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References
- Centers for Disease Control and Prevention, (2015). Venous Thromboembolism (Blood Clots) - Data & Statistics. Retrieved from the website http://www.cdc.gov/ncbddd/dvt/data.html
- Centers for Disease Control and Prevention, (2016). Venous Thromboembolism (Blood Clots) - Facts. Retrieved from the website http://www.cdc.gov/ncbddd/dvt/facts.html
- D-dimer, (2015). Lab Tests Online. American Association for Clinical Chemistry. Retrieved from the website https://labtestsonline.org/understanding/analytes/d-dimer/tab/test/
- Huether, S.E. & McCance, K. L. (2012). Understanding pathophysiology (Laureate custom ed.). St. Louis, MO: Mosby.
- McPhee, S. J., & Hammer, G. D. (2010). Pathophysiology of disease: An introduction to clinical medicine (Laureate Education, Inc., custom ed.). New York, NY: McGraw-Hill Medical.
- Zimbron, J. (2008). Mind maps—Dementia, endocarditis, and gastro-oesophageal reflux disease (GERD) [PDF]. Retrieved from http://MedMaps.co.uk
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Epidemiology
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Triad of Virchow
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Venous Stasis
- Immobility
- Age
- Congestive Heart Failure
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Venous Endothelial
- Trauma
- Intravenous medications
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Hypercolial Damage
- Inherited disorders
- Malignancy
- Pregnancy
- Oral contraceptives
- Hormone Replacement Therapy
- Orthopedic Trauma/ Surgery
- Spinal Cord Injury
- Obstetric/ Gynecologic Surgery or Diseases
- Genetic/ Inherited Abnormalities
- Associated with up to 100% rate of DVT
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Pathophysiology
- The clotting factor and platelets accumulation leads to thrombus typically near a valve.
- Inflammation near the clot leads to further accumulation and irritation growing the area of the thrombus.
- Most clots resolve without treatments.
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Clinical Presentation
- !!!!!Most DVTs are asymptomatic!!!!
- Associated pain in area of DVT
- Inflammation
- Redness or streaking in area affected ---> Typically lower extremities
- Post-thrombosis systems ---> Ulcers, Pain, Edema in affected area
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Diagnosis
- Elevated serum D-dimer
- Doppler Ultrasonography
- Often diagnosis is confirmed from occurrence
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Treatment
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Precautions/ Prevention for at-risk individuals
- Early ambulation after surgery
- Compression Therapy -Compression socks/ TED hoses
- Pneumatic Devices
- Prophylactic Anticoagulation i.e. Lovenox shots
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Anticoagulation Therapy
- Low-molecular-weight Heparin
- Warfarin
- Lovenox shots
- Inferior Vena Cava Filter ---> This may be indicated for some individual to help prevent pulmonary embolism.