Deep Vein Thrombosis Flashcards
What is venous thromboembolism (VTE)?
A common and potentially fatal condition involving a blood clot developing in the circulation.
It usually occurs secondary to blood stagnation or hypercoagulable states.
What is deep vein thrombosis (DVT)?
A thrombus that develops in a deep vein.
DVT is a component of venous thromboembolism.
What is a pulmonary embolism (PE)?
A condition where a thrombus travels to the lungs and becomes lodged in the pulmonary arteries, blocking blood flow.
This can occur when a thrombus from the deep veins embolizes.
What can happen if a thrombus passes through a septal defect in the heart?
It can travel to the left side of the heart and into the systemic circulation, potentially causing a large stroke.
List three risk factors for venous thromboembolism (VTE).
- Immobility
- Recent surgery
- Long haul travel
What are thrombophilias?
Conditions that predispose patients to develop blood clots.
Examples include antiphospholipid syndrome and Factor V Leiden.
What is the main contraindication for anti-embolic compression stockings?
Peripheral arterial disease.
What are common presentations of DVT?
- Calf or leg swelling
- Dilated superficial veins
- Tenderness to the calf
- Oedema
- Colour changes to the leg
What is the Wells score used for?
To predict the risk of a patient presenting with symptoms having a DVT or PE.
How is D-dimer used in the diagnosis of VTE?
It is a sensitive test to help exclude VTE when suspicion is low and is almost always raised if there is a DVT or PE.
What is the first-line imaging investigation for pulmonary embolism?
CT pulmonary angiogram (CTPA).
What are the initial anticoagulant options for suspected DVT or PE?
- Apixaban
- Rivaroxaban
- Low molecular weight heparin (LMWH)
What is the target INR for warfarin when treating DVTs and PEs?
Between 2 and 3.
What is an inferior vena cava filter?
A device designed to filter blood and catch blood clots traveling from the venous system towards the heart and lungs.
What is Budd-Chiari syndrome?
Obstruction to the outflow of blood from the liver caused by thrombosis in the hepatic veins or inferior vena cava.
What classic triad presents in Budd-Chiari syndrome?
- Abdominal pain
- Hepatomegaly
- Ascites
What is the usual imaging investigation for establishing Budd-Chiari syndrome?
Doppler ultrasonography.
Fill in the blank: The cause of recurrent venous thromboembolism to remember is _______.
antiphospholipid syndrome.
What should be considered when investigating unprovoked DVT?
Reviewing medical history, baseline blood results, and physical examination for evidence of cancer.
What is the recommended duration of anticoagulation for unprovoked VTE?
Long-term for unprovoked VTE, recurrent VTE, or an irreversible underlying cause.
What are the treatment options for Budd-Chiari syndrome?
- Anticoagulation
- Endovascular procedures
- Transjugular intrahepatic portosystemic shunt (TIPS)
- Liver transplant
DVT
