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{{Thrombosis}}
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==Diagnostic Evaluation==
'''Associate Editors-in-Chief:''' [[User:Ujjwal Rastogi|Ujjwal Rastogi, MBBS]] [mailto:urastogi@perfuse.org]
===Thrombosis Formation and Induced Ischemia===
==Overview==
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:
===Diagnostic evaluation===
'''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:'''  
*'''Unstable angina and MI''':
:*[[Anticardiolipin antibodies]] (ACLA) IgG and IgM ACLA
**Clinical signs and symptoms: chest pain, shortness of breath, substernal discomfort
:*[[Antithrombin III]]
**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)
:*[[Factor VIII]]
:*[[Homocysteine]]
:*[[Lupus anticoagulant]] (LA)
:*[[Proteins C]]
:*[[Protein S]]


'''Evaluation of hypofibrinolysis'''
*'''Cerebral stroke and TIA''':
:*4G/5G [[polymorphism]] of the [[plasminogen activator inhibitor]]-1 gene ([[PAI-1]])(requires cDNA-PCR assay for gene mutation)
**Clinical signs and symptoms: numbness, weakness, tingling, paresis, hemiplegia, slurred speech, imbalance
:*[[Lipoprotein a]] [[Lp(a)]]
**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)


{{Circulatory system pathology}}
{{Circulatory system pathology}}


==References==
{{reflist|2}}


[[Category:Hematology]]
[[Category:Hematology]]
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[[Category:Cardiology]]
[[Category:Cardiology]]
[[Category:Emergency medicine]]
[[Category:Emergency medicine]]
[[cs:Trombóza]]
[[de:Thrombose]]
[[eo:Trombozo]]
[[it:Trombosi]]
[[he:תרומבוס]]
[[ms:Trombotik]]
[[nl:Trombose]]
[[pt:Trombose]]
[[fi:Verihiutale]]


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Latest revision as of 20:45, 29 December 2018

Thrombosis Microchapters

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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

Serologic (blood) Tests

Evaluation of Hypofibrinolysis

References

Template:WH Template:WS

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