Pulmonary Vascular Disease COPY Flashcards
Where does thrombus normally form?
In the deep veins of the legs
What % of hospital admissions are due to pulmonary embolisms?
1%
Where do thrombus form in pulmonary embolism and where do they travel to?
Form in the venous system (usually in the legS) and embolises to the pulmonary arteries
What is an embolism?
A thrombus (clot) that is travelling in the blood
Does some or all of the thrombus break off and become an embolism?
Either can occur
What is the normal path of apulmonary embolism?
Travels up via the inferior vena cava
Enters the right atrium into the right ventricle
Then is pumped into the pulmonary artery where it lodges
Why does recent trauma and major surgery create a higher risk for pulmonary embolism?
As the clotting system will be more activated, therefore the blood has a higher risk of clotting
What are the major risk factors of pulmonary embolism?
Recent major trauma Recent surgery Cancer Pregnancy Sig. cardiopulmonary disease
What are some of the signs and symptoms of a pulmonary embolism?
Breathlessness (acute and isolate dyspnoea) Pleuritic chest pain Cough Haemoptysis Cardiac arrest (massive PE)
What scales can be used to calculate the risk of PE?
Wells score
Geneva score
What classes can PE be classified into?
Small-medium
Multiple
Massive
What investigations are done to diagnose pulmonary embolism?
Full blood count Chest X-ray ECG D-dimer CT Pulmonary Angiogram V/Q san Echocardiography consider CT abdomen and mammography
What does the mortality at 30 days vary form in pulmonary embolism?
0-25%
What is a PESI score based on?
Age
Sex
Cormobidity
Physiological parameters
What is the treatment for Pulmonary embolism?
Oxygen Warfarin (to thin blood) Direct Oral Anticoagulants Thrombolysis Pulmonary Embolectomy
What does warfarin do and why would it be used in the treatment of PE?
It thins the blood
What do thrombolysis do?
Break down clots
What is pulmonary hypertension?
Elevated blood pressure in the pulmonary arterial or tree
What is the pressure in pulmonary hypertension?
> 25mmHg
Is primary or secondary pulmonary hypertension more common?
Secondary
Who does secondary pulmonary hypertension tend to occur in?
Older age group
What are the symptoms of pulmonary hypertension?
Exertional dyspnoea Chest tightness Exertional presyncope or syncope Racing heartbeat Leg and ankle swelling
What is syncope?
Loss of consciousness
What investigations are done to diagnose pulmonary hypertension?
ECG Lung function tests Chest X-ray Echocariopgraphy V/Q scan CTPA Right heart catheterisation
