Deep Vein Thrombosis

Question 1

What is DVT

Answer 1

Where a blood clot forms deep in a vein, usually in the legs or arms. 3rd most common death from cardiovascular disease, after heart and stroke.

Question 2

Epidemiology and risk factors of DVT

Answer 2

-immobility, long flights or prolonged bed rest
-recent Rutgers or trauma
-pregnancy
- obesity or sedentary lifestyle
-smoking and use of hormonal contraceptives
-history of blood clotting disorders or family history of DVT
-varicous veins
-increased blood viscosity e.g dehydration
-increased prevalence with age
-cancer

Question 3

Clinical presentation for DVT

Answer 3

-swelling in the affected limb
-pain and tenderness often in the calf
-warmth and redness in the area
-possible visible veins
-limb edema maybe uni or bilateral if thrombosis extended to pelvis area
-red hot skin
-white LEX SWELLING
-calf swelling x3cm bigger than asymptomatic side, taken 10cm below the tibial tuberosity
-major surgery within 4 weeks.

Question 4

Systemic effects of DVT

Answer 4

Pulmonary embolism, if the clot dislodges and travels to the lungs
Post-thrombotic syndrome, causes chronic pain and swelling, skin changes and a heavy affected limb
Risk of recurrent DVT or development of chronic venous insufficiency

Question 5

Pathology of DVT

Answer 5

Blood flow disruption leading to a clot formation, typically forming in deep veins of the legs but can present in the arms too. These clots may partially or completely restrict blood flow in the veins. If the clot was to break and travel it can cause other systemic effects, potentially life threatening

Question 6

Differential diagnosis of DVT

Answer 6

-cellulitis
- muscles strain or tear
-bakers cyst
-superficial thrombophlebitis
-peripheral artery disease
Bursitis

Question 7

Treatment of DVT

Answer 7

Anticoagulants- warfarin, blood thinners,
Compression to reduce swelling and increase blood flow
Catheter or thrombectomy
Early mobilisation
Vena cava filter- in cases where anticoagulants are contraindicated