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Cardiovascular > DVT > Flashcards

Flashcards in DVT Deck (11):
1

Sequelae of DVT?

-PE
-Chronic venous insufficiency

2

Aetiology of DVT?

Virchow's Triad: endothelial activation (i.e. injury), hypercoaguability, stasis.

3

How does stasis affected DVT risk?

Venous stasis due to immobilisation inhibits clearance and dilution of coagulation factors.

4

What are the acquired contributors to hypercoaguability?

-Age
-Surgery
-Trauma
-Neoplasms
-Blood dyscrasias, hyper viscosity
-Hormonal (pregnancy, OCP)
-Heart failure

5

CFx DVT?

-Unilateral leg oedema, erythema, warmth and tenderness
-Palpable cord (thrombosed vein)
-Phlegmasia -cerulea dolens/-alba dolens with massive thrombosis

6

DDx DVT?

-MSK: strain/tear
-Vascular: lymphangitis/obstruction; venous valvular insufficiency; arterial occlusive disease
-Ruptured popliteal cysts
-Cellulitis

7

What is the purpose of VTE treatment?

-Prevent clot extension
-Prevent PE
-Reduce risk of recurrence
-Treat acute lower limb ischaemia/ venous gangrene
-Limit late complications (e.g. chronic venous insufficiency, chronic thromboembolic pulmonary HTN).

8

Initial Rx VTE?

-LMWH (requires renal dosing)

9

Long term Rx VTE?

Warfarin (initiated with heparin overlap ==> dual for 5/52. Cease once INR >2.0 for 2/7).

10

Duration of anticoagulant treatment?

-1st DVT + transient RFx: 3 months
-1st DVT + ongoing RFx: consider indefinite therapy
-1st DVT + idiopathic: 6-12 months
-Recurrent DVT: indefinite

11

Alternative to anti-coagulation in DVT?

IVC filter: only if distal acute DVT (