the following chapters:

    • Pulmonary embolism - Definition
    • Pulmonary embolism - Diagnosis
    • Pulmonary contrast angiogram
    • Pulmonary embolism - Summary

    Included Quiz Questions

    1. Endoscopic ultrasound
    2. Lung scanning with radiolabelled albumin
    3. CT scanning
    4. Pulmonary angiography

    Author of lecture Venous Diseases – Pulmonary Embolism

     Joseph Alpert, MD

    Joseph Alpert, MD

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