Difference between revisions of "Thromboembolism"

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(New page: right|thumb|125px|<small><center>'''Sarcoma embolus (dog)'''. Courtesy of T. Scase</center></small> ===Description=== *As the name implies, a thromboembolis...)
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[[Image:sarcoma embolus.jpg|right|thumb|125px|<small><center>'''Sarcoma embolus (dog)'''. Courtesy of T. Scase</center></small>]]
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== Introduction ==
 
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[[Image:Sarcoma embolus.jpg|thumb|right|200px|<small><center><b>Sarcoma embolus (dog)</b>. Courtesy of T. Scase</center></small>]]  
 
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As the name implies, a thromboembolism is a clot ([[Thrombosis|thrombus]]) or foreign body that blocks vessels a distance away from its site of origin. The most significant sites of thromboembolic formation are the following: lungs, CNS, terminal aorta, kidneys.
 
  
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In order for a thromboembolism to occur, some changes in the vasculature need to be present. These include disruption of endothelial integrity, disruption of flow, disruption of blood [[Haemostasis|haemostasis]] and disruption of fibrinolysis.
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===Description===
  
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The incidence of thromboembolism greatly increases with certain diseases including [[:Category:Cardiovascular System - Pathology|heart disease]], neoplasia, [[:Category:Lymphoreticular & Haematopoietic System - Pathology|blood disorders]], parasitic diseases and [[hyperadrenocorticism]].
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*As the name implies, a thromboembolism is a clot (thrombus) or foreign body that blocks vessels a distance away from its original site of origin.
  
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== Clinical Signs ==
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*The most significant sites of thromboembolic formation are the following: lungs, CNS, terminal aorta, kidneys.
  
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The '5 P's' are the characteristic clinical signs of thromboembolism. These are '''pain, paresis, pallor, pulselessness and polar (cold extremities)'''. Long term clinical effects include necrosis of the affected area. Specific clinical signs relating to the thromboembolism being in a particular area include acute onset neurological problems, renal failure if clot in kidneys and dyspnoea if it is in the lungs.
 
  
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== Diagnosis ==
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'''Requirements for thromboembolism formation:
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'''
  
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All findings and diagnostic procedures are heavily dependent on the site affected.
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1. Disruption of endothelial integrity
  
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Blood tests may reveal hyperkalemia, acidosis, increased lactate, [[Azotaemia|azotemia]] and elevated serum creatine phosphokinase. Radiography, echocardiography and angiography may also be used to diagnose a thromboembolism.
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2. Disruption of flow
  
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== Treatment ==
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3. Disruption of blood haemostasis
  
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It is important to treat the underlying conditions. Pain relief is vital and must be very strong, e.g. morphine. [[:Category:Fluid Therapy|I.V. fluids]] will also need to be given as supportive treatment. Anticoagulants, heparin or aspirin, should also be given.  
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4. Disruption of fibrinolysis
  
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== Prognosis ==
 
  
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Prognosis is grave in most cases.
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'''The incidence of thromboembolism greatly increases with certain diseases including:
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'''
  
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{{Learning
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-Heart Disease
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|full text = [http://www.cabi.org/cabdirect/FullTextPDF/2008/20083206605.pdf '''Feline thromboembolism.''' Moïse, N. S.; The North American Veterinary Conference, Gainesville, USA, Small animal and exotics. Proceedings of the North American Veterinary Conference, Volume 22, Orlando, Florida, USA, 2008, 2008, pp 229-232]
 
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}}
 
  
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== References ==
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-Neoplasia
  
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Ettinger, S.J. and Feldman, E. C. (2000) '''Textbook of Veterinary Internal Medicine Diseases of the Dog and Cat Volume 2''' (Fifth Edition) ''W.B. Saunders Company''
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-Blood Disorders
  
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Ettinger, S.J, Feldman, E.C. (2005) '''Textbook of Veterinary Internal Medicine '''(6th edition, volume 2) ''W.B. Saunders Company''
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-Parasitic Diseases
  
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Fossum, T. W. et. al. (2007) '''Small Animal Surgery '''(Third Edition)'' Mosby Elsevier ''
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-Hyperadrenocorticism
  
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Merck & Co (2008) '''The Merck Veterinary Manual '''(Eighth Edition) ''Merial''
 
  
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Nelson, R.W. and Couto, C.G. (2009) '''Small Animal Internal Medicine '''(Fourth Edition)'' Mosby Elsevier. ''
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====Diagnosis====
  
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=====History & Clinical Signs=====
  
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'''5 P's:'''
  
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{{review}}
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-Pain
  
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{{OpenPages}}
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-Paresis
  
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[[Category:Arterial_Pathology]] [[Category:Expert_Review - Small Animal]] [[Category:Vascular_Diseases_-_Dog]] [[Category:Vascular_Diseases_-_Cat]]
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-Pallor
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[[Category:Cardiology Section]]
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-Pulselessness
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-Polar (cold extremities)
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'''Long Term Effects:'''
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-Necrosis
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'''Specific Problems:'''
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*Signs are dependant on site of thromboembolism
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-Neurological problems (acute)
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-Renal Failure (acute)
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-Dyspnoea (acute)
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====Laboratory Findings====
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*Heavily dependent on thromboembolic site
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-Hyperkalemia
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-Acidosis
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-Increased Lactate
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-Azotemia
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-Elevated serum creatine phospohokinase
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====Radiography, Echocardiography, Angiography====
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-Clots may be seen by the above methods
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===Treatment===
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-Treat underlying conditions
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-Pain Relief (e.g. morphine)
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-Support with IV fluids
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-Anticoagulants:
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1. Heparin
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2. Aspirin
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===Prognosis===
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-Grave[[Category:Arterial_Pathology]][[Category:To_Do_-_Cardiovascular]]

Revision as of 14:41, 1 July 2010

Sarcoma embolus (dog). Courtesy of T. Scase

Description

  • As the name implies, a thromboembolism is a clot (thrombus) or foreign body that blocks vessels a distance away from its original site of origin.
  • The most significant sites of thromboembolic formation are the following: lungs, CNS, terminal aorta, kidneys.


Requirements for thromboembolism formation:

1. Disruption of endothelial integrity

2. Disruption of flow

3. Disruption of blood haemostasis

4. Disruption of fibrinolysis


The incidence of thromboembolism greatly increases with certain diseases including:

-Heart Disease

-Neoplasia

-Blood Disorders

-Parasitic Diseases

-Hyperadrenocorticism


Diagnosis

History & Clinical Signs

5 P's:

-Pain

-Paresis

-Pallor

-Pulselessness

-Polar (cold extremities)


Long Term Effects:

-Necrosis


Specific Problems:

  • Signs are dependant on site of thromboembolism

-Neurological problems (acute)

-Renal Failure (acute)

-Dyspnoea (acute)


Laboratory Findings

  • Heavily dependent on thromboembolic site


-Hyperkalemia

-Acidosis

-Increased Lactate

-Azotemia

-Elevated serum creatine phospohokinase


Radiography, Echocardiography, Angiography

-Clots may be seen by the above methods

Treatment

-Treat underlying conditions

-Pain Relief (e.g. morphine)

-Support with IV fluids

-Anticoagulants:

1. Heparin

2. Aspirin


Prognosis

-Grave

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