Deep vein thrombosis history and symptoms: Difference between revisions
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{{Deep vein thrombosis}} | {{Deep vein thrombosis}} | ||
==Overview== | ==Overview== | ||
In 25% of all hospitalized patients, there may be '''some''' form of DVT, which often remains clinically '''in-apparent''' (unless | In 25% of all hospitalized patients, there may be '''some''' form of DVT, which often remains clinically '''in-apparent''' (unless pulmonary embolism develops). It is vital that the possibility of pulmonary embolism be included in the history, as this may warrant further investigation (''see'' [[pulmonary embolism]]). There are several techniques during physical examination to increase the detection of DVT. | ||
==History== | ==History== | ||
Revision as of 00:42, 6 September 2011
Editors-in-Chief: C. Michael Gibson, M.S., M.D. Associate Editor-In-Chief: Ujjwal Rastogi, MBBS [1]
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Overview
In 25% of all hospitalized patients, there may be some form of DVT, which often remains clinically in-apparent (unless pulmonary embolism develops). It is vital that the possibility of pulmonary embolism be included in the history, as this may warrant further investigation (see pulmonary embolism). There are several techniques during physical examination to increase the detection of DVT.
History
In patients having known risk factors, a careful history should be taken. It must include the following:
- Use of hormonal contraception, containing estrogen
- recent long-haul flying,
- History of miscarriage (which can be a feature of thrombosis and several other disorders).
A family history can reveal a hereditary factor in the development of DVT.
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Deep venous thrombosis
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Deep venous thrombosis:Rear View:Note the edematous Left limb
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Deep venous thrombosis:Front View:Note the edematous Left limb
Symptoms
The classical symptoms of DVT include:
- Pain in the affected area.
- Swelling of the affected area.
- Dilation of the surface veins and redness of the overlying area.
There may be no symptoms referable to the location of the DVT. .
There are several techniques during physical examination to increase the detection of DVT, such as measuring the circumference of the affected and the contra-lateral limb at a fixed point (to objective edema), and palpating the venous tract, which is often tender. Physical examination is unreliable for excluding the diagnosis of deep vein thrombosis.
In phlegmasia alba dolens, the leg is pale and cold with a diminished arterial pulse. It usually results from acute occlusion of the iliac and femoral veins due to DVT.
In phlegmasia cerulea dolens, there is an acute and near-total venous occlusion of the entire extremity outflow, including the iliac and femoral veins. The leg is usually painful, cyanosed and oedematous. Venous gangrene may supervene.