Deep Venous Thrombosis

The management of DVTs will make up a big part of your clinical practice as a junior doctor. This is a great lecture to get started with the basic principles.

 

Lecture by

Video Duration: 5 minutes

  • Deep Vein Thrombosis
    Created by Dr Ed Wallitt
    General
    Epidemiology

    Common in post surgical patients

    Pathology

    Thrombosis of the deep veins

    Most occur below the knee however some may embolise to the pulmonary arteries causing a PE

    Top three causes

    Virchow's triad

    • Stasis: post surgery, obesity
    • Endothelial injury: inflammation
    • Hypercoagulable state: thrombophilias, malignancy
    Clinical Features
    Symptoms

    A patient with a red, tender and swollen calf

    Signs

    Homan's signs: pain/resistance on dorsiflexion of the foot

    Investigations
    Cultures

    None

    Bloods

    D-dimer: high negative predictive value

    Imaging

    US: if negative but there is a high clinical probability repeat in 2/52

    Scopic/Biopsy

    None

    Functional

    None

    Treatment
    Conservative

    Mobilisation, TEDs

    Medical

    LMWH/warfarin

    Surgical

    None