Cardiovascular Revision - Part 1

A blood clot that forms within a deep vein, usually in the leg.

A blood clot that travels to the lungs and blocks blood flow to a part of the lung.

Factors that increase the likelihood of developing a blood clot, such as age, obesity, family history, certain medical conditions, and specific medications.

A mutation in one of the clotting factors in blood, leading to an increased risk of blood clot formation.

A type of anticoagulant (blood thinner) that helps prevent blood clots. Examples include Rivaroxaban and Apixaban.

A type of anticoagulant (blood thinner) used to prevent or treat blood clots. Examples include Warfarin, Dabigatran, and Rivaroxaban.

A type of drug that prevents blood clot formation by blocking activated Factor X.

A type of medication used to prevent blood clots during pregnancy. It does not cross the placenta and is generally considered safer than other anticoagulants for mothers and babies.

Heparins are a type of anticoagulant that prevents blood clots by inhibiting coagulation factors. They are administered intravenously or subcutaneously. There are two main types: unfractionated heparin and low-molecular-weight heparin (LMWH).

LMWHs are readily eliminated during pregnancy, requiring frequent dose adjustments. It is crucial to discontinue treatment once labor begins. If further anticoagulation is necessary, consult a specialist.

One major adverse effect of heparin treatment is hyperkalaemia. This occurs due to the inhibition of aldosterone secretion, which normally helps regulate potassium levels. Patients with kidney disease or diabetes are at higher risk due to reduced potassium excretion. Regular monitoring of potassium levels is essential.

LMWHs, such as tinzaparin, enoxaparin, and dalteparin, exert their effect by inhibiting factor Xa. They possess a longer duration of action compared to unfractionated heparin, leading to a reduced risk of osteoporosis and heparin-induced thrombocytopenia (HIT).

Unfractionated heparin acts by activating antithrombin, a naturally occurring protein that inhibits coagulation factors. It has a shorter duration of action than LMWH and is preferred in patients with a high bleeding risk or renal impairment. Its effectiveness is assessed by monitoring the activated partial thromboplastin time (APTT).

Protamine sulfate can be administered to partially reverse the effects of heparin therapy. It binds to heparin, forming a stable complex that lacks anticoagulant activity.

Warfarin is an oral anticoagulant that works by inhibiting vitamin K synthesis, which is essential for blood clotting. It takes 2-3 days to become effective, and it is often used in conjunction with heparin for immediate anticoagulation.

Warfarin treatment duration depends on the specific situation. For isolated calf deep vein thrombosis, 6 weeks of treatment is typically sufficient. VTE triggered by factors such as surgery, oral contraceptives, pregnancy, or leg plaster requires 3 months of treatment. Unprovoked VTE, often associated with atrial fibrillation, may require longer duration of treatment.

A direct thrombin inhibitor used for prophylaxis in elective knee and hip surgeries.

A direct factor Xa inhibitor used for prevention of VTE (blood clots) in patients undergoing hip or knee replacement, and for treatment of DVT/PE (deep vein thrombosis and pulmonary embolism).

A direct factor Xa inhibitor used for various indications, including prophylaxis in hip and knee surgeries, treatment of DVT/PE, and for prevention of recurrent DVT/PE.

A direct thrombin inhibitor.

A direct factor Xa inhibitor.

A direct factor Xa inhibitor.

NOACs are medications that work by inhibiting specific clotting factors in the body. They're becoming increasingly popular for managing blood clots due to their ease of use and lower bleeding risks compared to traditional warfarin.

Patients with impaired kidney function might need adjustments in NOAC dosage, as these medications are primarily excreted by the kidneys. In severe cases, NOACs might be avoided altogether.

A blood clot blocks blood flow to the brain, causing sudden onset of symptoms lasting longer than 24 hours.

Antiplatelets prevent blood clots from forming, useful after an ischaemic stroke.

A temporary disruption of blood flow to the brain, causing sudden neurological symptoms lasting less than 24 hours.

Avoid aspirin, statins, and anticoagulants as they increase the risk of bleeding in patients with Intracerebral Haemorrhagic Stroke.

A weakened blood vessel in the brain bursts, causing a rush of blood out of the brain.

Warfarin is a medication that prevents blood clots. It is not safe for pregnant women, especially during the 1st and 3rd trimesters, due to the risk of birth defects and bleeding.

A yellow treatment book is used to record a patient's international normalized ratio (INR) levels and current warfarin dose. It informs healthcare professionals about the patient's medication regimen.

Calciphylaxis is a condition where calcium builds up in the small blood vessels of the skin and fat tissues, leading to blood clots. This can cause skin cell death due to insufficient blood flow.

Warfarin should be stopped if calciphylaxis is diagnosed. This is a serious condition that requires immediate medical attention.

Warfarin is a vitamin K antagonist, meaning it blocks the absorption of vitamin K, which is essential for blood clotting.

When rapid anticoagulation is needed, higher doses of warfarin are given initially, followed by adjustments to achieve the desired INR levels.

The target INR range for warfarin therapy depends on the patient's medical condition, aiming to keep the range within a narrow window.

Monitoring INR, liver function, renal function, and thyroid function is crucial for patients on warfarin therapy to ensure safe and effective treatment.