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Lumb (2017) points out that postoperative pulmonary complications (PPCs) happen to be rather common and are associated with increased mortality amongst patients. In the present case, the patient presents with shortness of breath, pleuritic chest pain, and palpations. The most likely diagnosis in this case would be acute pulmonary embolism. This is more so the case given that as Ouellette (2020) points out, “the classic presentation of PE is the abrupt onset of pleuritic chest pain, shortness of breath, and hypoxia.” It would also be prudent to note that according to Blann (2015), clinical data indicates that a vast majority of pulmonary embolism cases are reported in the 60-70 year age group. The patient in question is 65-years-old.
Pulmonary embolism could essentially be perceived as a venous thromboembolism that travels from the legs of a person to his or her lungs. One of the key symptoms that a person presents following the blockage of a pulmonary artery by a clot is shortness of breath. This is accompanied by pleuritic chest pain. According to Stein (2016), one leading cause of PE is surgery. In the scenario presented in this case, the problem could have occurred as a consequence of prolonged immobility (due to bed rest) following surgery. The patient had a total knee replacement 8 days ago. It is likely that he was confined to a bed following the said surgery. In the words of Merli, Awsare, and Baram (2020), “the incidence of pulmonary embolism appears to be significantly higher in blacks than in whites… mortality rates from pulmonary embolism for blacks have been 50% higher than those for whites…” (77). It is, however, important to note that the authors add that there has been a higher incidence of PE among whites than among other racial groups such as Native Americans and Asians.
References
Blann, A. (2015). Deep Vein Thrombosis and Pulmonary Embolism: A Guide for Practitioners. M&K Update.
Lumb, M.A. (2017). Postoperative pulmonary complications. British Journal of Anesthesia, 118(3), 317-334.
Merli, G.J., Awsare, B. & Baram, M. (2020). Pulmonary Embolism in the ICU. Elsevier Health Sciences.
Ouellette, D.R. (2020). Does pulmonary embolism (PE) have a racial predilection? Medscape. https://www.medscape.com/answers/300901-8457/does-pulmonary-embolism-pe-have-a-racial-predilection
Stein, P.D. (2016). Pulmonary Embolism. John Wiley & Sons.
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