Deep vein thrombosis natural history, complications and prognosis
Editors-in-Chief: C. Michael Gibson, M.S., M.D. Associate Editor-In-Chief: Ujjwal Rastogi, MBBS [1]
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Overview
Natural History
- Untreated proximal DVT
- Clinical PE occur in 1/3rd to 1/2 patients.
- Subclinical PE occurs in another 1/3rd.
- Untreated PE tends to recur in days to weeks.
- Post-phlebitic syndrome(10-30% of DVT)
- pain, edema, skin discoloration, and ulceration associated with chronic venous insufficiency.
Death occurs in about 6 percent of DVT cases within one month of diagnosis. [1]
According to a study done on 826 patients in Medical University of Vienna the risk of recurrence was almost four times as great among men as among women.[2]
Complications
Proximal vein thrombosis is responsible for more than ninety percent of acute pulmonary embolism which has high mortality if not treated promptly. [3]
The major outcomes of venous thrombosis are
- Recurrence,
- Post-thrombotic syndrome,
- Major bleeding due to anticoagulation,
- Death.
Thrombosis is also associated with impaired quality of life, particularly when post-thrombotic syndrome develops[4]. Death occurs within one month of an episode in about 6% of those with DVT and 10% of those with PE
Ongoing Health Care Needs
Medicines that thin your blood and prevent blood clots are used to treat DVT. These medicines can thin your blood too much and cause bleeding (sometimes inside the body). This side effect can be life threatening.
Bleeding may occur in the digestive system or the brain. Signs and symptoms of bleeding in the digestive system include:
- Bright red vomit or vomit that looks like coffee grounds
- Bright red blood in your stools or black, tarry stools
- Pain in your abdomen
Signs and symptoms of bleeding in the brain include:
- Severe pain in your head
- Sudden changes in your vision
- Sudden loss of movement in your arms or legs
- Memory loss or confusion
If you have any of these signs or symptoms, get treatment right away.
References
- ↑ White RH (2003). "The epidemiology of venous thromboembolism". Circulation. 107 (23 Suppl 1): I4–8. doi:10.1161/01.CIR.0000078468.11849.66. PMID 12814979.
- ↑ Kyrle PA, Minar E, Bialonczyk C, Hirschl M, Weltermann A, Eichinger S (2004). "The risk of recurrent venous thromboembolism in men and women". N Engl J Med. 350 (25): 2558–63. doi:10.1056/NEJMoa032959. PMID 15201412. Review in: ACP J Club. 2004 Nov-Dec;141(3):78
- ↑ Galanaud JP, Sevestre-Pietri MA, Bosson JL, Laroche JP, Righini M, Brisot D, Boge G, van Kien AK, Gattolliat O, Bettarel-Binon C, Gris JC, Genty C, Quere I (2009). "Comparative study on risk factors and early outcome of symptomatic distal versus proximal deep vein thrombosis: results from the OPTIMEV study". Thromb. Haemost. 102 (3): 493–500. doi:10.1160/TH09-01-0053. PMID 19718469. Retrieved 2011-12-14. Unknown parameter
|month=ignored (help) - ↑ Kahn SR, Ducruet T, Lamping DL, Arsenault L, Miron MJ, Roussin A; et al. (2005). "Prospective evaluation of health-related quality of life in patients with deep venous thrombosis". Arch Intern Med. 165 (10): 1173–8. doi:10.1001/archinte.165.10.1173. PMID 15911732.