Pulmonary Vascular Disease Flashcards
Where is a thrombus usually formed?
In the deep veins of the legs
What are the major risk factors for a pulmonary embolism?
- Recent major trauma
- Recent surgery
- Cancer
- Cardiopulmonary disease (e.g. MI)
- Pregnancy
- Inherited thrombophilia
What are the symptoms (from small PE to major PE) of a pulmonary embolism?
- Pleuritic chest pain
- Cough
- Haemoptysis
- Acute dyspnoea
- Syncope and cardiac arrest
What are the signs (from small PE to major PE) of a pulmonary embolism?
- Pyrexia
- Pleural rub
- Stony dullness to percussion at base (pleural effusion)
- Tachycardia
- Tachpnoea
- Hypoxia
- Hypotension
What are the two ways in which the likelihood of a PE can be determined?
Wells Score and Revised Geneva Score
What are the investigations that can be done when a pulmonary embolism is suspected?
- Full blood count/biochemistry/blood gases
- CXR
- ECG
- D-dimer
- CT pulmonary angiogram
- V/Q scan
- echocardiography
- Consider CT of abdomen/mammography
- Consider thrombophilia testing
What is used to determine the prognosis?
The PESI Score (takes into account age, sex, comorbities etc.
What is the treatment for a pulmonary embolism?
- Oxygen
- Low molecular weight heparin e.g. dalteparin,
- Warfarin
- Direct oral anticoagulants, -Thrombolysis (alteplase)
- Pulmonary embolectomy
What is pulmonary hypertension?
Elevated blood pressure in the pulmonary arterial or tree - pulmonary artery pressure > 25mmHg
What are the causes of pulmonary hypertension?
Secondary to chronic respiratory disease, secondary to left heart disease, chronic thromboembolic PH and mny others including HIV etc.
What are the symptoms of pulmonary hypertension?
Exertional dyspnoea, chest tightness and exertional presyncope/syncope
What are the signs of pulmonary hypertension?
Elevated JVP, right ventricular heave, loud pulmonary second heart sound, hepatomegaly and ankle oedema
What are the investigations that can be carried out if pulmonary hypertension is suspected?
ECG, lung function tests, CX-Ray, echocardiography, V/Q scan, CTPA and right heart catheterisation
How is pulmonary hypertension treated generally?
Treating the underlying condition, oxygen, anticoagulation and diuretics
What are the more specific treatments for pulmonary hypertension?
Calcium channel antagonist, prostacyclin, endothelin receptor antagonists and phosphodiesterase inhibitors
