DVT and PE Flashcards
What is DVT?
Deep vein thrombosis - A thrombus formed in the deep venous circulation
What is a PE?
Pulmonary Embolism - A thrombus that has embolised and lodged in the pulmonary circulation
What is VTE?
Venous Thromboembolic disease, covering both DVT and PE
Where does thrombus formation occur in DVT?
IN the venous valve pockets and other sites of assumed stasis
What is meant by a proximal DVT?
Any clot that involves the popliteal vein or higher
What is meant by a distal DVT?
Any clot that forms below the popliteal vein
What are some risk factors for DVT and PE?
Smoking
Long haul travel
Prothrombin mutations
Combined oral contraceptive pill
Hormone replacement
Protein C and S deficiency
Pregnancy
Active malignancy
Surgery
How does DVT usually present?
Painful swollen limb with redness and heat
Tenderness along vein
Sub-acute development
How does a PE usually present?
Sudden SOB with pleuritic pain
Collapse
Haemoptysis
Hypoxia and tachycardia
Hypotension
What score can be used to determine likelihood of PE?
WELLS score
What is the first test performed in suspected PE?
D-dimer test
What is the D-dimer test?
This is a highly sensitive test which tests for the breakdown of cross-linked fibrin
What should be done in cases of a positive D-dimer and high wells score?
Duplex scan
What should be done in cases of a negative D-dimer test?
No further test (Very good at ruling out PE, but not at ruling in PE)
What test is usually performed in PE in pregnancy?
CTPA - CT pulmonary angiogram or ventilation perfusion scanning
