Deep vein thrombosis history and symptoms

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Editor(s)-In-Chief: The APEX Trial Investigators, C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2] ; Kashish Goel, M.D.; Justine Cadet; Rim Halaby, M.D. [3]

Deep Vein Thrombosis Microchapters


Patient Information





Differentiating Deep vein thrombosis from other Diseases

Epidemiology and Demographics

Risk Factors



Natural History, Complications and Prognosis


Diagnostic Approach

Assessment of Clinical Probability and Risk Scores

Assessment of Probability of Subsequent VTE and Risk Scores

History and Symptoms

Physical Examination

Laboratory Findings





Other Imaging Findings


Treatment Approach

Medical Therapy

IVC Filter

Invasive Therapy



Cost-Effectiveness of Therapy

Future or Investigational Therapies

Special Scenario

Upper extremity DVT




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Case #1

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A proper history and physical exam is very important for establishing an accurate diagnosis of deep vein thrombosis (DVT). DVT can be either asymptomatic or associated with tenderness and swelling of the calf or thigh. One of the first steps in the management of DVT is the determination of the Wells score for DVT, whose criteria can be ascertained solely on the basis of history and physical exam. A high index of suspicion is also necessary to diagnose DVT. DVT can be complicated by pulmonary embolism (PE); therefore, it is important to inquire about the symptoms of PE among patients suspected to have DVT.

History and Symptoms

As depicted in the image below, the majority of patients with venous thromboembolism (VTE), that is DVT, PE, or both, are asymptomatic.

The challenge in diagnosis of VTE

Common Symptoms of DVT

The classical symptoms of DVT include:

However, sometimes there may be no symptoms referable to the location of the DVT.

Shown below is a picture depicting unilateral swelling and redness in a leg affected with DVT.

Unilateral swelling and redness in a leg affected with DVT By James Heilman, MD - Own work, CC BY-SA 3.0,

Less Common Symptoms of DVT

Symptoms of PE

Since VTE involves both DVT and PE, the patient can present with complaints of either of the diseases. Therefore it is important to inquire about the symptoms of both diseases. Symptoms of PE include:

Complete History

If VTE is suspected or diagnosed, a complete history should be elicited, including the following:


  1. 1.0 1.1 1.2 1.3 1.4 Cohen AT, Dobromirski M, Gurwith MM (2014). "Managing pulmonary embolism from presentation to extended treatment". Thromb Res. 133 (2): 139–48. doi:10.1016/j.thromres.2013.09.040. PMID 24182642.
  2. 2.0 2.1 2.2 2.3 2.4 Torbicki A, Perrier A, Konstantinides S, Agnelli G, Galiè N, Pruszczyk P; et al. (2008). "Guidelines on the diagnosis and management of acute pulmonary embolism: the Task Force for the Diagnosis and Management of Acute Pulmonary Embolism of the European Society of Cardiology (ESC)". Eur Heart J. 29 (18): 2276–315. doi:10.1093/eurheartj/ehn310. PMID 18757870.
  3. 3.0 3.1 Anderson FA, Spencer FA (2003). "Risk factors for venous thromboembolism". Circulation. 107 (23 Suppl 1): I9–16. doi:10.1161/01.CIR.0000078469.07362.E6. PMID 12814980.

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