DB3 Venous Thromboembolism

Hey, everyone. Today, we're gonna be talking about venous thromboembolism.

So to start, we have a case study.

We have a 40 year old female who presents with leg pain and leg swelling,

shortness of breath and tachycardia, which is just an increase in your heart rate.

So what is venous thromboembolism?

This is actually two separate conditions that occur together.

So the first one being deep vein thrombosis,

this usually occurs in your lower extremities,

but can also occur in the upper extremities.

This is when a blood clot forms

can be due to genetic factors, infection damage to the vessel.

But this blood clot then breaks away and it makes its way up to the upper body

and into the lung. And that is when we call it a pulmonary embolism.

When these two

conditions occur together, we then call it a venous thromboembolism.

So what are we looking for when we are scanning for this?

The first thing we're looking for is compressibility.

We want to be able to palpate that vessel

and be able to see it compress all the way

and the image to the left.

You can see a before and after with the before being completely open.

And the after being half closed,

we can see that there's something there that is

blocking us from being able to close that vein,

which would signify

that there's probably a blockage there

that leads us to disturbed flow.

So in the image to the left or sorry, the image to the right,

you see blood flow at the bottom is very good.

But when you get up to the top, the blood flow, there is very, very minimal

that shows that there's something there

disturbing that flow and causing that blockage

that also leads us to turbulent flow. We will discuss that in the next slide.

Then there's Doppler ultrasound versus duplex ultrasound.

We know that Doppler ultrasound is really good for

real time imaging and blood and you know,

monitoring blood flow

with duplex ultrasound.

This is just a more modern version of Doppler ultrasound

that is really good for this type of scan.

It gives us more data

and it allows us to see the surrounding structures in real time in

gray scale as well as whatever we are looking at at that moment.

So this is really good for

noticing turbulent flow in the surrounding structures as well,

which is a good indicator that there might be something going on somewhere else.

We will also be using color Doppler to help us with that blood flow movement.

So a turbulent flow

oftentimes when you have a blockage, that area tends to swell or enlarge.

And what happens is that creates stenosis in the surrounding structures.

So if you have a vessel that has a blockage or a clot in, it

oftentimes that will swell or enlarge.

And that is what can create that swelling in the leg pain that that

40 year old female was complaining of.

So when this happens,

it can press on the surrounding structures and

create um the narrowing of that structure.

In that case, we have a pressure gradient, we have a you know,

different pressure gradient which can cause turbulent flow,

which is also a very tricky situation because

that can lead to other conditions as well.

So in this image, you can see

aside from the red, the typical red and green, you also have some oranges in there,

some yellows in there, some you know greens in there

and blues in there and they all all types of colors.

You can tell

this is signifying that there's turbulent flow going on in that area.

And there is my work side. Thank you.

DB3 Venous Thromboembolism

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