Pulmonary vascular disease Flashcards
What are the major risk factors for venus thromboembolism?
-Recent major trauma
-Recent surgery- (not moving/bed ridden)
-Cancer - blood more coagulable
Significant cardiopulmonary disease e.g. MI
-Pregnancy
-Inherited thrombophilia e.g. Factor V Leiden
Where does a thrombus normally form?
Usually in deep veins of the legs
Where does a thrombus normally embolise?
Pulmonary arteries
How many hospital admissions are because of this?
Estimated 1%
What is an embolism?
A blood clot travelling from one part the body to another
What symptoms arise if there is an isolated small blood clot in a large peripheral artery?
Pleuritic chest pain, cough and haemoptysis
What happens when there is an isolated small blood clot in a large peripheral artery?
Part of the lung becomes infarcted= necrotic tissue. Surface of lung becomes inflammed pleura rubs against chest wall= pleurisy
What are the symptoms of 2 bilateral clots in the pulmonary arteries.
Isolated acute dyspnoea (breathlessness)
What are the symptoms of a massive pulmonary embolism
Syncope (black out) or cardiac arrest
What are the signs of an isolated small blood clot in a large peripheral artery?
Pyrexia, pleural rub, stony dullness to percussion at base (pleural effusion)
What are the signs of 2 bilateral clots in pulmonary arteries?
Tachycardia, tachpnoea and hypoxia
What are signs of a major pulmonary embolism?
Tachycardia, hypotension, tachypnoea (fast resp rate), hypoxia
What pre-test probability scores exist to determine likelyhood of developing a PE
- Wells score
- -Includes symtoms and sings of VTE
- Revised Geneva score
- -Based on risk factors , symptoms and signs
What Investigations are used to determine if some has a PE?
- Full blood count,biochemistry, blood gases
- Chest X-ray
- ECG
- D-dimer
- CT Pulmonary angiogram
- V/Q scan
- Echocardiography
- Consider CT abdomen and mammography
- Consider thrombophilia testing
What might show up in a chest X-ray when a patient has a PE?
Small pleural effusion
