DVT and pulmonary embolism Flashcards
What is a thrombus
Clot arising in wrong place
What is an embolism
Movement of clot along a vessel
What factors contribute to stasis (lack of flow) of blood
Bed rest
Travel
What factors contribute to hypercoagulability of blood
pregnancy
trauma
What factor contributes to vessel damage
atherosclerosis
Difference between a venous thrombus and arterial thrombus
Venous is red, arterial is white
Venous results in back pressure, arterial results in ischaemia and infarction
Venous is principally due to stasis and hypercoagulability and arterial is principally due to atherosclerosis
Symptoms and signs of DVT
unilateral limb swelling persisting discomfort calf tenderness warmth redness
symptoms and signs of pulmonary embolism
pleuritic chest pain breathlessness - dyspnoea haemoptysis tachycardia pleural rub on auscultation
Symptoms and signs of massive pulmonary embolism
severe dyspnoea of sudden onset collapse blue lips and tongue - cyanosis tachycardia low blood pressure raised JVP altered heart sounds may cause sudden death
Potential long-term consequence of DVT
post-phlebitic syndrome - swelling, discomfort, pigmentation, ulceration
Potential long-term consequence of pulmonary embolism
pulmonary hypertension
Risk factors for DVT
age tissue trauma immobility obesity smoking cancer pregnancy OCP inheritance
When people have an inherited predisposition to venous thrombosis, what is the most prevalent thrombophilia
Factor V Leiden
Investigations
Clinical assessment
D-dimer
For DVT:
Compression ultrasound
For PE:
Isotope ventilation/perfusion scan
CT pulmonary angiogram
Prevention of VTE in hospital
Early mobilisation
Anti-embolism stockings
Daily injections of low molecular weight heparin
