Critical Care Time 15. Pulmonary Embolism Part 1
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Jan 15, 2024 In this podcast, the hosts discuss the diagnosis, clinical decision support tools, and pathophysiology of pulmonary embolism. They delve into the nomenclature and classification approaches used by different organizations, highlight the typical manifestations and imaging findings of PE, and explore various methods to assess the right ventricle. The benefits of CT angiography and the use of peripheral blood samples in assessing PE are also discussed. The hosts express gratitude towards sponsors and mention it's a two-part episode.
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Clot Burden vs. RV Dysfunction
- Clot burden on imaging doesn't always correlate with right ventricle (RV) dysfunction severity.
- Focus on hemodynamic effects and RV function for accurate PE severity assessment.
IVC Reflux as Mortality Predictor
- Consider IVC contrast reflux on CT angiogram as a strong predictor of PE mortality.
- This signifies the RV's struggle to pump contrast forward, indicating significant dysfunction.
RV Sensitivity to Afterload
- The right ventricle (RV) is less resilient to increased afterload than the left ventricle (LV).
- This makes it more susceptible to dysfunction in conditions like PE, where pulmonary vascular resistance rises.