Pulmonary Vascular Disease Flashcards
Describe what happens in a pulmonary embolism.
Thrombus forms in the venous systems, usually the legs, and embolises to the pulmonary arteries.
List some of the major risk factors for developing a pulmonary embolism.
Recent major trauma
Recent surgery
Cancer
Significant cardiopulmonary disease e.g. MI
Pregnancy
Inherited thrombophilia e.g Factor V Leiden, Protein C or S deficiency
Why are you at an increased risk of developing a pulmonary embolism after major trauma or sugery?
Immobile so blood flow reduced
List the presenting symptoms for someone with a minor PE.
Pleuritic chest pain, cough and haemoptysis
What is meant by pleuritic chest pain?
Sharp pain, usually worse upon inspiration
Why may cancer increase risks of a PE?
There may be a tumour pressing on a vein and impacting blood flow.
Describe the presenting symptoms in someone with a major PE
Syncope- passing out/fainting
Cardiac arrest
What may be some clinical signs upon examination of a minor PE?
Pyrexia*, pleural rub, stony dullness to percussion at base (pleural effusion)
*raised temperature
What may be some clinical signs upon examination in someone with an intermediate sized PE?
Tachycardia, tachypnoea, hypoxia
What is meant by tachycardia?
HR over 100 bpm
Need to try and remember as this term comes up a lot
What may be some clinical signs upon examination in someone with a major PE?
Tachycardia, hypotension, tachypnoea, hypoxia
Why may a pre-test probability ranking be carried out?
To see how likely they are to have a PE before using time/resources ineffectively
Which two pre-test ranking tests may be used for someone w suspected PE?
Wells Score
Revised Geneva Score
Name some of the investigations which may be carried out in someone with a PE.
Full blood count, biochemistry, TnI, blood gases
Chest X-Ray
ECG
D-dimer
CT Pulmonary Angiogram (CTPA)
V/Q scan
Echocardiography
Consider CT abdomen and mammography
Consider thrombophilia testing
If d-dimer is negative, what does this indicate?
Unlikely to be a PE
