Flashcards in DVT and PE Deck (41)
Presentation of DVT?
Tenderness along vein
No other obvious cause
Presentation of PE?
Sudden SOB with pleuritic pain
+- collapse +- heamoptysis +-Hypoxia and tachycardia
BP may be low
Scoring system for PE probability?
What is D-Dimer?
Breakdown product of cross-linked fibrin
If a D Dimer has a high negative result?
->98% for VTE
No further investigations needed?
If there is a moderate to high probability a patient has a VTE what do they need?
Scan done for PE?
CT pulmonary angiogram (CTPA)
Severity assessment for
-Almost always symptomatic, clinical assessment, not very serious
-PESI score (PE severity index score) because for PEs there can be a risk of deterioration and death as PEs put strain on right heart
What is PTS?
Post thrombatic syndrome
Characteristics of PTS?
Varicose collateral veins
When does PTS occur?
Approx 5 years after treatment for VTE, in 1/3 of patients
What is thought to be associated with PTS?
DVT-induced damage to valves in the deep veins and valvular reflux leading to venous hypertension are thought to be associated with PTS.4
Management of DVT?
(highly specialised centres could consider thrombolysis)
What is thrombolysis othere name?
What does thrombolysis do?
Aggressive clot destruction
Examples of direct anti-coagulant?
1st line therapy
Only time warfarin hsould be used?
Vitamin K antagonist example?
- rarely used now
Low molecular wight heparin Injections?
Used in patients with active cancer and PE
Examples of anti-coagulants to treat with?
Direct oral anticoagulant
Vitamin K antagonist
Low molecular weight heparin injection
How long to treat provoked VTE with reversible factor for?
Duration to treat provoked VTE with irreversible factors?
Lifelong depending on patient factors
Duration to treat unprovoked VTE with
-Transient risk factor
-Non-major transient risk factor
-Woman with unprovoked VTE
-Man with unprovoked VTE?
- 3 months or long term
- Long term
Advice for man with unprovoked VTE?
Recommend life long anti coagulants ubless bleeding issue
Scoring system to see whether to keep patients on anti-coagulants?
Deep Vein Thrombosis
Clot (thrombus)formed in the deep venous circulation (usually legs) but can be anywhere
Thrombus (clot) that has embolised (travelled) and lodged in the pulmonary circulation
Venous Thromboembolic Disease
Covers both DVT and PE