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Deep Venous Thrombosis: Identifying The Killer Before It Strikes

November 2005

Abstract

DVT is a dangerous and entirely too common disease that is capable of striking fear into the hearts of all physicians in clinical practice. Its reputation is well deserved, since clots can propagate from the deep veins, leading to a fatal pulmonary embolus. DVT can be difficult to detect and, unfortunately, may be confused with other conditions.

Research into the detection and management of DVT has a long, rich history, and new studies on risk factors, diagnosis, and treatment, among other aspects of the disease, are ongoing today. In this issue of Emergency Medicine Practice, we will discuss our current understanding of how a thrombus forms, who is at risk for developing DVT, new modes of detection — including the increased use of emergent ultrasound in the ED and the utility of clinical prediction rules — as well as a variety of treatment options. We will discuss the feasibility of treating some DVT patients at home and detail the way management options for DVT have changed since the advent of low-molecular-weight heparin. Finally, since these patients present with a variety of special circumstances (for example, pregnant women), con siderations for the care of certain “special cases” will be examined.
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