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DISORDERS OF VASCULAR

ORIGIN

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PULMONARY EMBOLISM

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DEFINITION

..blockage in the

arteries of the lungs

from blood clots (usu.From legs)

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SYMPTOMS

Sudden dyspnea

Sharp chest pain (worse w/ cough &

deep breathe)

Cough w/ pink, foamy sputum

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SYMPTOMS (O)

Wheezing

Unilateral pedal edema

Cold cyanotic skin Excessive sweating

Tachycardia

Weak pulse

Lightheadedness

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CAUSE

DVT

Fracture

Tumor

Air bubbles

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RISK FACTORS

Prolonged immobility

Age

Family hx

Surgery

Medical conditions

Lifestyle

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DIAGNOSIS

CXR

Lung scan

CT Pulmonary angiogram

D-dimer blood test

UTZ

MRI

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MANAGEMENT

Meds

Anticoagulants Heparin & Warfarin

Thrombolytics Streptokinase

Surgery

Embolectomy

Vena cava filter

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PULMONARY HYPERTENSION

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DEFINITION

High blood pressure affects

arteries of the lungs & rightside of the heart;

narrowing or arteries

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SYMPTOMS

Dyspnea

Fatigue Syncope

Chest pain

Edema

Ascites Cyanosis

Palpitations

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CAUSES

IDIOPATHIC SECONDARY

Pulmonary emboli

COPD

Sleep apnea & disO

Congenital heart defects Sickle cell anemia

Cirrhosis

Cocaine, etc.

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RISK FACTORS

Idiopathic

Family hx

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DIAGNOSIS

Blood tests

CXR

Doppler ECG

Transesophageal ECG

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Right heart catheterization

Spirometry

Perfusion lung scan

CT

Open lung biopsy

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CLASSIFICATIONS

I: dx, x sx

II: x sx at rest, + N act.

III: comfy rest, + physical act.

IV: + at rest

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MANAGEMENT

Meds

Vasodilators: epoprostenol, iloprost

Endothelin receptor antagonist: bosentan

Sildenafil

High-dose Ca channel blocker: amlo, diltia, nife

Anticoagulants

Diuretics

O2 therapy

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MANAGEMENT

Surgery

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PULMONARY EDEMA

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DEFINITION

Excess fluid in the lungs

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SYMPTOMS

ACUTE

Dyspnea

Wheeze

Anxiety

Blood-tinged frothy

sputum

Excessive sweating

Pale skin

Chest pain

Palpitations

CHRONIC

Dyspnea when active

Orthopnea

Wheeze

Rapid wt. gain

Edema

Loss of appetite

Fatigue

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CAUSE

CAD

Cardiomyopathy

Heart valve probs HPN

Lung infxns

Exposure to toxins

Kidney dss

Smoking

Adverse drug rxn ARDS

High altitude

places

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DIAGNOSIS

CXR

ECG

Echocardiography

TEE

Pulmonary artery cath Cardiac cath

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MANAGEMENT

Preload reducers

Nitroglycerin

Diuretics Morphine

Afterload reducers

Vasodilators

BP meds