Deep vein thrombosis history and symptoms
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Deep Vein Thrombosis Microchapters
Deep vein thrombosis history and symptoms On the Web
A proper history and physical exam is very important for establishing an accurate diagnosis of deep vein thrombosis (DVT). DVT can be either asymptomatic or associated with tenderness and swelling of the calf or thigh. One of the first steps in the management of DVT is the determination of the Wells score for DVT, whose criteria can be ascertained solely on the basis of history and physical exam. A high index of suspicion is also necessary to diagnose DVT. DVT can be complicated by pulmonary embolism (PE); therefore, it is important to inquire about the symptoms of PE among patients suspected to have DVT.
History and Symptoms
Common Symptoms of DVT
The classical symptoms of DVT include:
- Pain in the affected area
- Swelling of the affected area
- Erythema around the affected area
- Dilation of the surface veins and erythema of the overlying area
However, sometimes there may be no symptoms referable to the location of the DVT.
Shown below is a picture depicting unilateral swelling and redness in a leg affected with DVT.
Less Common Symptoms of DVT
- In phlegmasia cerulea dolens, there is an acute and near-total venous occlusion of the entire extremity outflow, including the iliac and femoral veins. The leg is usually painful, cyanosed and edematous.
Symptoms of PE
Since VTE involves both DVT and PE, the patient can present with complaints of either of the diseases. Therefore it is important to inquire about the symptoms of both diseases. Symptoms of PE include:
- Dyspnea (78–81%)
- Pleuritic chest pain (39–56%)
- Fainting (22–26%)
- Cough (20%)
- Substernal chest pain (12%)
- Hemoptysis (11%)
- Cyanosis (11%)
- Fever (7%)
- Symptoms suggestive of shock (in case of massive PE)
If VTE is suspected or diagnosed, a complete history should be elicited, including the following:
- Risk factors
- Previous episode of VTE
- Past medical history of diseases associated with hyperviscosity
- History of thrombophilia
- Drugs that may increase the risk of VTE
- Family history (suggestive of inherited thrombophilia)
- Deep vein thrombosis
- Pulmonary embolism
- Recurrent miscarriage
- Social history
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