Venous Thromboembolism: Deep Venous Thrombosis and Pulmonary Embolism

Posted by e-Medical PPT Friday, July 23, 2010
Deep vein thrombosis commonly affects the femoral vein or the popliteal vein or the deep veins of the pelvis. Occasionally the veins of the arm are affected.In many cases the affected area will be painful, swollen, red, warm and the superficial veins may be engorged. The most serious complication of a DVT is that the clot could dislodge and travel to the lungs, which is called a pulmonary embolism (PE). DVT is a medical emergency, present in the lower extremity there is 3% chance of a PE killing the patient. A late complication of DVT is the post-phlebitic syndrome, which can manifest itself as edema, pain or discomfort and skin problems.
Venous thrombosis occurs via three mechanisms: decreased flow rate of the blood, damage to the blood vessel wall and hypercoagulability.The most commonly used tests for the diagnosis of DVT are a blood test called D-dimers and doppler ultrasound of the affected veins.
Pulmonary embolism (PE) is a blockage of the main artery of the lung or one of its branches by a embolised blood clot from elsewhere in the body.Usually this is due to embolism of a thrombus from the deep veins in the legs, a process termed venous thromboembolism.
Symptoms of pulmonary embolism include difficulty breathing, chest pain on inspiration, and palpitations. Clinical signs include low blood oxygen saturation and cyanosis, rapid breathing, and a rapid heart rate. Severe cases of PE can lead to collapse, abnormally low blood pressure, and sudden death.
Diagnosis is based on these clinical findings in combination with laboratory tests and imaging studies, usually CT pulmonary angiography. Treatment is typically with anticoagulant medication, including heparin and warfarin. Severe cases may require thrombolysis or may require surgical intervention via pulmonary thrombectomy.

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