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.
In this Article
- Introduction to deep vein thrombosis
- What are the causes of deep vein thrombosis?
- What are the symptoms of deep vein thrombosis?
- When should I seek medical care for deep vein thrombosis?
- How is deep vein thrombosis diagnosed?
- What is the treatment for deep vein thrombosis?
- What are the complications of deep vein thrombosis?
- Can deep vein thrombosis be prevented?
- Deep Vein Thrombosis - Slideshow
- Take the Blood Disorders Quiz!
- Spider & Varicose Veins - Slideshow
- Find a local Cardiologist in your town
When should I seek medical care for deep vein thrombosis?
The diagnosis of a superficial or deep thrombosis often relies on the clinical skill of the health care practitioner. Diagnostic tests need to be tailored to each situation.
Leg swelling, redness, and pain may be indicators of a blood clot and should not be ignored. These symptoms may be due to other causes (for example, cellulitis or infection), but it may be difficult to make the diagnosis without seeking medical advice.
If there is associated chest pain or shortness of breath, then further concern exists that a pulmonary embolus may be the cause. Once again, seeking immediate advice is appropriate.
How is deep vein thrombosis diagnosed?
The diagnosis of superficial thrombophlebitis is made clinically.
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" veins above the knee as compared to the veins below it.
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.
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 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, or pregnancy). For that reason, D-dimer testing must be used selectively.
Other blood testing may be considered based on the potential cause for the deep vein thrombosis.
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