Understanding Deep Vein Thrombosis (DVT)
Zero To Finals・9 minutes read
VTE involves blood clot development in circulation, with risk factors including immobility, recent surgery, and thrombophilias. Diagnosis and management of DVT or PE involve assessing risk, D-dimer blood tests, and anticoagulation therapy options.
Insights
- Venous thromboembolism (VTE) can result from blood clot formation due to various factors, such as immobility, surgery, pregnancy, or underlying conditions like thrombophilia, emphasizing the importance of recognizing these risk factors to prevent DVT or PE.
- The management of DVT or PE includes initial anticoagulation therapy with medications like apixaban or rivaroxaban, alongside interventions like catheter-directed thrombolysis for specific cases, highlighting the need for a tailored approach combining medication and procedures to address different presentations of VTE.
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Recent questions
What is venous thromboembolism (VTE)?
VTE involves blood clot development in circulation due to stagnation and hypercoagulable states, leading to deep vein thrombosis (DVT) or pulmonary embolism (PE).
What are the risk factors for DVT or PE?
Risk factors include immobility, recent surgery, long-haul travel, pregnancy, hormone therapy, malignancy, polycythemia, lupus, and thrombophilia.
How is VTE prophylaxis approached?
Prophylaxis involves assessing hospitalized patients for risk, with low molecular weight heparin usually used unless contraindicated.
What are the symptoms of DVT?
Symptoms include unilateral calf swelling, superficial veins, calf tenderness, edema, color changes, and a significant difference in calf circumference indicating swelling.
How is DVT or PE diagnosed and managed?
Diagnosis involves a D-dimer blood test for DVT, Doppler ultrasound scan, CT pulmonary angiogram, or VQ scan for PE. Management includes anticoagulation with medications like apixaban or rivaroxaban, catheter-directed thrombolysis for iliofemoral DVT, and long-term anticoagulation options like DOACs, warfarin, or LMWH.
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Summary
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Venous Thromboembolism: Risk Factors, Diagnosis, Treatment
- Venous thromboembolism (VTE) involves blood clot development in circulation due to stagnation and hypercoagulable states, leading to deep vein thrombosis (DVT) or pulmonary embolism (PE).
- Risk factors for DVT or PE include immobility, recent surgery, long-haul travel, pregnancy, hormone therapy, malignancy, polycythemia, lupus, and thrombophilia.
- Thrombophilias predispose patients to blood clots, with anti-phospholipid syndrome being a significant cause, often associated with recurrent miscarriage.
- VTE prophylaxis involves assessing all hospitalized patients for risk, with prophylaxis usually being low molecular weight heparin unless contraindicated.
- DVT presentation includes unilateral calf swelling, superficial veins, calf tenderness, edema, and color changes, with a significant difference in calf circumference indicating swelling.
- The Wells score predicts DVT or PE risk based on factors like recent surgery and clinical findings, aiding in diagnosis.
- Diagnosis involves a D-dimer blood test for DVT, with a Doppler ultrasound scan required, and a CT pulmonary angiogram or VQ scan for PE diagnosis.
- Initial management of DVT or PE involves anticoagulation with apixaban or rivaroxaban, considering catheter-directed thrombolysis for iliofemoral DVT, and long-term anticoagulation options like DOACs, warfarin, or LMWH.
