Venous Thromboembolic Disease Flashcards
What is VTE?
Clot formation within the venous circulation
What is DVT?
Thrombi form predominately in the venous valve pockets and other sites of presumed stasis
What is PE?
Thromboembolism detach and travel through the right side of the heart and block vessels in the lungs.
What is the definition of DVT?
Definition: Formation of thrombi within the lumen of the vessels that make up the deep venous system
What is a distal and proximal DVT?
Distal = calves Proximal = popliteal or femoral vein
What might be some risk factors for VTE?
Smoking long haul travel oral pill protein c and s deficiency etc surgery pregnancy
What are some consequences of VTE?
Fatal PE
Recurrent VTE
Post-thrombotic syndrome
Reduced quality of life
What is post thrombotic syndrome?
a complication that arises after DVT Features include: Pain Varicose collateral veins Oedema Hyperpigmentation Eczema Venous ulceration
What happens in Chronic Thromboembolic Pulmonary Hypertension (CTEPH)?
In CTPH, the original embolic material is replaced over time with fibrous tissue that is incorporated into the intima and media of the pulmonary arteries. This material may occlude the pulmonary artery, leading to pulmonary artery resistance and, ultimately, right heartfailure
What investigations might you do in VTE?
Pre-test probability scores
- D dimer are good exclusions (be cautious in patients with previous DVT)
Ultrasound
- Compression (if DVT vein might be hard to compress) vs doppler ultrasound
What is D dimer?
A breakdown of cross linked fibrin
what is the pre test probability score called?
Wells score
If you have a low wells score what should you do?
Check D dimer, no imaging needed if negative
If you have a mod/high wells score what should you do?
Need imaging regardless of d dimer
Name 2 other imaging techniques and what they might show?
CXR - Normal in PE. Might show pleural effusion or infarct
V/Q scan = show perfusion mismatch defects.
What imaging technique can you use in a pregnancy woman?
A perfusion only scan.
How can you treat DVT and PE pharmacologically?
Anticoagulation
Thrombolysis
Analgesia
How can you treat DVT and PE mechanically?
Compression stockings
IVC filters
