DVT + PE Flashcards
what is a DVT?
a thrombus formed in the deep venous circulation (usually legs) but can be anywhere
what is a PE?
a thrombus that has embolised and lodged in the pulmonary circulation
what is VTE?
venous thromboembolic disease
covers both PE and DVT
what does distal vein thrombosis refer to?
DVT of the calves
what does proximal vein thrombosis refer to?
DVT of the popliteal of the femoral vein
what can cause endothelial injury?
venous disorders
venous valvular damage
trauma or surgery
indwelling catheters
what can cause circulatory stasis?
left ventricular dysfunction
immobility or paralysis
venous insufficiency or varicose veins
venous obstruction from tumour, obesity or pregnancy
what can cause hypercoagulable state?
malignancy pregnancy and peripartum period oestrogen therapy inflammatory bowel disease sepsis thrombophilia
what are exposing risk factors for VTE?
surgery trauma acute medical illness acute heart failure acute respiratory failure central venous catheterisation cancer inflammatory disease
what are predisposing risk factors for VTE?
history of VTE chronic heart failure advanced age varicose veins obesity immobility or paresis myeloproliferative disorders pregnancy/ peripartum period inherited or acquired thrombophilia hormone therapies renal insufficiency
how does a DVT present?
painful and swollen limb with redness and heat
tenderness along vein
sub acute development
no other obvious cause
how does a PE present?
sudden SOB with pleuritic pain sometimes collapse sometimes haemoptysis hypoxia and tachycardia BP may be low
what score can be used for the probability of a PE?
Well’s score
what are the d dimers for someone with VTE?
high
what is d dimer?
breakdown product of cross linked fibrin
what is post thrombotic syndrome?
pain oedema hyperpigmentation eczema varicose collateral veins venous ulceration
what can be used to judge PE severity?
PESI
pulmonary embolism severity index
what is the management of a patient with a DVT?
oral anticoagulation
rare but sometimes thrombolysis
what is the management of a high risk PE?
thrombolysis then oral anticoagulation
what is the management of a intermediate or low risk PE?
oral anticoagulation
rarely but sometimes thrombolysis
which anticoagulant?
first line = DOAC
warfarin
LMWHI in patients with active cancer
