Deep Vein Thrombosis (cont.)
Benjamin Wedro, MD, FACEP, FAAEM
Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- Deep vein thrombosis (DVT) facts
- What is deep vein thrombosis (DVT)?
- What are the causes of deep vein thrombosis (DVT)?
- What are the symptoms of deep vein thrombosis (DVT)?
- When should I seek medical care for deep vein thrombosis (DVT)?
- What kind of doctor treats DVT?
- How is deep vein thrombosis diagnosed (DVT)?
- What is the treatment for deep vein thrombosis (DVT)?
- What medications treat deep vein thrombosis (DVT)?
- Surgery for deep vein thrombosis (DVT)
- What are the complications of deep vein thrombosis (DVT)?
- Can deep vein thrombosis (DVT) be prevented?
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What kind of doctor treats DVT?
Patients with a swollen extremity or concern that a DVT exists may be cared for by a variety of health-care professionals. Both the primary care provider (including internal medicine and family medicine specialists) and a health-care professional at in an urgent care (walk in) clinic or emergency department are able to recognize and diagnose a DVT. Some patients have their diagnosis made when they are in the hospital.
Treatment is usually started by the doctor who makes the diagnosis, and long-term follow up may be done by the primary provider. Depending upon the situation, a hematologist (specialist in blood disorders) may be consulted. If there is need for the clot to be removed or dissolved, an interventional radiologist may also be involved.
Depending upon the medication used to anticoagulate the blood, pharmacists and anticoagulation nurses may also be involved on the patient's treatment team.
How is deep vein thrombosis diagnosed (DVT)?
The diagnosis of superficial thrombophlebitis is often made by the health care professional at the bedside of the patient, based upon the physical examination.
DVT usually is diagnosed with ultrasound.
- Ultrasound is now the standard method of diagnosing the presence of a deep vein thrombosis.
- The ultrasound technician may be able to determine whether a clot exists, where it is located in the leg, and how large it is. Ultrasounds can be compared over time to see whether a clot has grown or resolved.
- Ultrasound is better at "seeing" the veins above the knee as compared to the small veins below the knee joint.
D-dimer is a blood test that may be used as a screening test to determine if a blood clot exists. D-dimer is a chemical that is produced when a blood clot in the body gradually dissolves. The test is used as a positive or negative indicator. If the result is negative, then in most cases no blood clot exists. If the D-dimer test is positive, it does not necessarily mean that a deep vein thrombosis is present since many situations will have an expected positive result (for example, from surgery, a fall, in cancer or in pregnancy). For that reason, D-dimer testing must be used selectively.
Other tests for DVT
- Venography, injecting dye into the veins to look for a thrombus, is not usually performed any more and has become more of a historical footnote.
- Other blood testing may be considered based on the potential cause for the deep vein thrombosis.
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