Pulmonary Vascular Disease Flashcards
What is a pulmonary embolism?
A blood clot travelling from one part of the body to another part. A blood clot traveling in the veinous arterial system.
In a pulmonary embolism where does a blood clot normally travel?
From the deep veins of the leg to the pulmonary artery
What are the major risk factors of venous thromboembolism?
Recent major trauma Recent surgery Cancer Significant cardiopulmonary disease Pregnancy Inherited thrombophilia
What are the symptoms of a pulmonary embolism?
Pleuritic chest pain, cough and haemoptysis
Isolated acute dyspnoea
Syncope or cardiac arrest
What tests would be carried out to check for a pulmonary embolism?
Full blood count, biochemistry, blood gases Chest X-Ray ECG D-dimer CT Pulmonary Angiogram (CTPA) V/Q scan Echocardiography Consider CT abdomen and mammography Consider thrombophilia testing
How are pulmonary embolisms treated?
Oxygen
Low molecular weight heparin e.g. dalteparin
Warfarin
Direct Oral Anticoagulants (DOAC) - rivaroxaban, apixaban
Thrombolysis - alteplase (rt-PA)
Pulmonary Embolectomy
What is pulmonary hypertension?
Elevated blood pressure in the pulmonary arterial tree
What is the prevalence of primary hypertension?
It is rare, 1-2 per million population and is more common in younger people
What are the two types of pulmonary hypertension?
Primary - occurring on its own, is rapidly progressive and can lead to premature death
Secondary - occurs a because of another illness and is more common in older aged people
What are the causes of pulmonary hypertension?
Idiopathic Secondary to chronic respiratory disease Secondary to left heart disease Chronic Thromboembolic PH (CTEPH) Collagen vascular disease Portal hypertension Congenital heart disease (L to R shunt) HIV infection
What are the symptoms of pulmonary hypertension?
Exertion dyspnoea
Chest tightness
Exertional presyncope or syncope
What are the signs of pulmonary hypertension?
Elevated jugular venous pressure Right ventricular heave Loud pulmonary second heart sound Hepatomegaly Ankle oedema
What tests should be done to test for pulmonary hypertension?
ECG Lung function tests Chest X-Ray Echocariography V/Q scan CTPA Right heart catheterisation for measuring pulmonary artery pressure, wedge pressure and cardiac output
How is pulmonary hypertension generally treated?
Treat underlying condition
Oxygen
Anticoagulation
Diuretics
