Thrombosis Flashcards
What is venous thrombosis
Clot in vein
Eg DVT or PE
What causes a venous thrombosis?
Virchows triad-
Hypercoagulability, endothelial injury, circulatory stasis
What is the pathophysiology of a venous thrombosis?
Low system pressure, no platelet activation -> clot rich in fibrin
How are DVTs formed?
Form in venous valve pockets, DVT in calves common and PVT common in popliteal and femoral vein
Factor from virchows triad satisfied
How are PEs formed?
95% are the result of a mobilised DVT embolus
Can also be embolism of a atrial clot in AF- an arterial thrombosis
How does a DVT present?
Hot swollen red tender leg, oedema, fever
How does a PE present?
Acute SOB, pleuritic chest pain, DVT signs, fever, tachycardia, hypoxia, hypotension, cyanosis
Diagnosis for DVT
do wells score
If Wells shows unlikely do D-dimer as a rule out
If Wells shows likely (or Ddimer +ve) do a US Doppler leg
Diagnosis for PE
Do Wells score
If Wells shows likely do CTPA
If Wells shows unlikely do D-dimer, do CTPA if pos
What is the alternative to a CTPA to diagnose a PE?
V/Q scan
How are venous thrombosis managed?
Anticoagulation
Apixaban/rivaroxaban (DOACs) first line
LMWH second line followed by vitK ant
What is the first line treatment for a massive PE causing circulatory failure?
Thrombolysis
