Thrombosis and embolism CC Flashcards
Laboratory abnormalities with MI
raised creatine kinase troponin raised (Released within 4-6hrs) increased lactate dehydrogenase
type of necrosis in MI
Coagulative
3 reasons why a DVT may develop
immobility–>impaired venous return
endothelial injury /dysfunction (eg in a leg fracture)
Thrombophilia
name 7 predisposing factors of DVT
immobility, post op, pregnancy/post partum, oral contraceptives, severe burns, cardiac failure, disseminated cancer
Signs and symptoms of pulmonary thromboembolism
sudden onset of shortness of breath sudden, sharp chest pain, worse with deep inspiration and coughing raised HR increased breathing rate coughing up blood
Risk factors of pulmonary thromboembolism?
immobility, injury, pregnancy, obesity, cancer, estrogen, thrmbophilia
note some cancers secrete pro coagulants
Describe the mechanism of air embolism
Air enters the veins (pressure lower than atmospheric)
Goes to right side of the heart and into pulmonary circulation
Increases pulmonary pressure and can reopen patent foramen ovale in heart
The air can now travel from the right to the left side of the heart and up to the brain to cause a stroke
How does fat embolism present clinically?
dyspnea, petechiae, and cognitive dysfunction
Two types of fat embolism?
Asymptomatic- much more common
Fat embolism syndrome- much more serious
What is the pathophysiology of fat embolism syndrome
Injure the pulmonary capillary endothelium (note injured by free fatty acids hydrolysed by lipiprotein lipase)
Releases local toxic mediator
These mediators cause increased vascular permeability, resulting in alveolar hemorrhage and edema and causing respiratory failure and ARDS
What can cause fat embolism
severe injuries to bones (main)
fatty liver
burns
What can amniotic fluid embolism cause?
triggers allergic reaction, cardiorespiratory collaspe, pulmonary oedema, bronchconstriction, decreased coronary blood flow, hypotensive shock
