University:
Western Sydney University
Course:
MEDI 2003 | Clinical Sciences 2
Academic year:

2024
Views:

282

Pages:

2
Author:

Mariam A. A.

Deep vein thrombosis Definition • • Formation of a blood clot in the deep veins, especially in lower limb veins Most at risk veins with the lower limb are: - Femoral - Profunda femoris vein - Popliteal Aetiology • • Transient Risk Factors - Surgery - C-section - Immobilisation - Obesity - Smoking - IV drugs - Intravascular devices, for example: implanted pacemaker Chronic risk factors - Age: over 60 - Past and family history - Active cancer - Autoimmune diseases Clinical Features • • • • • • • • May be asymptomatic Calf Pain Large lower limb veins are usually more affected Swelling: because veins can get damage from blood clot, which can cause blood to leak out Warmth Erythema Progressive tenderness, pain worsens when walking and relied by elevation Distension of superficial veins, because the obstruction of veins leads to increased superficial venous flow Diagnosis • Pertest probability of DVT Criteria Active cancer Previous history of DVT Paralysis or recent immobilisation of lower limb Major surgery under anaesthesia in the past 12 weeks Tenderness, localised along the deep venous system Score +1 +1 +1 +1 +1 Full leg swelling Calf swelling ≥ 3 cm compared to the contralateral leg Pitting edema confined to symptomatic leg Distended collateral superficial veins Alterative diagnosis as likely or more likely than DVT +1 +1 +1 +1 -1 Score interpretation: ✓ 0: low ✓ 1-2: intermediate ✓ More than 3: high D-dimer test - Measures D-dimer, which is the protein fragment that the body makes when clots dissolves - High D dimer test results means that a blood clot is present Venous Ultra sound - Identify vein that may potential be at risk - • • Treatment and Management • • • Drug therapies (primary treatment) - Warfarin - Heparin (LMWH) - Aspirin - Fondaparinux: inhibits factor Xa -> stop common pathway -> prevent clot formation Thrombectomy Inferior Vena Cava filter for patients how are at a high risk of pulmonary embolism Complications • • • Pulmonary Embolism Bleeding (from treatment) Postphlebitic syndrome: - Damaged veins -> blood clot -> obstruction -> reduced blood flow -> pain at affected areas