Hemodynamic Disorders 2 PDF

 Hemodynamic Disorders 2 Hemostasis and Thrombosis (2)-Abnormal Blood flow -Turbulence leads to arterial and -Processes that maintain blood in a cardiac thrombosis by endothelial injury. fluid, clot-free state in...

 Hemodynamic Disorders 2 Hemostasis and Thrombosis (2)-Abnormal Blood flow -Turbulence leads to arterial and -Processes that maintain blood in a cardiac thrombosis by endothelial injury. fluid, clot-free state in normal vessels while rapidly forming a -Stasis is a major factor in the localized hemostatic plug at the development of venous thrombi. site of vascular injury. - The pathologic counterpart of hemostasis is (3) hypercoagulability of the blood thrombosis, the formation of blood clot Important underlying risk factor for venous (thrombus) within intact vessels. thrombosis. Three elements: Primary (inherited) hypercoagulability: 1.The vascular wall. -young patients (>>Larger leg veins at or above the knee joint. >>>> in saphenous system, >>> popliteal, femoral, and iliac veins >>>>varicose veins. >>> more serious, prone to embolization. >>>>rarely embolize >>>cause local pain and edema. >>>>painful, congestion and swelling. >>>Asymptomatic in 50% of patients, >>>> Impaired venous outflow recognized after they embolize to lungs. >>>>varicose ulcers **Venous thrombosis (phlebothrombosis) Superficial or the deep veins of the leg. Pulmonary Thromboembolism -95% of cases originate from thrombi within deep leg veins above knee level. - Depending on size, a PE can occlude the main pulmonary artery, lodge at the bifurcation of the right and left pulmonary arteries (saddle embolus), or pass into the smaller, branching arterioles. - Recurrence. Systemic Thromboembolism -Origin of systemic emboli Clinical features *Most pulmonary emboli (60% to 80%) are 1.Most systemic emboli (80%) arise from small and clinically silent. intracardiac mural thrombi; -Large embolus that blocks a major pulmonary >>left ventricular infarcts. artery can cause sudden death. (saddle embolus) >>dilated left atrium -Embolic obstruction of medium-sized arteries 2.Aortic aneurysms and subsequent rupture of capillaries can cause 3.Thrombi overlying ulcerated atherosclerotic pulmonary hemorrhage. plaques, -Embolism to small end-arteriolar pulmonary 4. 10% to 15% unknown origin. branches usually causes infarction. -Multiple emboli occurring over time can cause pulmonary hypertension and right ventricular failure (cor pulmonale).