Pulmonary Vascular Disease Flashcards
Pulmonary embolism definition
blockage of an artery in the lungs
Clinical pulmonary embolism
thrombus forms in the venous system - usually in deep veins of the legs and embolisms to the pulmonary arteries
a massive PE can be fatal - although a minor PE can be traced with
anticoagulation
and has a very good prognosis
Major risk factors for venous thromboembolism
Recent major trauma
Recent surgery
cancer
pregnancy
MI (other significant cardiopulmonary disease)
venous thromboembolism
when a part of a blood clot breaks off and travels in the bloodstream
DVT
deep vein thrombosis
Pulmonary embolism symptoms
Pleuritic chest pain
cough
haemoptysis
isolated acute dyspnoea
syncope or cardiac arrest
syncope
temporary loss of consciousness
Pulmonary embolism signs
pyrexia
pleural rub
stony dullness to percussion at base (pleural effusion)
Signs of pulmonary embolism (patient)
tachycardia
tachypnoea
hypoxia
hypotension
Pre-test probability for pulmonary embolism
wells score
revised geneva score
Pulmonary embolism investigations
FBC CXR ECG D-dimer CT pulmonary angiogram V/Q scan Echocardiography
D-dimer
a product of fibrin degradation (a small protein present in the blood after a blood clot is formed by fibrinolysis)
CT pulmonary angiography
images the pulmonary arteries
echocardiogram
echo/ sonogram of the heart (creates images of the heart)
PE prognosis
Mortality at 30 days (varies from 0 - 25%)
Pe treatment
oxygen
low molecular weight
heparin
Direct oral anticoagulants (DOAC)
Thrombolysis
Pulmonary embolectomy
example of low molecular weight heparin
dalteparin
warfarin
Thrombolysis
dissolution of a blood clot by artificial infusion of an enzyme into the blood
Pulmonary embolectomy
emergency procedure - removes clotted blood from pulmonary arteries
Pulmonary Hypertension
elevated blood pressure in the pulmonary arterial or tree
(either primary or secondary to other conditions)
fairly rare condition (1-2 million population)
Aetiology of pulmonary hypertension
idiopathic
secondary to chronic respiratory disease
secondary to left heart disease
Pulmonary hypertension symptoms
exertional dyspnoea
chest tightness
exertional presyncope or syncope
Signs of pulmonary hypertension
elevated JVP
right ventricular heave
loud pulmonary heart sound
ankle oedema
Pulmonary hypertension investigations
ECG
lung function tests
CXR
echocardiogram
V/Q scan
Pulmonary hypertension GENERAL treatment
Treat the underlying condition that has lead to PH
oxygen
anticoagulation
diuretics
Pulmonary hypertension SPECIFIC treatment
calcium channel antagonist
prostacyclin
endothelin receptor antagonists
Pulmonary hypertension EXTREME treatments
thromendarerectomy
lung or heart lung transplant
