Pulmonary Vascular Diseases Flashcards
What is a Pulmonary Embolism
is a blockage of the lung’s main artery or one of its branches by a substance that has traveled from elsewhere in the body through the bloodstream (embolism)
What are the risk factors of PE
DVT - a clots that travels to a different part of the body
What causes DVT
The Virchow’s Triad of Stasis, Endothelial Damage and Hyper-coagulability
What is stasis
alternation in the normal blood flow. this includes long surgical operation, prolonged sitting during traveling/immbolization after fracture and varicose veins. CHF, paralysis, stoke.
What is Endothelial Damage
like vessel piercing and damages arising from shear stress or hypertension.This is ruled by bacteria, foreign material, biomaterials of implant or medical devices and membrane of activates platelets. (TRAUMA AND INJURY)
What is hyper-coagulability
Hyper-coagulability - underlying malignancy, cancer treatment (Chemotherapy and hormonal ), exogenous estrogen administration and pregnancy. Also Prior history of DVT/PE, Nephrotic syndrome and coagulopathies: Factor V, Lediden, inherited deficiencies of antithrombin/ protein
What are the signs of PE
SOB
Pleuritic chest pain with deep breaths
Hemoptysis
Tachypnea
What are the lab diagnostic test of PE
D-dimer - D-dimer (or D dimer) is a fibrin degradation product (or FDP), a small protein fragment present in the blood after a blood clot is degraded by fibrinolysis. It is so named because it contains two crosslinked D fragments of the fibrin protein.
Imaging test: Chest x-ray EKG - Tachycardia; S1Q3T3 Venous duplex ultrasound or Doppler V/Q scan Spiral CT scan Pulmonary Angiogram
How do you manage PE
Management O2 Pain relief - opioids Acute anticoagulation - LMWH Long term anticoagulation - Warfarin after 5 days Inferior Vena Cava filter
What is DVT
Deep vein thrombosis, or deep venous thrombosis, (DVT) is the formation of a blood clot (thrombus) within a deep vein,[a] predominantly in the legs. Non-specific signs may include pain, swelling, redness, warmness, and engorged superficial veins. Pulmonary embolism, a potentially life-threatening complication, is caused by the detachment (embolization) of a clot that travels to the lungs.
What are the causes of DVT
Virchow’s triad, Concentration of O2 and platelet activation
What is a differential diagnosis of DVT? and how do you rule it out
Cellulitis ( with a blood culture)
What are signs or DVT
Calf pain
Leg swelling
Erythema
Edema
What is Pulmonary Hypertension
is an increase of blood pressure in the pulmonary artery, pulmonary vein, or pulmonary capillaries, together known as the lung vasculature, leading to shortness of breath, dizziness, fainting, leg swelling and other symptoms.[1] Pulmonary hypertension can be a severe disease with a markedly decreased exercise tolerance.
What are the two mechanisms of pulmonary Hypertension
Hypoxia vasoconstriction
Volume/ pressure overload
