#92: Pulmonary Embolism for the Internist

The Curbsiders Internal Medicine Podcast

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6+ y ago 57:21

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Wow the crowd with your knowledge of pulmonary embolism! What are the red flags? What tools are available to guide you? How on Earth do you triage a patient with pulmonary embolism (PE)? What exactly is the RV spiral & how do PEs really cause morbidity and mortality?! Get schooled by pulmonary embolism expert, Dr. Oren Friedman, associate director of the Cardiac-Surgical Intensive care unit at the Cedars-Sinai Heart Institute. Doctors Cyrus Askin and Chris Chiu join as co-hosts. Test Yo’ Self Pulmonary embolism quiz

Written by Cyrus Askin, MD, Justin Berk, MD, MBA, MPH. Figure by Cyrus Askin, MD. Edited by Matthew Watto, MD

Full show notes available at http://thecurbsiders.com/podcast

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Time Stamps

5:10 - Start of Interview / Introduction
10:00 - Case Presentation - Introduction of DVT / PE Spectrum and Pathophysiology
16:18 - How to Triage and Work-Up Pulmonary Embolism (CT, Echo, troponins, “eyeball”)
23:30 - Other ways to risk-stratify (Other CT findings, clot burden)
28:45 - What does a low-risk patient look like?
30:35 - When to consider treatment modalities other than general anticoagulation
35:12 - Anticoagulation treatment options
36:38 - Next step intensive interventions after anticoagulation
42:00 - Evidence behind catheter-directed lysis
44:05 - IVC Filter discussion
47:22 - Discharge criteria for PE
50:00 - Incidental PEs
52:40 - Interdisciplinary PERT Team

Tags: pulmonary, embolism, thrombolysis, heparin, anticoagulation, right, ventricle, RV, left ventricle, LV, circulation, hypotension, shock, IVC, vena, cava, filter, catheter, TPA, echocardiogram, CT, scan, computed, tomography, shock, bleed, clot, deep, vein, thrombosis, vte, venous, embolism, assistant, care, doctor, education, family, foam, foamed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident

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