CSIM1.60 Case Open Flashcards
Define thrombosis and emoblism
Thrombosis = solid mass of blood constituients within vascular system while alive
Embolism = mass of material in bloo that can be stuck in a vessel and block its lumen
What is a thrombus made of
Fibrin, platelets, RBC,
Describe Virchows triad promoting thrombus formation and how they can be caused
Endothelial damage - phlebitis/arteritis/endocarditis/trauma/atheroma/MI
Hypercoagubility - genetic defect, immobilisation, MI, infarcts, neoplasias, COC pill
Abnormal blood flow - stagnation or turbulent flow
Describe the outcomes of a thrombus
thrombolysis - cleared by fibrinolytic system
Embolism - breakage, block downstream vessel
Recanalisation - endothelial cells form hole through thrombus
Fibrosis - fibrous tissue replacement of thrombus
How does an arterial thrombus form? Along the lines of Virchows triad
Vasculitis causing damage to the endothelial walls
Blood flow interupted by atheroma
Cigarette smoking making platelets sticky
How does an cardiac thrombus form? Along the lines of Virchows triad
MI causing damage to the walls or infective endocarditis
Atrial fibrillation then affects flow which results in blood stagnation
How does an venous thrombus form? Along the lines of Virchows triad
Iatrogenic causes of endothelial damage
Slow blood flow can be caused by immobilisation post-operatively
Surgery/injury/illness causes blood to be in a coaguble state.
List the possible things that can cause an embolism
Thrombus Atheroma Fat Infective vegetations Gas Amniotic fluid Foreign matter Tumour
What are the differences between a thromboembolism coming from the left or right side of the heart?
Left sided thromboembolism usually come from the heart, they will end up in the aorta or in the organs
Right sided embolisms usually originate from deep veins and end up in the lungs AKA pulmonary embolism.
Difference in effect depending on the size of the thromboembolus?
Big ones will block the larger vessels like the pulmonary artery going to the lung, this can cause sudden death
Medium ones will travel further into the lung, causing infarct to a portion of the lung
Small ones will cause small infarcts at the terminal ends of the lung, but accumulation of which can cause pulmonary hypertension over time.
What is the most likely origin of a left atrial embolus?
Left atrial fibrillation
What is the most likely cause of a left ventricular embolus?
Infarct
What is the most likely cause of a valvular embolus?
Infection
What is the most likely cause of an arterial embolus
Atheroma
What happens if a thromboembolus goes to the foot and occludes a vessel?
Infarct which might lead to gangrene
