DVT and PE Flashcards
what is the defintion of a DVT?
- a thrombus formed n the deep venous circulation
what is the defintion of a PE?
- a thrombus tht has embolised and lodged in the pulmonary circulation
what is the definition of a VTE?
- covers both DVT and PE
- venous thromboembolic disease
what is a distal DVT?
- in the calves
- no evidence to clinical treatment working
what is a proximal DVT?
- in the popliteal vein or femoral vein
- these thromboses are termed proximal because they are closer to the heart
what are the 3 components of virchows triad?
- hypercoagulable state
- circulatory stasis
- endothelial injury
how does a DVT present?
- painful and swollen limb with redness and heat
- tenderness along vein
- subcute development
- no other obvious case
how does PE present?
- sudden SOB with pleuritic pain +- collapse +- haemoptysis
- hypoxia and tachycardic on Obs
- BP may be low
what is D-dimer?
- a breakdown product of cross linked fibrin
how do you interpret pre test probability?
- high test = scan
- low test + high d-dimer = scan
what is post thrombotic syndrome characterised by ?
- pain
- oedema
- hyper pigmentation
- eczema
- varicose collateral veins
- venous circulation
how do you estimate the severity of PE?
- PESI score
how do you manage a DVT?
- oral anticoagulation
how do you manage a PE?
- high risk = thrombolysis then oral anticoagualtion
- immediate or low risk = oral anticoagulation
what is thrombolysis?
- aggressive clot destruction
which anticoagulatant do you use?
- direct oral anticoagulants eg apixaban or rivaroxban = these are as good as warfarin
- vitamin K antagonist
- LMWH injections = in cancer and PE