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Pulmonary embolism (PE)

Pulmonary embolism (PE)
Pulmonary embolism (PE)
Pulmonary embolism (PE)
Pulmonary embolism (PE)


Venous thromboembolism (VTE) is a common disorder that comprises deep vein thrombosis (DVT) and pulmonary embolism (PE). Most clinically important pulmonary embolism arises from proximal deep vein thrombosis i.e. popliteal, femoral or iliac veins in at least 90%.

Risk Factors

Signs and symptoms

• Transient dyspnea and tachypnea in the absence of other clinical features
• Pleuritic chest pain, cough, haemoptysis ,pleural effusion, and pulmonary infiltrate
• Severe dyspnea nad tachypnea and right side heart failure
• Cardiovascular collapse with hypotension, syncope, and coma
• Several less common and nonspecific presentation including unexplained tachycardia or arrhythmia, resistant cardiac failure, wheezing, cough, fever, apprehension and confusion.

Diagnostic criteria



  • Non-pharmacological

  • Pharmacological

    Long term anticoagulation is required to prevent a frequency of symptomatic extension of thrombosis and/or recurrent venous thromboembolic events.

    Warfarin is started with initial heparin or clexane therapy and then overlapped for 4-5days.

    • Warfarin 5mg PO for 4–5 days
    • Low Molecular weight Heparin 1mg/kg subcutaneous for 4–5days
    • Unfractionated Heparin by 75units/kg IV followed by continuous infusion of 18units/kg/hrs.

    Adolescents or children:

    • Lower loading dose then 15–25 Units /kg/hr by IV infusion or 250units/kg every 12hrs by subcutaneous injection.

    Pregnant women:

    • Low Molecular weight Heparin (Clexane) 1mg/kg SC and should be monitored by anti-Xa levels.


    Warfarin therapy should be monitor by INR after 5–7 days of treatment. Heparin should be monitored by aPTT before treatment is initiated and monitor aPTT hourly until aPTT is twice of the initial.


Updated on,

14 Novemba 2020 13:07:10


    1. STG
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