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Management of Deep Vein Thrombosis in the Emergency Department
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Pathophysiology for deep vein thrombosis (DVT) is related to the Virchow triad: venous stasis, endothelial vascular injury, and hypercoagulability.
Unprovoked DVT can be due to genetic causes, such as having a non-O blood group, factor V Leiden mutation, prothrombin gene mutation, or protein C and protein S deficiency.
Provoked DVT can result as a complication of cancer, oral contraceptive use, pregnancy, long-distance travel, surgery, or trauma.
Classic signs and symptoms of DVT include pain, swelling, discoloration, heaviness, and cramping sensation.
The Wells criteria, validated and endorsed by the American College of Emergency Physicians (ACEP), stratifies patients as low, moderate, or high pre-test probability of having a DVT.
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