Venous Thromboembolism Flashcards
What is a thrombus?
Clot arising in the wrong place
What is a thromboembolism?
Movement of a clot along a vessel
What is stasis?
Changes in the dynamics of blood flow
What is Virchow’s Triad?
It is a way of describing the three broad categories of factors that are thought to contribute to thrombosis
What events cause hypercoagulability?
Pregnancy
Trauma
What events cause stasis?
Bed rest
Travel
What event causes vessel damage?
Atherosclerosis
Give examples of venous thromboembolism.
Limb deep vein thrombosis Pulmonary embolism Visceral venous thrombosis Inter cranial venous thrombosis Superficial thrombophlebitis
What is superficial thrombophlebitis?
Thrombosis and inflammation of the superficial veins
What is a venous thrombus formed of?
Fibrin and red cells
What are venous thrombi due to?
Stasis and hypercoagulability
What type of pain can a venous thrombus cause?
Back pressure
How is an arterial thrombus described?
White clot
What is a white clot made of?
Platelets and fibrin
What does an arterial thrombus result in?
Ischaemia and infarction
What is an arterial thrombus usually secondary to?
Atherosclerosis
What are the signs and symptoms of DVT?
Unilateral limb swelling
Persisting discomfort
Calf tenderness
Warmth Erythema
What are the signs and symptoms of pulmonary embolism?
Pleuritic chest pain Dyspnoea Haemoptysis Tachycardia Pleural rub on auscultation
What are the signs and symptoms of a massive pulmonary embolism?
Severe dyspnoea of sudden onset Collapse Central cyanosis Tachycardia Low blood pressure Raised JVP Altered heart sounds
What can a massive pulmonary embolism cause?
Sudden death
What are the potential long-term consequences of DVT?
Post-phlebitic syndrome
What are the signs of post-phlebitic syndrome?
Swelling
Discomfort
Pigmentation
Ulceration
What is the potential long-term consequence of pulmonary embolism?
Pulmonary hypertension
What are the risk factors of venous thrombosis?
Increased age Tissue trauma Immobility Obesity Smoking Some systemic diseases Inheritance Pregnancy Exogenous oestrogen
What is heritable thrombophilia?
An inherited predisposition to venous thrombosis
What is the most prevalent heritable type of thrombophilia?
Fator V Leiden
What increases the risk of venous thromboembolism by 40 folds?
Taking the oral contraceptive with Factor V Leiden
What increases the risk of VTE during travel?
The short The tall The overweight Women on the contraceptive pill Window seats
How is DVT diagnosed?
Clinical assessment
D-dimer blood test
Compression ultrasound
How is pulmonary embolism diagnosed?
Clinical assessment
D-dimer test
Isotope ventilation/perfusion scan
CT pulmonary angiogram
What methods can be used to prevent VTE in hospital?
Early mobilisation
Anti-embolism
stockings
Daily injection of low molecular weight heparin
When should compression stockings be used?
Prevention of DVT Chronic venous insufficiency Varicose veins Oedema Lymphedema Prevention of post-phlebitic syndrome
What is the treatment of VTE?
LMW heparin for 5 or more days
Oral anticoagulant for at least 3 months after
Thrombolysis for massive pulmonary embolism
