Respiratory diseases

Apr 16th, 2015
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Pulmonary Thromboembolism(PTE)An Elusive DiagnosisDr Wanjiku1GoalsUnderstand the historical context of pulmonary emboliComprehend the pathophysiology and know some commonrisk factorsBe aware of the clinical features of PE and have a basicunderstanding of various diagnostic testGain a therapeutic approach to the treatment of PE anddiscuss a simplified method in the work-up of PEAttempt to dispel a few mythsabout pulmonary emboli2Perspective A Commondisorder and potentially deadly 650,000cases occurring annually Highestincidence in hospitalized patients Autopsyreports suggest it is commonly misseddiagnosed3PerspectivePresentation is often atypicalSigns and symptoms are frequently vague andnonspecific and rarely classicUntreated mortality rate of 20% - 30%,plummets to 5% with timely intervention4Historical Context Pre-1930s Heparin EugineRobin article5Historical Context PIOPED(Prospective Investigation ofPulmonary Embolism Diagnosis) TheElectronic Era, 2000 and Beyond6So What Do We Do ???Confusingfor Emergency PhysicianDo we under diagnose/over diagnose?Why dont we have a standardized method ofwork up after all these years?7PathophysiologyRudolph Virchow, 1858Triad:HypercoagulabilityStasis to flowVessel injury8Risk FactorsHypercoagulabilityMalignancyNonmalignan

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