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Emergency: requires immediate attention
Deep vein thrombosis
See also in: Cellulitis DDx
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Other Resources UpToDate PubMed
Emergency: requires immediate attention

Deep vein thrombosis

See also in: Cellulitis DDx
Print Images (13)
Contributors: Michael W. Winter MD, Paritosh Prasad MD
Other Resources UpToDate PubMed

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Synopsis

Deep vein thrombosis : Erythema, Leg pain, Recent air travel, Sedentary lifestyle, Skin warm to touch, Tender skin lesion, Unilateral distribution, Unilateral leg edema, Inpatient
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
  • Pregnancy and postpartum period
  • Presence of a central venous catheter
  • Polycythemia, thrombocytosis
  • Malignancy
  • Chronic inflammatory diseases (eg, inflammatory bowel disease [ischemic colitis, Crohn disease], systemic lupus erythematosus)
  • 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)
  • Foam sclerotherapy (endovenous foam-induced thrombosis [EFIT])
  • 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

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Reviewed:01/03/2022
Last Updated:09/11/2018
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Emergency: requires immediate attention
Deep vein thrombosis
See also in: Cellulitis DDx
Captions Print   View all Images (13)
(with subscription)
A medical illustration showing key findings of Deep vein thrombosis : Erythema, Leg pain, Recent air travel, Sedentary lifestyle, Skin warm to touch, Tender skin lesion, Unilateral distribution, Unilateral leg edema, Inpatient
Clinical image of Deep vein thrombosis - imageId=3525996. Click to open in gallery. caption: 'Increased girth of the right leg.'
Increased girth of the right leg.

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