DVT Flashcards
What is a DVT?
development of a blood clot within a vein deep in muscular tissue planes
What are RF for DVT?
- Active cancer
- Trauma
- Major surgery
- Hospitlisation
- Immobilisation
- Pregnancy
- COCP
What are symptoms of DVT?
- Calf swelling
- Localised pain along deep venous system
- Positive Wells Score
- Tenderness
- Erythema
- Painless
- Warmth
- Varicosities
What are some differential diagnosis of DVT?
- Cellulitis
- Calf muscle tear
- Calf muscle haematoma
- Large or ruptured popliteal cyst
- Pelvic/thigh mass/tumour compressing venous outflow from the leg
What investigations do you carry out for DVT?
- Venous doppler US imaging
- Quantitative D-dimer level
- FBC
- Urea and creatinine
- LFTs
- Clotting screen
- ECG CXR, ABG if PE suspected
What investigation confirms DVT?
venous US imaging
What anticoagulants are used for DVT?
- LMWH or fondaparinux
- Warfarin (if LMWH or DOACs contraindicated) with LMWH and then stop LMWH when INR 2
- DOACs (apixaban, rivaroxaban)
How long do you continue anticoagulants for?
Continue for 3 months and sometimes continue more if at risk
What are possible complications of DVT?
- Chronic pain
- Swelling
- Skin discoloration
- Venous ulcers
- PE
- HIT
- Bleeding during initial treatment
- Post-thrombotic syndrome
What are signs for DVT?
Homan’s signs
What is Homan’s sign?
forced passive dorsiflexion of ankle causes deep calf pain
What criteria and score is used for PE and DVT?
Wells criteria: DVT
Well’s score: PE
What is gold standard investigation for DVT?
doppler Venous US imaging
What does D-dimer level suggest?
as strong negative predictive value (so if neg strongly suggest no DVT)
What does impedence phlethysmogrpahy show?
changes in blood volume in vein due to thrombosis causes change in electrical resistance
