Epidemiology and Pathophysiology

Epidemiology

Incidence of PE

Pulmonary Embolism (PE) is a common and potentially fatal cardiovascular disorder that affects approximately 1 in 1,000 adults in the United States annually. The incidence increases with age, with a higher prevalence in males and individuals with underlying health conditions such as cancer, surgery, immobilization, or genetic predispositions.

 

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Pathophysiology

Virchow’s Triad

The pathogenesis of PE typically involves Virchow’s triad, a set of three broad categories of factors that contribute to thrombosis:

• Hypercoagulability: Includes genetic factors, malignancy, pregnancy, oral contraceptive use, hormone replacement therapy, etc.
• Hemodynamic Changes (Stasis): Prolonged immobilization, paralysis, surgery, obesity, heart failure, etc.
• Endothelial Injury/Dysfunction: Surgery, trauma, smoking, hypertension, etc.

 

Acute Right Ventricular Dysfunction

Acute PE can cause right ventricular (RV) dysfunction due to increased pulmonary vascular resistance. The obstruction in the pulmonary artery leads to increased afterload in the RV, causing RV dilatation and hypokinesis. This can result in decreased cardiac output and potential shock if not managed promptly.

Additionally, here’s the table summarizing the common risk factors for PE under the categories of Virchow’s triad:

Hypercoagulability	Hemodynamic Changes (Stasis)	Endothelial Injury/Dysfunction
Genetic factors	Prolonged immobilization	Surgery
Malignancy	Paralysis	Trauma
Pregnancy	Surgery	Smoking
Oral contraceptives	Obesity	Hypertension
Hormone replacement therapy	Heart failure

These visual elements can be incorporated into the course to provide a clear and concise

Above, you can find the flowchart illustrating Virchow’s triad in the pathogenesis of Pulmonary Embolism (PE). It visually represents the three broad categories of factors that contribute to thrombosis:

• Hypercoagulability
• Hemodynamic Changes (Stasis)
• Endothelial Injury/Dysfunction