DVT Flashcards
what is DVT
presence of coagulated blood, a thrombus in one of the deep venous conduits that return blood to the heart
primary mechanism for the development of DVT
Virchow’s triad
venous stasis
vessel wall injury
hypercoagulable state
what does DVT lead to
pulmonary embolism
what disease entity does DVT and PE manifest from
venous thromboembolism
what does DVT dx depend on
high clinical suspicion and the presence of risk factors
DVT risk factors in order
Age >40
immobilization longer than 3 days
pregnancy or post partum period
major surgery in previous 4 weeks
long plane or car ride (>4h) in previous 4 weeks
cancer
previous DVT/PE
CHF
sepsis-acute infection
trauma- blow to the leg
lower extremity fx
IV drug abuse
oral contraceptives
estrogens
signs/symptoms
- erythematous
- edematous
- painful
- palpable cord
- variable discoloration of lower extremities
- Homan’s sign
dx r/o blood test
d-dimer
a noninvasive procedure to see if the vein has a clot and if it is compressible
duplex ultrasonography–gold standard
validated clinical prediction rules used to estimate the pretest probability of venous thromboembolism
Wells probability score
an invasive procedure where a contrast medium is injected
venography–definitive, but not often used
treatment options
anticoagulation
physical measure
fibrinolytics
endovascular
anticoagulation therapy
heparin– LMW and unfractionated
Warfarin (Coumadin)
Factor Xa inhibitors
heparin used until Coumadin is at full range
INR target of 2.5 for Coumadin
duration of anticoagulation treatment
first episode- 3-6 months
recurrent- a year
physical measure for treatment
elastic compression stockings and early ambulation
