What is the mechanism by which deep vein thrombosis causes shock

The mechanism of shock is effective circulating volume depletion.

Deep vein thrombosis can fall off, and usually the embolus that breaks off enters the heart and embolizes the coronary arteries, causing an acute myocardial infarction, causing a sharp drop in cardiac output and then causing shock (cardiogenic shock).

But rarely** in the veins of the upper limbs, head and neck. Stagnation, increased blood coagulability, and venous endothelial injury are contributing factors to thrombosis. Therefore, trauma, prolonged bed rest, varicose veins, venous cannulation, pelvic and hip surgery, obesity, diabetes, contraceptives or other causes of hypercoagulation mechanism can easily induce venous thrombosis.

Early thrombosis is brittle, and the fibrinolytic system acts so that the risk of pulmonary embolism is highest in the first few days of thrombosis.

Guidance: It is best to go to a tertiary hospital In addition to symptomatic measures such as oxygen inhalation, analgesia, correction of shock and heart failure, and bronchial dilation, specific methods include anticoagulation, thrombolysis, and surgery**.

1. Internal Medicine**.

1) General**: The onset of this disease urgently requires emergency treatment, and the patient should be kept on absolute bed rest and oxygen inhalation.

b) Anticoagulation**.

1 Heparin. 2 Vitamin K antagonists.

3) Fibrinolytic agent: that is, thrombolytic agent can promote the dissolution of venous thrombosis and pulmonary emboli, and restore obstructed blood circulation is a safe method.

2. Surgery**.

a) Pulmonary embolectomy.

2) Vena cava occlusion: mainly to prevent embolism and endanger pulmonary blood vessels.

In addition to symptomatic measures such as oxygen analgesia, correction of shock and heart failure, and bronchial dilation, specific approaches include anticoagulation, thrombolysis, and surgery**.

For anticoagulation and thrombolysis, see "Myocardial infarction".Inferior vena cava occlusion is suitable for anticoagulation** patients with risk of fatal bleeding and repeated embolization, and can be ligated or placed with special clips or filters. Pulmonary thrombectomy has a high mortality rate and is limited to patients with thrombolysis or vasopressin-active** shock.

This paragraph] pulmonary embolism in the elderly.

Overview of the disease. Common symptoms of pulmonary embolism in older people are dyspnea, chest pain, tachycardia, and tachypnea. All patients had at least one symptom of chest pain, dyspnea, or tachycardia, and 35% of patients had all three of these symptoms at the same time.

ECG reveals sinus tachycardia, ST-segment and T-wave abnormalities, incomplete right bundle branch block, and T-wave inversion in lead III.

On echocardiology**, it may be normal, with right ventricular dilation, mild vena cava dilation, and a ventricular septum that may shift to the left ventricle.

In older people, pulmonary embolism is often missed. Only a high level of vigilance for the disease can increase the number of diagnoses, shorten the time required for diagnosis, and improve prognosis.

After thrombosis, it can spread proximal along the direction of venous blood flow, and the thrombus in the lower leg can continue to extend to the inferior vena cava, or even to the opposite side. When the thrombus completely blocks the main trunk of the vein, the thrombus can also extend retrograde distally. The thrombus can break off and flow through the right heart with the bloodstream, embolizing the pulmonary artery and complicating pulmonary embolism.

On the other hand, thrombosis can be organized, recanalized and reintributionized, so that the venous lumen can be restored to a certain degree of patency.

Venous valve insufficiency can occur due to the contraction of fibrous tissue and the destruction of the valve itself. Venous thrombosis causes impaired venous return, the extent of which depends on the size and location of the blood vessels involved, as well as the extent and nature of the thrombus. Distal to obstruction Venous pressure increases, capillary stasis, and endothelial cell hypoxia increases capillary permeability and swelling of the limb distal to the obstruction.