The patient is a 32-year-old female presenting with multiple modifiable risk factors in combination with a potential venous thromboembolism (VTE) derived pulmonary embolism (PE) in progress. The following study identifies the risk factors for VTE, assessing their contribution to the presenting complaints experienced by the patient.
Modifiable risk factors identified in this patient include the use of mixed (containing both progestin and Ethinyl estradiol) oral contraceptive pill (OCP), smoking, obesity and prolonged immobility. Of particular concern is the combination of smoking and use of mixed OCP.
Smoking isolated from other risk factors slightly increased the risk of VTE, with evidence pointing to inflammation, increases in blood viscosity and reduced fibrinolysis being responsible (Cheng et al., 2013). Mixed OCP is believed to have a synergistic effect with smoking (Pomp, Rosendaal & Doggen, 2008). Evidence suggests a link between OCP, coagulation and fibrinolysis abnormalities, which are further exacerbated by smoking, through increases in plasma fibrinogen and factor XIII (Tapson, 2005). The combination is believed to cause an 8.8-fold increased risk, when compared to non-smoking women, not using OCP (Pomp, Rosendaal & Doggen, 2008). …show more content…
Patients who present with obesity at minimum double their risk of VTE when compared to populations with normal BMI (20-24.9) (Allman-Farinelli, 2011). The risk is amplified due to increases in procoagulant factors and fibrinogen combined with decreases in protein C, protein S and tissue plasminogen activator levels (Tapson,
Modifiable risk factors identified in this patient include the use of mixed (containing both progestin and Ethinyl estradiol) oral contraceptive pill (OCP), smoking, obesity and prolonged immobility. Of particular concern is the combination of smoking and use of mixed OCP.
Smoking isolated from other risk factors slightly increased the risk of VTE, with evidence pointing to inflammation, increases in blood viscosity and reduced fibrinolysis being responsible (Cheng et al., 2013). Mixed OCP is believed to have a synergistic effect with smoking (Pomp, Rosendaal & Doggen, 2008). Evidence suggests a link between OCP, coagulation and fibrinolysis abnormalities, which are further exacerbated by smoking, through increases in plasma fibrinogen and factor XIII (Tapson, 2005). The combination is believed to cause an 8.8-fold increased risk, when compared to non-smoking women, not using OCP (Pomp, Rosendaal & Doggen, 2008). …show more content…
Patients who present with obesity at minimum double their risk of VTE when compared to populations with normal BMI (20-24.9) (Allman-Farinelli, 2011). The risk is amplified due to increases in procoagulant factors and fibrinogen combined with decreases in protein C, protein S and tissue plasminogen activator levels (Tapson,