Condition Info - BotMed Application

ConditionName

Deep Vain Thrombosis (DVT)

ConditionDescription

Symptoms

Sudden SOB with clear lungs on exam and normal chest xRay;
Cough;
Hemoptysis; 
If DVT is present – leg pain;
Pleuritic chest pain from lung infarction;
Feeling that something terrible happen to them - anxiety; 
Fever;
Big clot - hypotension;
Altered mental status;

PhysicalFindings

Tachypnea;
Tachycardia;
(+) Homans sign - short duration calf pain;

ClinicalTests

Best initial tests: Chest x-Ray, ECG, ABG;

D-dimer can help to r/o DVT and PE;
Duplex ultrasonography (US);

x-Ray may show atelectasis, pleural infusion or “Hampton’s hump”;

ECG: sinus tachycardia;
Most common abnormality: ST-T wave changes;

5% will show right axis deviation, RV hypertrophy or RBBB;

ABG: hypoxia and resp. alkalosis;

Most accurate test: angiography (0.5% mortality) almost never used;

Wells risk score :
Clinical signs and symptoms of DVT;
PE is #1 diagnosis OR equally likely;
Heart rate > 100;
Immobilization at least 3 days OR surgery in the previous 4 weeks;
Previous, objectively diagnosed PE or DVT;
Hemoptysis;
Malignancy w/ treatment within 6 months or palliativepneumo;

RiskFactors

Smoking;
Drugs (IV);
Medication: OCP, heparin, chemotherapy, corticosteroids, antidepressants;
Pregnancy;
Cancer (Lung – 17%, Pancreas – 10%, Colon and rectum – 8%, Kidney – 8%, Prostate – 7%);
Surgery, trauma;
Genetic predisposition;
Immobilization;
Prolong sitting;
Obesity;
Hypertension;
CHF;
Diabetes mellitus;
Hypercholesterolemia;
Prior DVT;
Severe burns;

IsRedFlag

IsNPLEX

Consequence

Pulmonary Embolism (PE);
Cellulites;

ProgressionFromCondition

IBD: Crohn's disease, ulcerative colitis;
Renal disease, heart disease, liver disease;
Covid 19;

TreatmentOptions

Start O2;

IV fluids ;

PharmOptions

Heparin: best initial therapy;
Oral warfarin should be started with heparin;

Never use ASA!!!

WebLink

https://www.merckmanuals.com/en-ca/professional/cardiovascular-disorders/peripheral-venous-disorders/deep-venous-thrombosis-dvt | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3399231/