VTE.pptx - VENOUS THROMBOEMBOLISM Caipang Ceniza Gealon Venous Thromboembolis m is a condition in which a blood clot forms most often in the deep veins

VTE.pptx - VENOUS THROMBOEMBOLISM Caipang Ceniza Gealon...

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VENOUS THROMBOEMBOLISM Caipang, Ceniza, Gealon
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Venous Thromboembolis m is a condition in which a blood clot forms most often in the deep veins of the leg, groin or arm (DVT) and travels in the circulation, lodging in the lungs (PE).
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DEEP VEIN THROMBOSIS (DVT) A blood clot that forms in a deep vein, usually the leg, groin or arm. PULMONARY EMBOLISM (PE) A blood clot that occurs when a DVT clot breaks free from a vein wall and travels to the lungs blocking some or all of the blood supply.
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2 million DEVELOP VTE EACH YEAR 60,000 DIE 600,000 HOSPITALIZED
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ETIOLOGY AGE VENOUS STAT HISTORY OF VTE
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ETIOLOGY VASCULAR INJURY DRUG THERAPY HYPERCOAGULABLE STATES
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P A T H O P H Y S I O L O G Y
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CLINICAL PRESENTATION & DIAGNOSIS 9
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DEEP VEIN THROMBOSIS General Venous thromboembolism most commonly develops in patients with identifiable risk factors during or following a hospitalization. Many, perhaps the majority, of patients have asymptomatic disease. Patients may die suddenly of pulmonary embolism. Symptoms The patient may complain of leg swelling, pain, or warmth. Symptoms are nonspecific and objective testing must be performed to establish the diagnosis. Signs The patient’s superficial veins may be dilated and a “palpable cord” may be felt in the affected leg. The patient may experience pain in back of the knee when the examiner dorsiflexes the foot of the affected leg (known as Homans sign). Laboratory Tests Serum concentrations of D-dimer, a byproduct of thrombin generation, is usually elevated. The patient may have an elevated erythrocyte sedimentation rate and white blood cell count. Diagnostic Tests Duplex ultrasonography Venography (also known as phlebography)
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PULMONARY EMBOLISM General Pulmonary embolism (PE) most commonly develops in patients with risk factors for venous thromboembolism during or following a hospitalization. Although many patients develop a symptomatic deep vein thrombosis prior to developing a PE, many do not. Patients may die suddenly before effective treatment can be initiated. Symptoms The patient may complain of cough, chest pain, chest tightness, shortness of breath, or palpitation. The patient may spit or cough up blood (hemoptysis). When PE is massive, the patient may complain of dizziness or lightheadedness. Symptoms may be confused for a myocardial infarction, requiring objective testing to establish the diagnosis. Signs The patient may have tachypnea (increased respiratory rate) and tachycardia (increased heart rate). The patient may appear diaphoretic (sweaty). The patient’s neck veins may be distended. In massive PE, the patient may appear cyanotic and may become hypotensive. In such cases, oxygen saturation by pulse oximetry or arterial blood gas will likely indicate that the patient is hypoxic. In the worse cases, the patient may go into circulatory shock and die within minutes.
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