A deep venous thrombosis (DVT) results when a blood clot forms in the deep veins, often of the lower extremity. DVT may cause pain, erythema, or swelling locally but can also be asymptomatic. It carries the potential for embolization to the lungs (pulmonary embolism), which can precipitate potentially life-threatening cardiopulmonary events including cardiac arrest.
Risk factors for DVT include:
Prolonged immobilization
Postoperative state
Prior history of DVT
Pelvic / lower extremity trauma
Older than 60
Certain drugs: oral contraceptive pills, hormone replacement therapy, chemotherapy
Hypercoagulable state (eg, antithrombin III deficiency, factor V Leiden, protein C or protein S deficiency, lupus anticoagulant, prothrombin gene mutation, anticardiolipin antibody, activated protein C resistance, hyperhomocysteinemia)
Endovenous laser ablation or radiofrequency ablation (endovenous heat-induced thrombosis [EHIT])
Once diagnosed, anticoagulation is initiated in efforts to stabilize the existing thrombus, prevent further thrombus aggregation, and allow for dissolution over time. Duration of therapy depends on the inciting etiology and patient substrate. Barring any contraindication to anticoagulation, treatment should be initiated urgently once the condition is diagnosed to prevent clot extension or pulmonary embolism.
Codes
ICD10CM: I80.209 – Phlebitis and thrombophlebitis of unspecified deep vessels of unspecified lower extremity
SNOMEDCT: 128053003 – Deep vein thrombosis
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