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The diagnostic evaluation of thrombosis begins with history and physical examination to assess for occlusion of the tissue artery/vein in each organ and to assess for organ-specific symptoms. Clinical and para-clinical signs and laboratory findings may be used to confirm the diagnosis. Individual organ thrombosis is discussed below:
The diagnostic evaluation of thrombosis begins with history and physical examination to assess for occlusion of the tissue artery/vein in each organ and to assess for organ-specific symptoms. Clinical and para-clinical signs and laboratory findings may be used to confirm the diagnosis. Individual organ thrombosis is discussed below:


Unstable angina and MI: With thrombus formation and occlusion in the coronary arteries, cardiac pain new ECG findings (mainly ST segment changes and T wave inversions) occur. With cardiac tissue infarction (MI) specific cardiac enzymes (troponin, CK-MB) levels elevate in the plasma.
*'''Unstable angina and MI''':
**Clinical signs and symptoms: chest pain, shortness of breath, substernal discomfort
**Imaging and other diagnostics: new ECG findings (mainly ST segment changes and T wave inversions), elevation of cardiac tissue infarction (MI)-specific cardiac enzymes (troponin, CK-MB)


Cerebral stroke and TIA: Beside global or lateralized clinical signs and symptoms of CNS defect, CT scan, MRI and arteriography are used for the diagnosis.
*'''Cerebral stroke and TIA''':
**Clinical signs and symptoms: numbness, weakness, tingling, paresis, hemiplegia, slurred speech, imbalance
**Imaging and other diagnostics: occlusion or thrombosis noted on CT head or MRI


Peripheral arterial occlusions: Clinical signs such as pain, claudication, weakness, paleness and coldness. The diagnosis is confirmed by arteriography.
*'''Peripheral arterial occlusions''':
**Clinical signs and symptoms: weakness, paresthesia, numbness, claudication
**Imaging and other diagnostics: filling defect or perfusion defect on CT angiography


Atrial thrombosis: There should be an underlying reason; usually a structural heart defect or arrhythmia. The diagnosis is essentially confirmed by echocardiography.
*'''Atrial thrombosis''':
**Clinical signs and symptoms: chest pain, shortness of breath, dyspnea on exertion
**Imaging and other diagnostics: echocardiography


Ventricular thrombosis: The underlying cause is usually myocardial infarction, and some case reports have pointed to the role of hypereosinophilia. The diagnosis is essentially confirmed by echocardiography.
*'''Ventricular thrombosis''':
**Clinical signs and symptoms: chest pain, shortness of breath, dyspnea on exertion
**Imaging and other diagnostics: echocardiography


Visceral arteries thrombosis: This mainly consists renal, adrenal, mesenteric and splenic arteries. beside visceral pain and organ specific signs and symptoms, the diagnosis is confirmed by CT angiography, color -doppler sonography and/or MRI as proposed by majority of studies.
*'''Visceral arteries thrombosis''':
**Clinical signs and symptoms: visceral pain, abdominal pain
**Imaging and other diagnostics: CT angiography of the renal, adrenal, mesenteric or splenic arteries; Doppler ultrasound


===Underlying etiology===
===Underlying etiology===

Latest revision as of 20:45, 29 December 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Shyam Patel [2]

Diagnostic Evaluation

Thrombosis Formation and Induced Ischemia

The diagnostic evaluation of thrombosis begins with history and physical examination to assess for occlusion of the tissue artery/vein in each organ and to assess for organ-specific symptoms. Clinical and para-clinical signs and laboratory findings may be used to confirm the diagnosis. Individual organ thrombosis is discussed below:

  • Unstable angina and MI:
    • Clinical signs and symptoms: chest pain, shortness of breath, substernal discomfort
    • Imaging and other diagnostics: new ECG findings (mainly ST segment changes and T wave inversions), elevation of cardiac tissue infarction (MI)-specific cardiac enzymes (troponin, CK-MB)
  • Cerebral stroke and TIA:
    • Clinical signs and symptoms: numbness, weakness, tingling, paresis, hemiplegia, slurred speech, imbalance
    • Imaging and other diagnostics: occlusion or thrombosis noted on CT head or MRI
  • Peripheral arterial occlusions:
    • Clinical signs and symptoms: weakness, paresthesia, numbness, claudication
    • Imaging and other diagnostics: filling defect or perfusion defect on CT angiography
  • Atrial thrombosis:
    • Clinical signs and symptoms: chest pain, shortness of breath, dyspnea on exertion
    • Imaging and other diagnostics: echocardiography
  • Ventricular thrombosis:
    • Clinical signs and symptoms: chest pain, shortness of breath, dyspnea on exertion
    • Imaging and other diagnostics: echocardiography
  • Visceral arteries thrombosis:
    • Clinical signs and symptoms: visceral pain, abdominal pain
    • Imaging and other diagnostics: CT angiography of the renal, adrenal, mesenteric or splenic arteries; Doppler ultrasound

Underlying etiology

Laboratory Findings

cDNA-PCR Assays for Gene Mutations and Polymorphisms

Serologic (blood) Tests

Evaluation of Hypofibrinolysis

References

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