Racial/Ethnic Variables and Physiological Impact in Thrombotic Events
In the context of the presented case, the patient’s racial and ethnic background may play a role in influencing physiological functioning, particularly in the development of thrombotic events. Research indicates that certain racial and ethnic groups exhibit variations in the prevalence and manifestation of thrombotic disorders (Nicholson et al., 2020).
Studies have shown that individuals of African, Asian, and Hispanic descent may have a higher risk of venous thromboembolism (VTE) compared to Caucasians. Genetic factors, including polymorphisms associated with coagulation and fibrinolysis, may contribute to these differences (Nicholson et al., 2020). For instance, individuals of African descent may have a higher prevalence of certain genetic markers that increase the likelihood of thrombus formation.
Moreover, socioeconomic factors related to race and ethnicity, such as access to healthcare, quality of care, and lifestyle factors, can impact the management and prevention of thrombotic events. Health disparities and variations in healthcare utilization may contribute to delayed diagnosis and treatment, influencing the overall physiological response to the thrombotic process (Nicholson et al., 2020).
Healthcare providers must consider these racial and ethnic variables in assessing and managing patients with thrombotic risk factors, as personalized approaches may be necessary. Tailoring preventive measures, such as anticoagulant therapy or lifestyle modifications, based on an individual’s genetic and ethnic predispositions can enhance the effectiveness of interventions and improve overall outcomes (Nicholson et al., 2020).
Interplay of Pathophysiological Processes in the Presentation of the Patient
The case of the 38-year-old female with systemic lupus erythematosus, recent airplane travel, and oral contraceptive use involves a multifaceted interplay of pathophysiological processes that collectively contribute to her complex clinical presentation. Firstly, the patient’s systemic lupus erythematosus (SLE) creates a proinflammatory state and a hypercoagulable condition, increasing the risk of thrombotic events. SLE is associated with endothelial dysfunction and immune system dysregulation, fostering an environment conducive to the formation of blood clots (Chopard et al., 2020).
The recent airplane travel introduces an additional layer of risk, as prolonged periods of immobility during flights can lead to deep vein thrombosis. The venous stasis resulting from immobility can trigger clot formation in the deep veins of the left leg, which is evident in the patient’s symptoms of unilateral leg pain, redness, and +2 pitting oedema (Chopard et al., 2020). Moreover, oral contraceptive use further amplifies the thrombotic risk. Combined hormonal contraceptives have been linked to an increased likelihood of venous thromboembolism, particularly in individuals with underlying prothrombotic conditions. The estrogen component of oral contraceptives can exacerbate the hypercoagulable state associated with SLE, contributing to the development of thrombi (Chopard et al., 2020).
The culmination of these factors results in the patient’s dyspnea, indicative of a pulmonary embolism stemming from a clot originating in the left leg. The clot obstructs pulmonary vasculature, compromising blood flow to the lungs and triggering a cascade of physiological responses, including increased heart and respiratory rates, to compensate for decreased oxygenation (Chopard et al., 2020).
References
Fernandes, C. J., Luppino Assad, A. P., Alves-Jr, J. L., Jardim, C., & de Souza, R. (2019). Pulmonary embolism and gas exchange. Respiration, 98(3), 253-262. https://doi.org/10.1159/000501342
Nicholson, M., Chan, N., Bhagirath, V., & Ginsberg, J. (2020). Prevention of venous thromboembolism in 2020 and beyond. Journal of Clinical Medicine, 9(8), 2467. https://doi.org/10.3390/jcm9082467
R., Albertsen, I. E., & Piazza, G. (2020). Diagnosis and treatment of lower extremity venous thromboembolism: a review. Jama, 324(17), 1765-1776. 10.1001/