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Deep Vein Thrombosis (Risk Factors (Synthetic oestrogen, Trauma, Surgery…
Deep Vein Thrombosis
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Key Facts
Unlike arterial thrombosis occurs in normal vessels, often in the deep veins of the leg
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Below the calf there are 6 veins, from the popliteal fossa upwards they merge into 1
Can occur in any vein of the leg or pelvis, but is particularly found in the veins of the calf
Clinical Presentation
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With complete occlusion, particularly in a large vein can result in a cyanotic discolouration of the limb and severe oedema
Pain in the calf, often with swelling, redness and engorged superficial veins
Pulmonary embolism can occur with any DVT but is more frequent from an iliofemoral thrombosis and is rare with thrombosis confined to the veins below the knee
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Diagnosis
Compression ultrasound
Find the popliteal vein, if you can squash it shut = no DVT
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Plasma D-dimer
D-dimer are elevated in other conditions e.g. cancer, pregnancy and post-operatively and a positive result is NOT DIAGNOSTIC of DVT and requires further imaging
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Type of fibrinogen degradation product that is released into the circulation when a clot begins to dissolve
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Epidemiology
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Commonly occurs after periods of immobilisation but it can occur in normal individuals for no obvious reasons
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Causes
Genetic
Factor V Leiden (5%) - common in caucasians, increased risk of thrombus
PT20210A (3%) - common in caucasians, increased risk of thrombus
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Surgery, immobility, leg fracture, oral contraceptive pill, long haul flights, malignancy