Deep Vein Thrombosis and Pulmonary Embolism Flashcards
What are the three aspects of Virchow’s triad?
Stasis
Vessel damage
Hypercoagulability
Give examples of stasis
Bed rest, travel
Give examples of vessel damage
Atherosclerosis
Give examples of hypercoagulability
Pregnancy, trauma
What are venous thrombi also known as and what are they composed of?
Red thrombus
Fibrin and red cells
What principally cause venous thrombus?
Stasis and hypercoagulability
What result from venous thrombus?
Back pressure
What are arterial thrombus also known as and what are they composed of?
White clot
Fibrin and platelets
What do arterial thrombi result in?
Ischaemia and infarction
What do arterial thrombi tend to arise secondary to?
Atherosclerosis
Give examples of VTEs?
Limb deep vein thrombosis
PE
Visceral venous thrombosis
Intracranial venous thrombosis
What are the signs and symptoms of DVT?
Unilateral limb swelling Persisting discomfort Calf tenderness Warmth Erythema
How do you diagnose DVT?
Clinical assessment & pre-test probability score (Wells score)
D-dimer if low pre-test probability score
Imaging (compression USS) if +ve D-dimer or high test test probability
What are the long-term consequences of DVT?
Post-thrombotic syndrome (swelling, discomfort, pigmentation, ulceration if severe0
What are the signs and symptoms of PE?
Pleuritic chest pain, SoB, haemoptysis, tachycardia, pleural rub
What are the signs and symptoms of a massive PE?
Severe dyspnoea of sudden onset, collapse, cyanosis, tachycardia, low BP, raised JVP
Can cause sudden death
How do you diagnose PE?
Clinical assessment and Wells/Geneva score
D-dimer if low score
Isotope VQ scan/CTPA if D-dimer +ve or high pretest score
What is a potential consequence of PE?
Pulmonary hypertension
What are the treatment options for PE?
Anticoagulation - UF heparin/LMWH or DOACs/warfarin
Thrombolysis reserved for massive PE
How do we prevent VTE in hospital?
Early mobilisation
Anti-embolism stockings
Pharmacological thromboprophylaxis
