Pathophysiology of Vascular Diseases, Venous Flashcards
arterial thrombosis
- Need anti-platelet therapy
- Underlying vasculature is abnormal
- Pathophysiology: Local shear stress & thrombogenic vascular surface
- Occlusive or non-occlusive
- White thrombi: Composed of mostly platelets
venous thrombosis
- Need anti-coag (NOT anti-platelets)
- Underlying vasculature is abnormal
- Pathophysiology: Stasis & hypercoagulability
- Occlusive
- Red thrombi: Composed of mostly fibrin & red cells
3 components of Virchow’s triad (3 reasons why a person would develop VTE)
- Endothelial injury
- Hypercoagulability (too much clotting factors, deficiency in anti-clotting factors)
- Abnormal blood flow
Risk factors for VTE
- Age > 40
- History of VTE
- Vascular injury
- Stasis
- Hypercoagulability
Vascular injury risk factors
- Trauma (T)
- Major orthopedic surgery (T)
Stasis risk factors
- Major medical illness (A,T)
- Major surgery (T)
- Paralysis/immobility (A)
- Obesity (A)
- Varicose veins (A)
Hypercoagulability risk factors
- Malignancy (A)
- IBD (A)
- Hormone therapy (T)
- Pregnancy (T)
- APA syndrome (A)
- Factor V Leiden (I)
- Protein C deficiency (I)
- Protein S deficiency (I)
- Antithrombin III deficiency (I)
Which of the risk factors are transient?
- Trauma (T)
- Major orthopedic surgery (T)
- Major medical illness (T)
- Major surgery (T)
- Hormone therapy (T)
- Pregnancy (T)
Which of the risk factors are acquired?
- Major medical illness (A)
- Paralysis/immobility (A)
- Obesity (A)
- Varicose veins (A)
- Malignancy (A)
- IBD (A)
- APA syndrome (A)
Which of the risk factors are inherited?
- Factor V Leiden (I)
- Protein C deficiency (I)
- Protein S deficiency (I)
- Antithrombin III deficiency (I)
Signs/Symptoms of DVT
- Leg edema
- Local tenderness or pain
- Erythema/discoloration
- Warmth
- Unilateral
Signs/Symptoms of PE
- Chest pain
- Dyspnea
- Tachypnea
- Tachycardia
- Hemoptysis
- Palpitations
- Cough (can cough up blood)
- Diaphoresis (sweating)
- low-grade fever
- hypotension
- Cardiovascular collapse
- Characterized by cyanosis, shock, and oliguria
DVT Objective Diagnostic Tests
- Invasive test: Venography
- Noninvasive test: Ultrasound
PE Objective Diagnostic Tests
- Invasive test: Angiography
- Noninvasive test: CT scan
When is a lab panel done to diagnose VTE? (Hypercoaguable work-up)
to see why the clot happened; mainly done in idiopathic patients in patients under 40 years