PVD & DVT Flashcards
Gold standard for DVT
Contrast venography
Other tests for DVT
Duplex with doppler
Prevention of DVT
Ambulation Pressure stockings Pneumatic compression Heparin Warfarin
Tx of DVT
Heparin Short term anticoag w/ hep Long term w/ paraffin IVC filters Compression in surgical pt
Virchow’s Triad
Venous stasis
Hypercoaguable
Endothelial damage
What is a PE
embolization from venous system to lung through right ventricle
Presentation of PE
Dyspnea Pleuritic CP Hemoptysis Tachycardia & tachypnea low o2
Gold standard for PE
Pulmonary angiography
Treatment of PE
- Anticoagulant with heparin then warfarin
- Thrombolytic in in unstable pt
- Surgery to remove thrombus
What are 3 presentations of PE
Acute cor pulmonate
Pulmary infarction
Acute dyspnea
Cor pulmonale
Massive pulmonary embolism
Acute hypotension/cardiac arrest
Dyspnea, tachycardia, tachypnea
Can resemble MI or septic
Pulmonary infarction
Pleuritic CP
Rales or wheezes
Confused with pneumonia, pleuritic, or MI
XRAY: small effusion of infiltrates; elevated hemidiaphragm
Acute unexplained dyspnea
Sub massive embolism without infarction
Lungs clear, ECG/CXR wnl
Peripheral Arterial Occlusive Disease
Most important of PVD
Atherosclerosis of artier
Reduced perfusion of peripheral tissues
Hallmark of peripheral arterial occlusive disease
Intermittent claudication relieved by legs in dependent position
TX of PAOD
- Antiplatelets
- Exercise
- Reduce cardiovascular risk
- Surgery
Differential Dx of PAOD
Spinal cord compression
Osteoarthrisits
Venous disease
Arterial Thrombus
- Loss of distal circulation due to thrombosis or embolism
- Severe unrelenting pain
5 (6) P’s of arterial thrombus
Pain, pallor, paresthesia, paralysis, pulselessness, ( poikilothermic)
Raynaud’s
- Episodic, vasospastic ischemic attacks of digits
- Digital vessels overly reactive to cold
Manifestation of Raynaud’s
White-Blue-Red
Lived reticularis
- Reticular (fishnet) pattern of blanching and bluish skin
- Vasospams
Varicose Veins
- Venous insufficiency
- Superficial veins become engorged and back flow occurs
Tx of varicose veins
- Stripping/sclerosing
- Stockings
Stasis Dermatitis
- Incompetent veins and leakage of blood into tissues
- Swelling, pigmentation, ulcers
- Pitting edema
Lymphedema
- Limb enlargement due to decreased lymphatic drainage
- Primary: lamp system
- Secondary: breast cancer tx and filariasis
Lymphangitis
- Bacterial/fungal info of lymphatics with cellulitis
- Red streaking
- Leukocytosis
- Antibx and elevate limb
