Venous Thromboembolic Disease Flashcards
What is a thrombus?
clot that stays in situe
What is an embolus?
clot that travels
Distal Vein Thrombosis
DVT of the calves
Proximal Vein Thrombosis
DVT of the popliteal vein or the femoral vein
What are all scanned and hospital treated DVTs?
Proximal
What triad makes the perfect conditions for clot forming?
Virchows
What makes up Virchows Triad?
Endothelial injury - Venous disorders, Venous valvular damage, Trauma or surgery, Indwelling catheters
Circulatory stasis - Left ventricular dysfunction, Immobility or paralysis, Venous insufficiency or varicose veins, Venous obstruction from tumour, obesity or pregnancy
Hypercoagulable state - Malignancy, Pregnancy and peripartum period, Oestrogen therapy, Inflammatory bowel disease, Sepsis, Thrombophilia
What are the consequencs of VTE?
o Fatal PE o Risk of recurrent VTE o Post-thrombotic syndrome (PTS) o Chronic thromboembolic pulmonary hypertension (CTEPH) o Reduced quality of life
What is post thrombotic syndrome? (PTS)
Occurs in nearly one-third of patients within 5years after idiopathic DVT
What are the characteristics of PTS?
Pain Oedema Hyperpigmentation Eczema Varicose collateral veins Venous ulceration
What can often occur due to Chronic Thromboembolic Pulmonary Hypertension (CTEPH)?
right heart failure
What are the investigations of PTS?
- pre test probability scores (D-Dimer)
- ultrasounds
- CXR
- V/Q Scan
What does a negative D-Dimer score indicate?
low chance of having a VTE
What are the types of pre test probability scores?
Wells
Geneva
What are the pharmacological treatment options of DVTs and PEs?
Anticoagulation
Thrombolysis
Analgesia
