DVT Flashcards
What are the major risk factors for PE?
previous VTE FHx VTE trauma/surgery pregnancy immobilisation lower limb fracture malignancy
Name three minor risk factors for PE
CV disease
obesity
COPD
thrombophilia
What are the causes of PE?
DVT R ventricular thrombus (post-MI) septic emboli (IE) Amniotic fluid embolism fat embolism (fractures)
What are the symptoms of PE?
acute onset dyspnoea pleuritic chest pain haemoptysis cough syncope dizziness
What are the signs of PE?
tachyopnoea tachycardia hypoxia fever hypotension raised JVP pleural rub
What are the differential diagnoses for PE?
ACS
aortic dissection
pneumothorax
pneumonia
Which scoring is used to stratify risk for PE?
Geneva score
What are signs of PE on ECG?
tachycardia, R axis deviation, RBBB, S1Q3T3- presence of S wave in lead I and Q wave and inverted T wave in lead III.
What are the investigations for PE?
bloods- routine bloods, troponin, D dimer CXR ECG ABG CTPA Doppler USS leg (if DVT suspected)
What is the management of suspected PE?
oxygen therapy + analgesia
LMWH until PE is confirmed on CTPA- change in guidelines, now DOAC?
What is the management of proven PE?
switch from LMWH to DOAC
Continue anticaog for three months, longer if recurrent PE (same management for DVT)
What prophylaxis is available for PE?
early mobilisation, TED stockings, prophylactic LMWH
