lecture2 part 2

Deep Vein Thrombosis (DVT) Overview

• A DVT occurs when a blood clot (thrombus) forms in a deep vein, primarily in the legs.

• The impact on the body systems depends on:

  • The location of the thrombus

  • The size of the thrombus relative to the vein's lumen

Locations of DVT

• Most common sites for DVTs:

  • Above the knee (majority)

  • Below the knee (fewer instances)

  • Upper limb (very rare)

Clinical Features of DVT

• Asymptomatic Presentation:

  • DVTs may not present noticeable symptoms, which can lead to serious complications.

• Symptomatic Presentation:

  • Swelling:

    • Occurs in the area of the thrombus and distally.

  • Tenderness:

    • Tenderness in the affected area upon touch.

  • Pain:

    • Ongoing pain that persists.

  • Superficial Vein Dilation:

    • Superficial veins may become dilated due to impaired drainage into deep veins.

  • Increased Temperature:

    • Increased blood flow leads to elevated temperature in the affected area.

  • Color Changes:

    • May present as increased redness or altered skin color, typically unilateral (one limb).

Diagnostic Tests for DVT

1. D Dimer Blood Test:

   • Detects fragments that may result from thrombus breakdown.

   • A positive result does not confirm a DVT; other conditions can also elevate D dimer levels.

   • Clinical reasoning from signs and symptoms aids in diagnosis.

2. Venous Ultrasound:

   • Imaging test used to visualize veins and assess for thrombus presence.

   • Thrombus appears as a white area within the vein image.

Management and Treatment of DVT

• Pharmacological Options:

  • Thrombus Growth Inhibitors: Medications to slow the growth of the thrombus.

  • Thrombolytics: Drugs that dissolve existing thrombi.

• Surgical Options:

  • Surgical removal of the thrombus may be necessary in severe cases.

Possible Complications of DVT

• Resolution:

  • Some cases can resolve without further problems.

• Permanent Damage:

  • Damage to vein valves may occur, leading to chronic complications:

    • Chronic Limb Swelling: Due to impaired venous return.

    • Pain and Inflammation: Resulting from chronic venous insufficiency.

    • Chronic Ulcers: Can develop from sustained pressure in swollen limbs.

• Embolism Risk:

  • The thrombus or parts of it can break off and travel as an embolus, potentially blocking smaller vessels, leading to emergency situations.

  • Terminology:

    • Embolus (single) vs. Emboli (multiple).