Failure to Diagnose Pulmonary Embolism
Pulmonary embolisms are the second leading cause of sudden death in the United States. A pulmonary embolism is a blood clot which, in approximately 90% or more of the cases, develops in the deep veins of the lower extremities, frequently the calf, which travels to the heart and lungs and then causes death by blocking the exchange of oxygen from the lungs to the blood supply. Risk factors for pulmonary embolism include pregnancy, birth control pills, hormone therapy, inactivity, obesity, major surgery to repair broken bones, joint replacements, and can occur for no apparent reason. If not promptly diagnosed and treated, a pulmonary embolism can cause death by cutting off the oxygen supply from the lungs to the circulatory system. The signs and symptoms of pulmonary embolism can include shortness of breath (dyspnea), rapid heart rate (tachycardia), increased respiration rate (typicnia), pain in the calf without any injury, and swelling or edema in the lower leg. If blood gases are drawn at the hospital, they can indicate increased carbon dioxide, and decreased oxygen saturation. A physician who suspects a deep vein thrombosis (DVT) may order a venous duplex scan which will show a DVT of the leg through an ultrasound. The definitive diagnosis of a PE is made by a spiral CT scan or VQ scan. If diagnosed, anti-coagulation therapy such as heparin or coumadin will be ordered and the survival rate of a PE, if detected promptly, is in excess of 95%.
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