Pulmonary Embolism And Thromboembolic Disease Flashcards
Bimodal peaks
Infancy
Adolescence
PTE secondary to CVL develops in __ and __
SVC
Right atrium
Most important etiologic factors in PTE in infancy
CHD
Central venous line (CVL)
Most commonly affected pediatric age group
Preterm infants
Common cause of PTE in adolescents
Physical trauma and resultant immobility (DVT)
Inherited thrombophilias
Gain-of-function: Factor V (Leiden), prothrombin gene 20210
Loss-of-function: protein C, protein S, antithrombin
Acquired thrombophilia
APAS from SLE
Nephrotic syndrome
Sepsis
Corticosteroids
Myeloproliferative neoplasms
Pathogenesis of PTE
Occlusion of large pulmonary artery causing right heart failure and release of thromboxane, histamine, serotonin, thrombin, and related vasoactive substances
Characteristics of clots
Longer, more castlike
Composed of platelets in various states of senescence, RBC, WBC in fibrin sheath
In adults and adolescents, PTEs arise from:
Legs (DVT) and pelvic veins during and after pregnancy
In children, PTE arises from:
Trauma and surgery causing immobility
Upper circulation (CVL)
Most common final site of PTE in children
Segmental pulmonary arteries
Most common fatal site of PTE
Main pulmonary arteries
Virchow triad
Stasis
Endothelial injury
Hypercoagulability
Clinical features of PTE
Sudden severe worsening of respiratory status
Sense of unease
Dyspnea
Pleuritic pain if with significant infarction/ischemia
Shock, cyanosis, desaturation
Dullness
Diminished breath sounds
Pleural friction rub
