Deep Vein Thrombosis Flashcards
What is a DVT?
Formation of thrombus (blood clot) within the deep veins- usually in calf or thigh
How does blood flow in veins, normally?
Superficial veins drain into deep veins with the help of muscle compression and one way valves.
What are the three components of virchow’s triad?
- slowed blood (stasis) 2. Hyper-coagulation 3. Damage to blood vessel walls
Name some risk factors for DVT
• Obesity • Immobility • Pregnancy • Post-surgery • Dehydration • Smoking • Polycythaemia • Thrombophilia (protein C deficiency) • Malignancy
What are some symptoms of DVT?
Swollen calf, can elicit some pain.
What must you do alongside a DVT assessment?
A pulmonary embolism assessment (check for SOB and chest pain)
What will you see on examination?
Unilateral calf swelling, redness (erythema), warmth. There might be colour changes and variscocites
What is Homan’s sign?
forced passive dorsiflexion of the foot would bring about deep calf pain if person has DVT
What is the Well’s Score?
Assessment of DVT risk- higher the score, the higher the chance of getting DVT
What would you test in a PE examination?
Respiratory rate, pulse oximeter and pulse rate
What investigations would you do to confirm DVT?
- Do ultrasound to detect poor flow [GOLDSTANDARD]
- Venography and x-ray to identify blockage
- Impedance Plethysmography (changes in blood volume due to electrical resistance
- Bloods- Measure D-Dimer levels and do a thrombophilia screen if indicated
Mention some examinations for PE
ECG, CXR, ABG
How do you treat DVT?
- Anticoagulants – warfarin, heparin
- Filter in vena cava to prevent PEs
- Also wear compression socks and do calf exercises to prevent stasis
^ in that order- heparin/ warfarin is first line
What is a contraindication of heparin/ warfin administration?
Brain injury (e.g. subdural haematoma)
Name some complications of DVT
PE, venous infarction, thrombophlebitis (inflammation of vein wall)
