Pulmonary Embolism

Pulmonary embolism (PE) is an obstruction of one or more pulmonary arteries, most commonly by a blood clot (thrombus) originating from the deep veins of the legs or pelvis (deep vein thrombosis — DVT). PE is the third most common acute cardiovascular syndrome (after MI and stroke) and carries a mortality rate of 10–30% if untreated. PE exists on a clinical spectrum: - Intermediate-risk PE: right ventricular strain on echocardiogram or elevated troponin/BNP but hemodynamically stable - High-risk PE: hemodynamically unstable — SBP < 90 mmHg or requiring vasopressors; mortality > 50% Most PEs arise from DVT — the term venous thromboembolism (VTE) encompasses both conditions. Risk factors and prevention are inseparable from treatment: VTE prophylaxis is one of the most testable nursing interventions on NCLEX-RN. For the NCLEX-RN: recognize the sudden onset dyspnea + pleuritic chest pain + tachycardia triad, know the DVT risk factors (Virchow's triad), and understand anticoagulation management and safety.