Deep Vein Thrombosis (DVT) Flashcards
What is DVT
Thrombus (clot) formed in the deep venous circulation
What are the 3 factors DVT may arise from
Hypercoagulable state
Endothelial injury
Circulators stasis
What are Hypercoagulable states
Malignancy
Pregnancy
Oestrogen therapy
IBD (inflammatory bowl disease)
Sepsis
Thrombophilia
What are the endothelial injuries
Venous disorder
Venous valvular damage
Trauma or surgery
Indwelling catheters
What are the Circulatory stasis
Left ventricular dysfunction
Immobility or paralysis
Venous insufficiency/varicose veins
Venous obstruction - tumour, obesity, pregnancy
Where do DVTs form
Venous valve pockets
Other sites of assumed stasis
What is Distal vein thrombosis
DVT of calves
What is proximal vein thrombosis
DVT of popliteal or femoral vein (more likely to embolism)
What are the symptoms for DVT
Calf - warmth, tenderness, swelling, erythema
Mild fever
What are signs of DVT
Pitting oedema
What are the investigations for DVT
D-dimer - rule out test (based on wells score)
US Doppler leg scan - diagnostic, indicates raised D-dimers or high levels of Wells score
What is first line testing for DVT
US doppler leg scan
What is the acute management of DVT
Anticoagulation - apixaban or rivaroxaban (first line)
What treatment is used if apixaban and rivaroxaban is not suitable
LMWH followed by dabigatran or
Edoxaban or LMWH followed by vitamin K antagonist
What is secondary treatment for DVT
options for long term anticoagulation are:
Warfarin
DOAC
LMWH