Venous thrombosis Flashcards
What are the symptoms of a DVT?
Pain, swelling in leg, puffy ankle, sometimes red
What are the signs for a DVT?
Tenderness, swelling, warmth, discolouration
What investigations are used for DVT?
D-dimer
Ultrasound compression test proximal veins - clot prevents closure of vein
What treatment is used for DVT?
Low-molecular weight heparin
Oral warfarin
Compression stockings to prevent post thrombotic syndrome
Treat-seek underlying cause (malignancy)
What are the risks for getting a DVT?
Surgery, immobility, leg fracture/plaster of paris
Oral combined pill - oestrogen increases risk (pregnancy, HRT)
Long haul flights (8-10 hours)
Inherited thrombophilia
Increased age
What can be done to prevent DVTs?
Mechanical hydration and early mobilisation
Compression stockings
Foot pumps
Chemical - LMW heparin
Assessment on admission to hospital - possible heparin injection
When should thrombo-prophylaxis be used?
In medical and surgical patients
Deltaparin - sub cut twice daily, no use if DVT already present
What are the symptoms of a PE?
Breathlessness, pleuritic chest pain, signs/symptoms of DVT
What are the signs of a PE?
Tachycardia, tachypnoea, pleural rub
What investigations are done for a PE?
CXR usually normal
ECG sinus tachycardic
Blood gases - type 1 reap failure, decreased O2 and CO2
What treatment is used for a PE?
As for DVT
Ensure normal Hb, platelets, renal function, baseline clotting
LMW heparin, oral warfarin
Prevention strategies for PE
Same as for DVT
Early mobilisation and hydration
What is a thrombosis?
Blood coagulation inside a vessel
What can thrombosis lead to if present in coronary, cerebral or peripheral arteries?
MI
CVA/stroke
Peripheral vascular disease (claudication), rest pain, gangrene
What are the risk factors for atherosclerosis?
Smoking, hypertension, diabetes, hyperlipidaemia, obesity/sedentary lifestyle, stress/type A personality
