Deep vein thrombosis history and symptoms

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Editors-in-Chief: C. Michael Gibson, M.S., M.D. Associate Editor-In-Chief: Ujjwal Rastogi, MBBS [1]

Deep Vein Thrombosis Microchapters

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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). There are several techniques during physical examination to increase the detection of DVT.

History and 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 cool with a diminished arterial pulse due to spasm. It usually results from acute occlusion of the iliac and femoral veins due to DVT.

In phlegmasia cerulea dolens, there is an acute and nearly 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.

It is vital that the possibility of pulmonary embolism be included in the history, as this may warrant further investigation (see pulmonary embolism).

A careful history should be taken, in patients having known risk factors, including

A family history can reveal a hereditary factor in the development of DVT.

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