Pulmonary Vascular Disease Flashcards
Name two Thromboembolic diseases
- Pulmonary embolism
- Deep venous thrombosis
From what thrombi do the majority of emboli originate from?
Thrombi in leg veins
Are thrombi more likely to embolise in smaller or bigger veins?
Bigger
Give another condition which might result in pulmonary embolism
- cardiac thrombus
- septic embolus
- air embolus
- amniotic fluid embolus
What is Virchow’s Triad?
3 broad categories of factors that are risk factors for pulmonary embolism and deep venous thrombosis
What risk factors are in Virchow’s Triad?
- Decreased blood flow
- abnormal vessels
- hyper-coagulable states
Name a condition/state that could be considered a hyper-coagulable state
- pregnancy
- oral contraceptive pill/HRT
- malignancy
- surgery
- genetic factors
Give a condition that might lead to decreased blood flow
- immobility
- travel
- bed-bound
- heart failure
- obesity
What range of people does pulmonary thromboembolic disease affect?
Wide range - young and old, well and unwell
What would worsen the prognosis of a patient with pulmonary thromboembolic disease?
An underlying disease
Why is pulmonary embolism difficult to diagnose?
Patients with pulmonary embolism don’t always have symptoms
Pulmonary embolism can mimic other conditions
What is a deep venous thrombosis?
A deep vein clot
What are the symptoms of deep venous thrombosis?
- leg swelling
- redness
- tenderness
- oedema
- tight calves
What does a Well’s score of more than 2 indicate?
A high risk of deep venous thrombosis
How many conditions are taken into account when calculating a patients Well’s score?
9
What three investigations would be done if there was a suspicion of deep venous thrombosis in a patient?
- D-Dimer test
- Ultrasound
- Venography
Why is a positive D-Dimer test result not conclusive of DVT?
D-Dimer is non-specific, it can increase in almost any inflammatory condition
D-Dimer test results are most helpful when they are
negative
What is D-Dimer?
Product of fibrin degradation
What is a pulmonary embolism?
When a blood clot lodges in the pulmonary arterial circulation
What three factors do the consequences of pulmonary embolism depend on?
- where the emboli lodge
- whether there are single or multiple emboli
- size of emboli
Are most pulmonary embolisms single or multiple?
Multiple
Would one large clot or multiple small clots be more likely to cause chronic pulmonary hypertension?
Multiple small clots
A pulmonary embolism is most likely to be life threatening if there is
a large clot
