Deep vein thrombosis resident survival guide: Difference between revisions
Jump to navigation
Jump to search
| Line 23: | Line 23: | ||
==Diagnostic approach== | ==Diagnostic approach== | ||
{{familytree/start}} | {{familytree/start}} | ||
{{familytree | | | | | | | | | | | A01 | | | | |A01='''Pretest Probability of DVT'''<br>'''Major points'''<br>1-Active cancer<br> 2-Paralysis,paresis or plastic immobilization of leg or foot <br>3-Recent bed rest >3 days or major surgery in the last 4 weeks or both<br> 4-Calf or thigh swelling 5->3 cm calf swelling below the tibial tuberosity<br> 5-Strong F/H of DVT<br>'''Minor points'''<br>1-H/O recent trauma to the suspected leg<br>2-Pitting edema in the suspected leg<br>3-Dilated superficial veins in the suspected leg<br>4-Hospitalization in the last 6 months<br>5-Erythema }} | {{familytree | | | | | | | | | | | A01 | | | | |A01='''Pretest Probability of DVT'''<br>'''Major points'''<br>1-Active cancer<br> 2-Paralysis,paresis or plastic<br> immobilization of leg or foot <br>3-Recent bed rest >3 days <br>or major surgery in the last 4 weeks or both<br> 4-Calf or thigh swelling 5->3 cm calf swelling<br>below the tibial tuberosity<br> 5-Strong F/H of DVT<br>'''Minor points'''<br>1-H/O recent trauma to the suspected leg<br>2-Pitting edema in the suspected leg<br>3-Dilated superficial veins in the suspected leg<br>4-Hospitalization in the last 6 months<br>5-Erythema }} | ||
{{familytree | | | |,|-|-|-|-|-|-|-|+|-|-|-|-|-|-|-|-|-|-|-|-|-|.| }} | {{familytree | | | |,|-|-|-|-|-|-|-|+|-|-|-|-|-|-|-|-|-|-|-|-|-|.| }} | ||
{{familytree | | | C01 | | | | | | C02 | | | | | | | | | | | C03 |C01=low*|C02=Moderate*|C03=High*}} | {{familytree | | | C01 | | | | | | C02 | | | | | | | | | | | C03 |C01=low*|C02=Moderate*|C03=High*}} | ||
Revision as of 14:53, 27 November 2013
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Definition
Deep vein thrombosis (also known as deep venous thrombosis or DVT and colloquially referred to as economy class syndrome) is the formation of a blood clot ("thrombus") in a deep vein. The risk is significantly increased if the thrombus embolizes to the lungs, causing pulmonary embolism.
Causes
Life Threatening Causes
Common Causes
- Long term immobility
- Clotting disorders
- Cardiac failure
- Hip replacement
- Estrogen in OCP and HRT
- Nephrotic syndrome
- Obesity
- Pregnancy
Diagnostic approach
| Pretest Probability of DVT Major points 1-Active cancer 2-Paralysis,paresis or plastic immobilization of leg or foot 3-Recent bed rest >3 days or major surgery in the last 4 weeks or both 4-Calf or thigh swelling 5->3 cm calf swelling below the tibial tuberosity 5-Strong F/H of DVT Minor points 1-H/O recent trauma to the suspected leg 2-Pitting edema in the suspected leg 3-Dilated superficial veins in the suspected leg 4-Hospitalization in the last 6 months 5-Erythema | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| low* | Moderate* | High* | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| D-Dimer | D-Dimer | U/S | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Negative | Positive | Negative | Positive | Negative | Positive | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| No DVT | U/S | No DVT | U/S | Repeat in 7 days | D-Dimer | Treat | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Negative | Positive | Negative | Positive | Negative | Positive | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| No DVT | Treat | Repeat in 7 days | Treat | No DVT | Repeat in 7 days | U/S | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||