The pulmonary embolism which the patient experienced may have been caused by various factors. It is most commonly caused by deep vein thrombosis (DVT) or any blood clot in his body (Marik, p. 4419). The DVT usually starts in the leg or at the abdominal cavity…
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Prolonged immobilization is one of the main causes for DVT (Poelkens, et.al., p. 111). In this case, the patient’s decompression surgery could have contributed to the formation of the thrombus, and such thrombus later travelled up his chest cavity, manifesting as pulmonary embolism.
Initially, a thrombus which separates from its original site then travels through the circulatory system then on to the inferior venacava (Smulders, p. 23). The right ventricle then pushes the thrombus to the pulmonary arteries where the thrombus eventually lodges. Since the pulmonary arteries branch out to smaller blood vessels, the thrombus will likely lodge itself there (Smulders, p. 23). Multiple thrombi may be seen in the pulmonary area and they may be big or microscopic in size; the bigger ones may totally or partially block the major branches of the pulmonary artery. Such thrombus cuts the blood flow in the pulmonary arteries and this can cause increased resistance to blood flow in the pulmonary blood vessels. In instances of 50-60% decreased perfusion, pulmonary hypertension, right ventricle strain, and cardiac heart failure may occur (McGill University). Pulmonary reflexes also cause the release of humoral substances which then lead to the constriction of pulmonary blood vessels, thereby increasing vascular resistance. The pulmonary embolism, along with the patient’s lumbar decompression is causing the manifestation of his other symptoms including: tachypnoea, pleuritic chest pain, tachycardia, dyspnoea, and fever.
Assessment The patient’s pulmonary embolism was diagnosed; however it is still important to note the clinical presentation of this condition in the patient. Since the patient is at a high risk for having PE, it is crucial to note the manifestations of this incident. Some common symptoms include: dyspnoea, pleuritic chest pain, tachypnoea, and tachycardia (Fedullo and Tapson, p. 1247). However, these symptoms cannot sufficiently establish a finding of PE. These symptoms are all apparent in this patient. These may all indeed point to his pulmonary embolism, however, some of these symptoms may be due to his lumbar decompression surgery. Other diagnostic tests may be used in order to detect pulmonary embolism. The first test is the D-dimer test which evaluates
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