BCE 77 Pulmonary Embolism Workup in Pregnancy

As a follow up to Episode 113 Pulmonary Embolism Challenges in Diagnosis we have Dr. Elisha Targonsky, Emergency Physician at North York General Hospital tell his Best Case Ever that elucidates the practical challenges of working up pregnant patients in the ED with a suspicion of pulmonary embolism. Since this recording, the first ever multi-center prospective outcome study looking at the pulmonary embolism workup in pregnancy was published in the Annals of Internal Medicine. A suggested algorithm and analysis of the study by Lauren Westafer are provided in these show notes….

Podcast Production by Anton Helman and Elisha Targonsky,

Audio Editing and Sound Design by Anton Helman, November 2018

 

pulmonary embolism workup in pregnancy

Care of the The Short Coat in EM blog

 

pulmonary embolism workup in pregnancy

 

pulmonary embolism pregnancy algorithm

 

PDF of PE in pregnancy infographic

 

Dr. Targonsky and Dr. Helman have no conflicts of interest to declare.

 

References

  1. Righini M, Robert-ebadi H, Elias A, et al. Diagnosis of Pulmonary Embolism During Pregnancy: A Multicenter Prospective Management Outcome Study. Ann Intern Med. 2018.
  2. Hunt BJ, Parmar K, Horspool K, et al. The DiPEP (Diagnosis of PE in Pregnancy) biomarker study: An observational cohort study augmented with additional cases to determine the diagnostic utility of biomarkers for suspected venous thromboembolism during pregnancy and puerperium. Br J Haematol. 2018;180(5):694-704.
  3. Leung AN, Bull TM, Jaeschke R, Lockwood CJ, Boiselle PM. Evaluation of Suspected Pulmonary Embolism in Pregnancy. American Journal of Respiratory Critical Care Medicine 2011; 184: 1200-1208.
  4. Choi H, Krishnamoorthy D. The diagnostic utility of D-dimer and other clinical variables in pregnant and post-partum patients with suspected acute pulmonary embolism. Int J Emerg Med. 2018;11(1):10.
  5. Leung AN, Bull TM, Jaeschke R, et al. American Thoracic Society documents: an official American Thoracic Society/Society of Thoracic Radiology Clinical Practice Guideline–Evaluation of Suspected Pulmonary Embolism in Pregnancy. Radiology. 2012;262(2):635-46.

 

FOAMed resources on Pulmonary Embolism Workup in Pregnancy

The Short Coat on Pulmonary Embolism Workup in Pregnancy – Is D-dimer a thing?

EM Cases on Diagnostic Challenges in Pulmonary Embolism – Imaging, Pregnancy & Subsegmental PEs

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About the Author:

Dr. Anton Helman is an Emergency Physician at North York General in Toronto. He is an Assistant Professor at the University of Toronto, Division of Emergency Medicine and the Education Innovation Lead at the Schwartz-Reisman Emergency Medicine Instititute. He is the founder, editor-in-chief and host of Emergency Medicine Cases.

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