Plumunary Infarction.pptx DEATH OF PART OF LUNG

Plumunary Infarction.pptx

1. . PLUMUNARY INFARCTION PLUMUNARY INFARCTION 31-Aug-24 PRESENTED BY MUTEGEKI ADOLF

2. Definition Pulmonary infarction refers to the death of lung tissue due to the obstruction of its blood supply, typically caused by a pulmonary embolism (PE). When a PE obstructs a pulmonary artery, it can lead to an area of lung tissue receiving inadequate blood flow and oxygen, resulting in tissue necrosis or infarction. Pulmonary infarction is less common than PE because the lungs have a dual blood supply from both the pulmonary and bronchial arteries.

3. Aetiology Pulmonary Embolism (PE) : The most common cause, where a blood clot blocks the pulmonary arteries. Emboli from Other Sources : Fat emboli, air emboli, amniotic fluid emboli, or septic emboli can also cause infarction. Underlying Lung Disease : Conditions like chronic obstructive pulmonary disease (COPD) or heart failure can increase the risk due to compromised blood flow. Vascular Disorders : Vasculitis or severe atherosclerosis affecting the pulmonary arteries can also lead to infarction.

4. Pathophysiology Obstruction of Blood Flow : A thrombus or embolus blocks a branch of the pulmonary artery, cutting off the blood supply to a segment of the lung. Necrosis of Lung Tissue : Due to the lack of oxygen and nutrients, the affected lung tissue undergoes ischemia and necrosis. Dual Blood Supply Compromise : Normally, the bronchial circulation can partially compensate for the loss of pulmonary artery blood flow. However, if both circulations are compromised, infarction is more likely. Inflammatory Response : The necrotic tissue elicits an inflammatory response, causing the area to become swollen and hemorrhagic.

5. Clinical Presentations Pleuritic Chest Pain : Sharp, localized pain that worsens with breathing or coughing due to irritation of the pleura. Dyspnea (Shortness of Breath) : Often sudden onset due to impaired lung function. Hemoptysis : Coughing up blood or bloody sputum as a result of hemorrhage into the infarcted area. Cough : Often accompanied by productive sputum, which may be blood-tinged. Fever : May occur due to the inflammatory response or secondary infection. Tachypnea and Tachycardia : As a compensatory response to reduced oxygenation.

6. Investigations Chest X-ray : May show a wedge-shaped consolidation (Hampton's hump) indicating an area of infarction, but can be normal in early stages. Computed Tomography Pulmonary Angiography (CTPA) : The gold standard for detecting pulmonary embolism and associated infarction. Ventilation-Perfusion (V/Q) Scan : Useful in patients where CTPA is contraindicated; shows mismatch due to the infarcted area. D-Dimer Test : Elevated in cases of embolism but non-specific for infarction. Arterial Blood Gas (ABG) : Can show hypoxemia and sometimes respiratory alkalosis. Echocardiography : To assess for right heart strain or other complications associated with PE.

7. Management Anticoagulation Therapy : Primary treatment to prevent further clot formation and allow the body to dissolve the existing clot. Common medications include: Heparin (initial treatment) and transition to oral anticoagulants like warfarin Analgesics : Pain management with nonsteroidal anti-inflammatory drugs (NSAIDs) or other analgesics to relieve pleuritic pain. Oxygen Therapy : To correct hypoxemia in cases of severe infarction. Supportive Care : Hydration and, if necessary, respiratory support. Thrombolysis or Embolectomy : Considered in cases of massive PE with hemodynamic instability.

8. Prevention Risk Factor Management : Addressing and managing risk factors such as immobilization, cancer, and other conditions that predispose to thromboembolism. Prophylactic Anticoagulation : For high-risk patients, such as those undergoing major surgery, especially orthopedic or those with a history of PE/DVT. Compression Devices and Early Mobilization : In hospitalized patients to prevent DVT. Lifestyle Modifications : Including smoking cessation, regular exercise, and weight management.

9. NOTE: Pulmonary infarction is primarily caused by pulmonary embolism and can lead to severe clinical symptoms such as pleuritic chest pain, dyspnea, and hemoptysis. Prompt diagnosis and management with anticoagulation, supportive care, and addressing underlying risk factors are crucial to prevent complications and improve outcomes.