Venous disease signs and symptoms

Risk factors for DVT

#1 Recent hip or knee surgery

Bed rest

Extrinsic compression (by right iliac artery)

Long distance travel

Smoking

Virchow Triad:

Trauma - endothelial damage, intrinsic (drugs) or extrinsic (falling down)

Stasis - bed rest, MI, CHF, hypotension, COPD, obesity, pregnancy, surgery

Hypercoagulability - Pregnancy, cancer treatment, estrogen intake, myeloproliferative disorders, polycythemia vera

Signs and symptoms of venous disease

Pain, HOMAN SIGN (pain experienced with quick dorsiflexion of the foot), swelling, redness/rubor, warmth, pitting edema, pallor, venous HTN, Cyanosis, hyperpigmentation, ulcers (wet oozing, NOT painful)

D-dimer levels

Measures the amount of cross-linked fibrin in the blood

Increased levels can indicate DVT

Also increases with pregnancy, malignancy, recent surgery, trauma

More accurate predictor of negative DVT diagnosis than for positive diagnosis due to numerous other conditions that elevate D-dimer

Normal D-dimer

<500ng/ml

Abnormal D-dimer

>500ng/ml

Virchow’s triad of symptoms includes blood stasis, recent trauma and:

Anemia

Hyperhydration

Polycythemia vera

Hyperpigmentation

Polycythemia vera

Venous disease causes pain that is relieved by ____________, while arterial disease causes pain that is relived by:

Elevating the legs; standing up

Venous disease typically causes swelling that begins at the _____________, while CHF typically causes swelling that beings at the ___________

Ankle; foot

Localized redness and warmth of the distal calf is most commonly associated with:

Cellulitis

Hyper pigmentation associated with venous disease typically affects the:

Distal calf

Insufficiency in the ______________ vein is the most common cause of a venous ulcer on the legs

Posterior arch vein

D-dimer levels are the most accurate for predicting:

The absence of DVT

Characteristics of a venous ulcer

Wet, oozing, discoloration

Hyperpigmentation

Brawny discoloration of the calf caused by chronic venous disease; cell waste and debris cannot efficiently exit the leg in the venous system, so it is pushed into the tissues outside the veins

Non-pitting edema

Lymphedema occurs due to the obstruction of the lymphatic system

Fluid accumulation leads to foot and leg edema that will resist depression and pulls the skin taught

Elevating the leg does NOT alleviate fluid retention