Week 5 - Pulmonary Vascular Disease Flashcards
What are 4 causes of pulmonary embolism?
lung cancer, surgery, pregnancy, trauma
What are symptoms of pulmonary embolism?
cough, haemoptysis, pleuritic chest pain, dyspnoea
What are signs of pulmonary embolism?
tachypnoea, tachycardia, hypoxia, hypotension, dull percussion at base, pleural rub
What investigations do you carry out for pulmonary embolism?
CXR, ECG, FBC, echocardiography, CTPA (CT pulmonary angiogram), D-dimer test
What is D-Dimer test for?
high levels of this protein tells us you have significant formation and breakdown of clots in your body. if its low, its unlikely PE
What is the treatment for pulmonary embolism?
- O2 if hypoxic
- anticoagulants (warfarin),
- thrombolysis if in circulatory shock,
- low molecular weight heparin or unfractionated heparin (if patient is in circulatory shock)
What is pulmonary hypertension?
elevated blood pressure in pulmonary arterial tree
What is the cause?
- rarely idiopathic.
- secondary to left heart disease
- secondary to chronic respiratory disease
- CTEPH - chronic thromboembolic pulmonary hypertension - repeated PE’s or PE that doesn’t resolve
- Miscellaneous - sarcoidosis…
What are the symptoms of pulmonary hypertension? (4)
- exertional dyspnoea,
- exertional chest tightness,
- exertional presyncope (light headedness),
- haemoptysis
What are signs of pulmonary hypertension?
- elevated JVP
- right ventricular heave over heart
- loud heart sound
- hepatomegaly
- ankle oedema
Investigations for pulmonary hypertension?
same for any breathless person. CXR, ECG, lung function tests, V/Q scan. right heart catheterisation to measure pulmonary arterial pressure directly
What are the treatments for pulmonary hypertension?
O2 if hypoxic, if secondary to another disease treat that, if idiopathic then anticoagulate, diuretics to prevent oedema
