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A patient with calf pain
Published in Tim French, Terry Wardle, The Problem-Based Learning Workbook, 2022
It is important to remember that clinical examination is not a reliable way to diagnose DVT. The differential diagnoses are extensive, and difficulties arise because DVT can complicate many of these conditions. Further investigation is needed; however key features in the physical examination that suggest DVT include: calf warmth and erythemalocalised tenderness over the deep veins (anterior and posterior tibial, popliteal or femoral)calf swelling (usually measured 10 cm below the tibial tuberosity; >3 cm difference is significant)pitting oedema confined to the affected legsuperficial, dilated, collateral veins; but not varicose veins.
Venous Thromboembolism in Pregnancy
Published in Sanjeewa Padumadasa, Malik Goonewardene, Obstetric Emergencies, 2021
Sanjeewa Padumadasa, Aflah Sadikeen
The typical features of DVT are pain, redness, warmth and swelling of one leg, although these may not be present in all cases. Calf swelling should be measured 10 cm below the tibial tuberosity and is considered significant if it is more than 3 cm when compared with the other calf. There may also be lower abdominal pain which may indicate extension of the thrombus into pelvic vessels.
Vascular Surgery
Published in Kristen Davies, Shadaba Ahmed, Core Conditions for Medical and Surgical Finals, 2020
Deep vein thrombosis (DVT) is a formation of a thrombus in a deep vein, usually in the legs, which either partially or completely obstructs blood flow. The most serious complication of a DVT is a pulmonary embolism.
Patient-specific hemodynamic analysis of IVCS-induced DVT
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2022
Xudong Jiang, Xueping Gu, Tianze Xu, Xiaoqiang Li, Peng Wu, Lili Sun
Deep venous thrombosis (DVT) is the abnormal coagulation of blood in the veins of the lower extremities caused by various reasons, which can block the corresponding blood vessels and cause the obstruction of venous return. If the treatment is not timely, severe venous diseases of the lower extremities may occur, such as varicose veins, pigmentation, chronic and unhealed ulcers, etc. Pulmonary embolism (PE) caused by thrombosis is a serious complication of DVT, which may endanger the life of patients at any time (Beckman et al. 2010; Prandoni 2012). Iliac vein compression syndrome (IVCS) is a disorder of lower extremity and pelvic venous reflux caused by iliac vein compression or abnormal intracavitary adhesion structures, and it usually occurs in the left iliac vein (Cockett and Thomas 1965). IVCS is considered to be the most common secondary risk factor for DVT, the anatomical basis for the occurrence of DVT (Kim et al. 2004), and an important factor for thrombosis recurrence (Meng et al. 2013; Vedanthaqm et al. 2014). Therefore, timely intervention of IVCS to prevent the occurrence of DVT will greatly improve the quality of life.
The effectiveness of exercise training in treating venous thromboembolism: a systematic review
Published in The Physician and Sportsmedicine, 2021
Lin Xu, Chenying Fu, Qing Zhang, Chengqi He, Quan Wei
The best treatment option for VTE has been widely studied among researchers, and pharmacological treatment and surgical methods are commonly recommended for such patients according to disease severity [7]. Compression therapy and exercise training are common nonpharmacological and noninvasive treatment methods. Compression therapy is commonly used for all DVT patients because it reduces tissue swelling and enhances calf muscle contractility [8]. However, exercise training is rarely used clinically because it conflicts with more intense aftercare in patients with VTE. Some studies have explored the role of exercise training in survivors with VTE. Evidence-based clinical practice guidelines from the American College of Chest Physicians suggest early ambulation over initial bed rest for patients with acute DVT of the leg [9]. In addition, a few guidelines and consensus documents have suggested that exercise rehabilitation is necessary and safe for acute DVT patients with or without PE after therapeutic anticoagulation is achieved or if compression therapy is received at the same time [7,8,10]. However, these guidelines are vague about the introduction of exercise prescriptions and lack detailed information; thus, exercise training implementation clinically remains low, and no published, high-level evidence to date supports its application in VTE survivors.
Prevention, treatment, and risk factors of deep vein thrombosis in critically ill patients in Zhejiang province, China: a multicenter, prospective, observational study
Published in Annals of Medicine, 2021
Li Li, Jia Zhou, Liquan Huang, Junhai Zhen, Lina Yao, Lingen Xu, Weimin Zhang, Gensheng Zhang, Qijiang Chen, Bihuan Cheng, Shijin Gong, Guolong Cai, Ronglin Jiang, Jing Yan
DVT can lead to pulmonary embolism, and ICU patients are at high risk of DVT. The DVT prevention rate is one of the indicators of ICU care quality. However, currently, no specific assessment tool is available for evaluating the risk of DVT in general ICU patients. Moreover, domestic prevention of DVT lacks attention. Therefore, the lack of evaluation of DVT risk results in a low prevention rate. Furthermore, the epidemiology and the prevention and treatment patterns of DVT are poorly known in China. Therefore, this study aimed to investigate the prevention and treatment patterns of DVT in ICU patients in multiple hospitals of Zhejiang Province, China and to explore the risk factors for DVT in the Chinese population. The results revealed that the prevalence of DVT in ICU patients was 6.2%. The 28- and 60-day survival rates, ICU stay, total hospital stay, pulmonary embolism, and coagulopathy were similar between the two groups, but haemorrhage events were higher in the DVT group. The d-dimer levels, basic prophylaxis, and physical prophylaxis were independently associated with DVT in ICU patients.