Thrombosis diagnostic evaluation: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Thrombosis}} | {{Thrombosis}} | ||
{{CMG}} | {{CMG}} {{shyam}} | ||
==Diagnostic Evaluation== | ==Diagnostic Evaluation== | ||
===Thrombosis Formation and Induced Ischemia=== | |||
The diagnostic evaluation of thrombosis begins with history and physical examination to assess for occlusion of the tissue artery/vein in each organ and to assess for organ-specific symptoms. Clinical and para-clinical signs and laboratory findings may be used to confirm the diagnosis. Individual organ thrombosis is discussed below: | |||
*'''Unstable angina and MI''': | |||
**Clinical signs and symptoms: chest pain, shortness of breath, substernal discomfort | |||
**Imaging and other diagnostics: new ECG findings (mainly ST segment changes and T wave inversions), elevation of cardiac tissue infarction (MI)-specific cardiac enzymes (troponin, CK-MB) | |||
*'''Cerebral stroke and TIA''': | |||
**Clinical signs and symptoms: numbness, weakness, tingling, paresis, hemiplegia, slurred speech, imbalance | |||
**Imaging and other diagnostics: occlusion or thrombosis noted on CT head or MRI | |||
*'''Peripheral arterial occlusions''': | |||
**Clinical signs and symptoms: weakness, paresthesia, numbness, claudication | |||
**Imaging and other diagnostics: filling defect or perfusion defect on CT angiography | |||
*'''Atrial thrombosis''': | |||
**Clinical signs and symptoms: chest pain, shortness of breath, dyspnea on exertion | |||
**Imaging and other diagnostics: echocardiography | |||
*'''Ventricular thrombosis''': | |||
**Clinical signs and symptoms: chest pain, shortness of breath, dyspnea on exertion | |||
**Imaging and other diagnostics: echocardiography | |||
*'''Visceral arteries thrombosis''': | |||
**Clinical signs and symptoms: visceral pain, abdominal pain | |||
**Imaging and other diagnostics: CT angiography of the renal, adrenal, mesenteric or splenic arteries; Doppler ultrasound | |||
===Underlying etiology=== | |||
===Laboratory Findings=== | |||
====cDNA-PCR Assays for Gene Mutations and Polymorphisms==== | ====cDNA-PCR Assays for Gene Mutations and Polymorphisms==== | ||
*4G/5G [[polymorphism]] of the [[plasminogen activator inhibitor]]-1 gene (PAI-1) | *4G/5G [[polymorphism]] of the [[plasminogen activator inhibitor]]-1 gene (PAI-1) | ||
* | *Cystathionine beta synthetase (CBS) CBS T833C & G919A | ||
*[[Factor V Leiden]] | *[[Factor V Leiden]] | ||
* | *Glycoprotein IIIa A1/A2 (platelet glycoprotein) | ||
*[[Methylenetetrahydrofolate reductase]] (MTHFR) MTHFR C677T | *[[Methylenetetrahydrofolate reductase]] (MTHFR) MTHFR C677T | ||
*[[Prothrombin]] G20210A | *[[Prothrombin]] G20210A | ||
| Line 14: | Line 43: | ||
====Serologic (blood) Tests==== | ====Serologic (blood) Tests==== | ||
*[[Anticardiolipin antibodies]] (ACLA) IgG and IgM ACLA | *[[Anticardiolipin antibodies]] (ACLA) IgG and IgM ACLA | ||
*[[Beta-2-glycoprotein antibodies]] | |||
*[[Antithrombin III]] | *[[Antithrombin III]] | ||
*[[Factor VIII]] | *[[Factor VIII]] | ||
| Line 22: | Line 52: | ||
====Evaluation of Hypofibrinolysis==== | ====Evaluation of Hypofibrinolysis==== | ||
*4G/5G [[polymorphism]] of the [[plasminogen activator inhibitor]]-1 gene ([[PAI-1]])(requires cDNA-PCR assay for gene mutation) | *4G/5G [[polymorphism]] of the [[plasminogen activator inhibitor]]-1 gene ([[PAI-1]]) (requires cDNA-PCR assay for gene mutation) | ||
*Lipoprotein a (Lp a) | *Lipoprotein a (Lp a) | ||
Latest revision as of 20:45, 29 December 2018
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Differentiating Thrombosis from other Diseases |
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Diagnosis |
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Thrombosis diagnostic evaluation On the Web |
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Risk calculators and risk factors for Thrombosis diagnostic evaluation |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Shyam Patel [2]
Diagnostic Evaluation
Thrombosis Formation and Induced Ischemia
The diagnostic evaluation of thrombosis begins with history and physical examination to assess for occlusion of the tissue artery/vein in each organ and to assess for organ-specific symptoms. Clinical and para-clinical signs and laboratory findings may be used to confirm the diagnosis. Individual organ thrombosis is discussed below:
- Unstable angina and MI:
- Clinical signs and symptoms: chest pain, shortness of breath, substernal discomfort
- Imaging and other diagnostics: new ECG findings (mainly ST segment changes and T wave inversions), elevation of cardiac tissue infarction (MI)-specific cardiac enzymes (troponin, CK-MB)
- Cerebral stroke and TIA:
- Clinical signs and symptoms: numbness, weakness, tingling, paresis, hemiplegia, slurred speech, imbalance
- Imaging and other diagnostics: occlusion or thrombosis noted on CT head or MRI
- Peripheral arterial occlusions:
- Clinical signs and symptoms: weakness, paresthesia, numbness, claudication
- Imaging and other diagnostics: filling defect or perfusion defect on CT angiography
- Atrial thrombosis:
- Clinical signs and symptoms: chest pain, shortness of breath, dyspnea on exertion
- Imaging and other diagnostics: echocardiography
- Ventricular thrombosis:
- Clinical signs and symptoms: chest pain, shortness of breath, dyspnea on exertion
- Imaging and other diagnostics: echocardiography
- Visceral arteries thrombosis:
- Clinical signs and symptoms: visceral pain, abdominal pain
- Imaging and other diagnostics: CT angiography of the renal, adrenal, mesenteric or splenic arteries; Doppler ultrasound
Underlying etiology
Laboratory Findings
cDNA-PCR Assays for Gene Mutations and Polymorphisms
- 4G/5G polymorphism of the plasminogen activator inhibitor-1 gene (PAI-1)
- Cystathionine beta synthetase (CBS) CBS T833C & G919A
- Factor V Leiden
- Glycoprotein IIIa A1/A2 (platelet glycoprotein)
- Methylenetetrahydrofolate reductase (MTHFR) MTHFR C677T
- Prothrombin G20210A
Serologic (blood) Tests
- Anticardiolipin antibodies (ACLA) IgG and IgM ACLA
- Beta-2-glycoprotein antibodies
- Antithrombin III
- Factor VIII
- Homocysteine
- Lupus anticoagulant (LA)
- Protein C
- Protein S
Evaluation of Hypofibrinolysis
- 4G/5G polymorphism of the plasminogen activator inhibitor-1 gene (PAI-1) (requires cDNA-PCR assay for gene mutation)
- Lipoprotein a (Lp a)