Arterial Thrombosis Flashcards
what is arterial thrombosis
a blood clot in an artery, causing obstruction in blood flow from the heart to major organs and tissues
what is the difference between thrombus and embolus
thrombi are blood clots formed in situ. emboli are blood clots that have formed else where and travelled to and blocked an artery in another part of the body (e.g. carotid artery clot blocking the meningeal artery)
what can arterial thrombosis manifest as/ cause/ complications
heart attacks, strokes, peripheral vascular disease (legs), tissue necrosis
aetiology
atherosclerosis; can be due to high cholesterol, damage to the artery wall, abnormal heart rhythm (fibrillation),
diseases of the clotting cascade
risk factors
risk factors of atherosclerosis (smoking, high cholesterol, weight, inactivity, alcohol, hypertension, diabetes, injury to artery wall)
atrial fibrillation
disorders of clotting cascade
mitral stenosis
endocarditis
summarise atherosclerosis
1) the fatty streak, which represents the initiation 2) plaque progression, which represents adaption and 3) plaque disruption, which represents the clinical complication of atherosclerosis
symptoms depends on what
the complication caused by a ruptured emboli; heart attack, stroke or peripheral vascular disease
symptoms of heart attack
angina, palpitations, pain radiating to shoulder and neck
physical examination findings
The health care provider may find decreased or no pulse, and decreased or no blood pressure in the arm or leg. There may be signs of tissue death or gangrene
what disease is intermittent claudication related to
peripheral vascular disease
what is intermittent claudication
Symptoms include pain on exercise, known as intermittent claudication, and cold extremities. Intermittent claudication usually occurs in the calf when walking, and is relieved by rest. If the condition becomes worse, there may also be pain at rest.
what is the reason for pain in intermittent claudication
The pain is due to lack of blood in the leg muscle during exercise, caused by narrow arteries in the lower leg and foot
prevention
There are two main ways of preventing arterial thrombosis – lifestyle changes and medication
investigations
Angiography of the affected extremity or organ
Doppler ultrasound exam of an extremity
Duplex Doppler ultrasound exam of extremity
Echocardiogram
MRI of the arm or leg
Myocardial contrast echocardiography (MCE)
Plethysmography
Transcranial Doppler exam of arteries to the brain
Transesophageal echocardiography (TEE)
treatment goals
Control symptoms and to improve the interrupted blood flow to the affected area of the body.
