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This Concept Map, created with IHMC CmapTools, has information related to: Hershel Greene C-1 pt. 2, Troponin I Troponin level was normal Suggests that CP is not due to Acute MI Myocardial infarction, PT PT/INR used to monitor when taking warfarin Warfarin, Platelets Pt's low platelet count (90,000) indicates thrombocytopenia. PT/PTT would still be unchanged due to no affect on coagulation PT, Vit K Synthesis of Factor VII is dependent on Vitamin K Factor VII, Thrombosis degraded by a natural anticoagulant protein, antithrombin Antithrombin, Antithrombin Deficiency or Dysfunction in this can lead to clot formation Pulmonary embolism, Sharp CP worse with inspiration Sharp Acute CP May Indicate Myocardial infarction, Fibrinogen will become fibrin, when activated by thrombin Fibrin, Platelets Activated platelets release serotonin which can be detected on a serotonin release assay Serotonin release assay, Platelets Timing and degree of platelet count decreases are important factors to assess in a 4T test to get the 4T score 4T score, Tissue factor Initiates the Extrinsic Coagulation Cascade Extrinsic pathway, Plasminogen Plasminogen activators like tPA are contraindicated in any vascular injury Vascular Injury, Endothelium will release tissue factor when damaged Tissue factor, Aspirin acetylation of COX causes irreversible binding, inhibits thrombaxane A2 synthesis, leading to decreased platelet aggregation Platelets, PT Inherited deficiency of FVII is characterized by a prolonged PT, normal PTT Factor VII, Hershel Greene 65 Y/O M C/C "Sudden Chest Pain" Presents with Sharp CP worse with inspiration, EKG Showed Sinus Tach No ST-segment elevation Myocardial infarction, Warfarin Warfarin inhibits synthesis of Vitamin K-dependent clotting factors Vit K, D-dimer test Increased dimer levels can be indicative of DIC, AKA low platelet count due to consumption Platelets, Dyspnea, Anxiety, Chest pain, Tachycardia, Hypotension, 91% POX Past MHx Knee replacement surgery eight days prior