Pulmonary Vascular Disorders Flashcards
Virchow’s triad
Venous stasis
Injury to the vessel wall
Hypercoagulability
(Risk factors for PE and DVT are the same)
Causes physiologic deadspace: Pulmonary vasculature obstruction
ventilation of the lung without perfusion:
Hypoxemia due to R to Left “shunting” of blood
Decreased cardiac output
Surfactant depletion causing atelectasis
Pulmonary Embolus Symptoms
Dyspnea** Pleuritic chest pain** Cough Leg pain Hemoptysis Palpitatins Wheezing Anginal pain
Pulmonary Embolus Signs
Tachypnea Crackles Tachycardia S4 S3 Accentuated S2 Low grade fever Homan’s sign Pleural friction rub Cyanosis
PE EKG Findings
S1Q3T3
Q waves in lead III R bundle branch block S wave in lead I Tachycardia Inverted T waves in lead III
PE Chest X-ray
Wedge shaped peripheral defect (Hampton’s hump)
Atelectasis
Parenchymal infiltrates
Pleural effusion
Prominent central pulmonary artery (Westermark sign)
A normal CXR is the most common finding
Pulmonary hypertension
Increase in pulmonary arterial pressure from increased pulmonary vascular resistance
Pulmonary artery systolic pressure > 30 mmHg or a mean PAP of > 20 mmHg
Pulmonary hypertension symptoms
Dyspnea on exertion Fatigue Chest pain Syncope with exertion Nonproductive cough
Pulmonary hypertension signs
Narrow splitting of S2 with loud pulmonary component
RAE
Enlarged central pulmonary arteries on CXR
JVD
Right sided heart failure symptoms (Hepatomegaly, LE edema)
Cor Pulmonale
RV systolic and diastolic failure secondary to pulmonary disease or from pulmonary vascular disease
Poor prognosis
Most commonly caused by Pulmonary hypertension, COPD or idiopathic pulmonary fibrosis
Cor Pulmonale Symptoms
Chronic productive cough Exertional dyspnea Wheezing Easy fatigability Weakness RUQ pain Dependent edema
Cor Pulmonale Signs
Cyanosis Clubbing Distended neck veins RV heave or gallop Prominent lower sternal or epigastric pulsations Hepatomegaly Dependent edema Ascites Severe lung disease
