DVT & PE Flashcards
What are the three components of Virchow’s triad?
Circulatory stasis
Hypercoagulability
Endothelial injury
Why is D-dimer not a diagnostic test for DVT/PE?
It is raised in other pathologies - infection, MI, surgery, liver disease, pregnancy
What are some of the signs/symptoms of DVT?
Calf/leg pain Swelling Redness Hot/inflamed Localised pain over deep vessels
What investigations should be done for DVT?
D-dimer
Duplex scanning ultrasound
What is Venous Plethysomography?
A method used for measuring changes in volume in an extremity e.g. the leg
What is the immediate treatment of DVT?
Anti-coagulation with LMWH & warfarin
What is the long term treatment for DVT?
Compression stockings
TEDs for 6 weeks
What is Phlegmasia Dolens?
A severe form of DVT causing obstruction of arterial inflow threatening the life of the limb
What is the treatment for phlegmasia dolens?
IVC filter Femoral arterial line tPA intra-arterially Surgical review Decompression Amputation
What are the four classifications of PE?
Massive - with shock or syncope
Major with right-ventricular dysfunction
Major with normal right-ventricular function
Minor
What are some of the symptoms of PE?
SOB Collapse Pleuritic Chest Pain Haemoptysis Sudden death
What are some of the signs of PE?
Tachypnoea, hypotension, cardiorespiratory arrest Wheeze Tachycardia Fourth heart sound Pleural Rub Oligemia on CXR (segmental loss of pulmonary vasculature) Signs of Pleural effusion Consolidation on CXR
What investigations should be done if a diagnosis of PE is suspected?
Arterial blood gases CXR V/Q Scan CTPA Echocardiogram Angiography- rarely done ECG- S1Q3T3 only seen in 20%
What is the first line treatment in PE?
Anticoagulation with LMWH
When should thrombolysis of PE be considered?
Major PE
