DEEP VEIN THROMBOSIs (DVT) | Tutorial D-1 CVS

130110110177|Gabriella Chafrina| 25/10/13

Definition
Condition in which a blood clot (thrombus) forms in or more of the deep veins that returns the blood from heart. Most
commonly in veins of calves, femoral, popliteal, and iliac vessels

Epidemiology
- 80/100 000 cases/year
- Up to 2 million people in US suffer from DVT/year
- Out of 200 000 people with DVT, 50 000 will be complicated by pulmonary embolism

Etiology
- Prolonged inactivity/stasis of blood flow
- Post surgery (vascular damage)
- Long travel hour
- Hyperviscosity syndrome

Risk factor
- Antithrombin III deficiency
- Protein C/S deficiency
- Smoking
- Pregnancy and oral contraceptive use
- A pacemaker catheter that has been passed through the vein in the groin
- Bedrest
- Family history of blood clots
- Fracture is the pelvis;legs
- Giving birth within the last 6 months
- Obesity
- Recent surgery (most commonly hip, knee, or female pelvic surgery)
- Too many blood cells being made by the bone marrow, causing the blood to be thicker and slower than normal

Clinical Manifestation
- Asymptomatic
- Symptomatic
o Pain during dorsiflexion of foot (Homans sign)
o Tenderness, erythema, edema of lower limb
o Intermittent claudication
o Cyanosis/painful blue inflammation (phlegmasia cerulea dolens)

Diagnosis
- Serum D-Dimer test: (+) not specific
- Coagulation profile: evaluate hypercoagulable state, prolonged PT/APTT doesnt imply lower risk of DVT
- USG: venous compression duplex, 95% sensitivity for symptomatic DVT
- MRI

Differential Diagnosis
- Arthritis
- Hematoma
- Superficial thrombophlebitis
- Varicose vein

Complication
- Pulmonary embolism
- Venous insufficiency/post thrombotic syndrome
Prognosis
- Disappear without problem but can recurrence