Deep Vein Thrombosis
A hospitalization for a deep vein thrombosis (DVT) is a serious matter and can be life threatening. DVT is a venous obstruction caused by incompetent valves. This is treated extremely aggressively due to the potential for it to cause embolization to the pulmonary circulation. Patient T.V. has recently had abdominal surgery and is now in the hospital to treat DVT in her left leg. After the third day she begins having shortness of breath and supplemental oxygen is needed. Considering T.V.’s history and her recent abdominal surgery, she is most likely experiencing respiratory distress due to pulmonary emboli. DVT is the most frequent source of pulmonary emboli, which is a blockage in the main artery of the lung. Pulmonary embolism is usually caused by thrombi that are dislodged from the leg veins or the pelvis, but they most commonly arise in the deep veins of the legs. There are a number of predisposing factors that might cause a pulmonary embolism. In T.V.’s case, it was most likely due to her recent surgery since there is not enough evidence given to determine if there is another predisposing factors. To support the diagnosis of T.V., several diagnostic tests can be done. The most definitive test would be a pulmonary angiography. This test does pose some risk to the patient, so there are other options, as well. Perfusion defects in areas that are beyond occluded vessels can be found in lung scans. A chest x-ray will help to rule out other pulmonary diseases. Although ECGs are inconclusive, they can still help distinguish Myocardial Infarction from pulmonary embolism. In addition, ABG measurements showing a decrease in PaO2 and PaCO2 are sometimes characteristic with pulmonary embolism. Lastly, a right ventricular S3 gallop and increased intensity of a pulmonic component of S2 can occasionally be heard through auscultation. All these tests will likely match up with the signs such as tachycardia, productive cough with possible blood, signs of circulatory collapse
References: Copstead, L. & Banasik, J. (2013). Pathophysiology. St. Louis, MO: Saunders, an imprint of Elsevier, Inc. Kluwer, K. (2013). Pathophysiology made Incredibly Easy! Ambler, PA: Williams & Wilkins. Leboyer method. (2009). In D. Venes (Ed.), Taber’s Cyclopedic Medical Dictionary (21st ed., p. 746). Philadelphia, PA: F. A. Davis.