pulmonary vascular disease Flashcards
(44 cards)
how does a pulmonary embolism form?
a thrombus form in the venous system, usually in thj deep veins of the legs and embolises to the pulmonary arteries
what is the treatment for a minor pulmonary embolism?
anticoagulation
why do thrombi aften form in the deep veins of the leg?
they are low flow, low pressure vessels
what is the relationship between embolism size and and severity of condition?
the larger the embolism the larger the pulmonary artery it will get lodged in do the bigger the section of lung cut off from blood so the more serious
what are some risk factors for venous thromboembolism?
- recent major trauma
- recent surgery
- cancer
- significant cardiopulmonary disease
- pregnancy
- inherited thrombophilia
why can recent trauma increase the risk of venous thromboembolism?
there are increased coagulation factors within the blood to clot the blood at the wound, however this will increase of blood clots elsewhere
why can recent surgery increase the risk of venous thromboembolism?
patient will be bead-ridden so blood clots will be more likely
why can cancer increase the risk of venous thromboembolism?
the cancer can release factors that increase blood clotting.
why can significant cardiopulmonary disease increase the risk of venous thromboembolism?
blood flow is reduced
why can pregnancy increase the risk of venous thromboembolism?
increased blood coagulation factors, and feotus compressing veins
why can inherited thrombophilia increase the risk of venous thromboembolism?
eg. in factor V Leiden
coagulation is increased as the coagulation factor V can’t be inhibited
what are the symptoms of pulmonary embolism?
Pleuritic chest pain, cough and haemoptysis
- Isolated acute dyspnoea
- Syncope (temporary loss or consciousness) or cardiac arrest (massive PE)
what are the signs of pulmonary embolism?
- Pyrexia, pleural rub, stony dullness to percussion at base (pleural effusion)
- Tachycardia, tachpnoea, hypoxia
- Tachycardia, hypotension, tachypnoea, hypoxia
what are the two pre-test probability scoring methods for PE?
wells score
revised geneva score
what are the pros and cons of the Wells score?
pros- it is validated
cons- it it subjective
what are the pros and cons of the revised geneva score?
pros- it is not subjective
cons- it is not yet validated
what are the investigations for PE?
-Full blood count, biochemistry, blood gases
-Chest X-Ray
-ECG
-D-dimer
-CT Pulmonary Angiogram (CTPA)
-V/Q scan
-Echocardiography
-Consider CT abdomen and mammography (for cancers)
-Consider thrombophilia testing
(for inherited disorder)
how can a full blood count, biochemistry and blood gas be a useful investigation for PE?
to look for clotting factors and if blood gases are affected by the PE
how can a chest x-ray be a useful investigation for PE?
can sometimes show the emolism
how can an ECG be a useful investigation for PE?
abnormalities such as a sinus tachycardia can be useful for diagnosing PE
how can D-dimer a useful investigation for PE?
it tests for a breakdown product of blood clots, if negative then PE can be ruled out
how can a CT pulmonary angiogram be a useful investigation for PE?
it is the most useful investigation and involves injecting a contrast agent into the blood to diagnose PE
how can a V/Q scan be a useful investigation for PE?
it will check for and V/Q imbalance that may be caused by a pulmonary embolism
how can echocardiography be a useful investigation for PE?
it can act as a easy, non invasive test for PE without complications
