Pulmonary Embolism & Hypertension Flashcards
What is a thrombus?
A solid mass formed in the circulation
What is an embolus?
A fragment that breaks off a thrombus and blocks vessels
Define; DVT & PE
Deep vein thrombosis
Pulmonary embolism
How does a DVT present?
swollen, hot, red & tender leg
Usually proximal and it may be the whole leg or just the calf depending on the site
What investigations can be done for a DVT?
Ultrasound doppler leg scan
CT scan of ileo-femoral veins, IVC and pelvis
What does the presentation of a PE depend on?
size
Explain the different presentations of PE by size
small - recurrent, progressive dyspnoea, pulmonary hypertension, RHF
medium - pleuritic pain, haemoptysis, breathlessness
large - cardiovascular shock, low BP, central cyanosis
What are the risk factors for PE?
Sex - female Pregnancy Age Surgery Malignancy Oestrogen DVT/PE Immobility Colossal size Antiphospholipid Lupus anti-coagulant
State four ways a PE can be prevented
- post op mobilisation
- compression stockings (TEDs)
- calf exercises
- anticoagulants
State eight symptoms of a PE
- tachycardia
- tachypnoea
- cyanosis
- fever
- low BP
- crackles
- rub
- pleural effusion
Name four underlying causes of a PE
- none
- cancer
- autoantibodies
- thrombophilia scan
How long is the treatment for a PE?
Usually 3-6 months
What are the three different treatment options?
- LMWH once daily infection & warfarin. stopped after 3-5 days when INR is in target range
- Direct oral thrombin inhibitor is often less hassle and just as effective
- Thrombolysis - tissue plasminogen activation used for life threatening/massive PE, low sBP <90, sever hypoaemia, cardiorespiratory arrest
Name a few contradictions to PE/DVT treatment
pregnancy, anti-coagulants, hypertension, liver disease, stroke, neoplasm, trauma, GI bleeding
Define pulmonary hypertension
mean pulmonary arterial pressure >25
