pulmonary embolism and pulmonary hypertension Flashcards
Examples of Thromboembolic disease
DVT, Pulmonary embolism
What is a pulmonary embolism?
A blockage of a pulmonary artery by a blood clot, fat, tumour or air
What is a pulmonary infarction
If blood flow and oxygen to the lung tissues is compromised the lung tissue may die
What type of DVT is most likely to embolise? (Proximal or distal)?
Proximal
What is the clinical presentation of DVT
Whol leg/calf involved depending on the site.
Swollen, hot, red, tender
What investigations are used for DVT
Ultrasound Doppler leg scan (1st line)
CT scan
Pulmonary Emboli clinical presentation
Large - Cardiovascular shock, low BP, central cyanosis, sudden death
Small recurrent - progressive dyspnoea, pulmonary hypertension and right heart failure
risk factors for DVT and PE
Thrombophilia Contraceptive pill (especially if smokes) Pregnacny Pelvic obstruction Trauma (RTA) Surgery Immobility Obesity Pulmonary hypertension Vasculitis
Prevention of DVT
early post-op movement
TED compression socks
calf muscle exercise
anticoagulants
History of presenting complaint (PE)
Shortness of breath (often acute onset) Chest pain (pleuritic) Haemoptysis Leg pain/swelling Collapse / Sudden death
clinical features of PE
Tachycardia, tachypnoea, cyanosis, fever, low BP, crackles, rub, pleural effusion.
Arterial blood gases (ABGs)
CXR
Prediction scores (guide to likelihood of PE occuring)
Diagnosis and investigation of PE
Pulmonary Embolism Severity Index (PESI) ECG Troponin levels Isotope lung scan CT pulmonary angiogram (CTPA) Leg/pelvic ultrasound Echocardigram
Who has thrombolysis
Tissue plasminogen activator
For life-threatening massive PE
Patient has low BP, sustained sys ,90 mmHg for 15 mins
what is thrombolysis
the dissolution of a blood clot, especially as induced artificially by infusion of an enzyme into the blood.
pulmonary hypertension
“high flow, low pressure system”
