Deep vein thrombosis natural history, complications and prognosis: Difference between revisions
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==Overview== | ==Overview== | ||
Thrombus formation usually starts in the calf veins, then progresses to the proximal veins and then ultimately to the pulmonary artery leading to [[pulmonary embolism]]. Most of the times, calf DVT's are assymptomatic. | |||
==Natural History== | ==Natural History== | ||
*Untreated proximal DVT | * Untreated proximal DVT | ||
**Clinical PE occur in 1/3rd to 1/2 patients. | ** Clinical PE occur in 1/3rd to 1/2 patients. | ||
**Subclinical PE occurs in another 1/3rd. | ** Subclinical PE occurs in another 1/3rd. | ||
**Untreated PE tends to recur in days to weeks. | ** Untreated PE tends to recur in days to weeks. | ||
*[[Post-thrombotic syndrome|Post-phlebitic syndrome]](10-30% of DVT) | *[[Post-thrombotic syndrome|Post-phlebitic syndrome]](10-30% of DVT) | ||
** | ** Pain, edema, skin discoloration, and ulceration associated with chronic venous insufficiency. | ||
Death occurs in about 6 percent of DVT cases within one month of diagnosis. <ref name="pmid12814979">{{cite journal| author=White RH| title=The epidemiology of venous thromboembolism. | journal=Circulation | year= 2003 | volume= 107 | issue= 23 Suppl 1 | pages= I4-8 | pmid=12814979 | doi=10.1161/01.CIR.0000078468.11849.66 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12814979 }} </ref> | Death occurs in about 6 percent of DVT cases within one month of diagnosis. <ref name="pmid12814979">{{cite journal| author=White RH| title=The epidemiology of venous thromboembolism. | journal=Circulation | year= 2003 | volume= 107 | issue= 23 Suppl 1 | pages= I4-8 | pmid=12814979 | doi=10.1161/01.CIR.0000078468.11849.66 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=12814979 }} </ref> | ||
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The major outcomes of venous thrombosis are | The major outcomes of venous thrombosis are | ||
*Recurrence, | * Recurrence, | ||
*[[Post-thrombotic syndrome]], | * Major bleeding due to [[anticoagulation]], | ||
* | * Death. | ||
* | Other complications include: | ||
* [[Post-thrombotic syndrome]], | |||
* [[Phlegmasia alba dolens]], | |||
* [[Phlegmasia cerulea dolens]], | |||
* [[Lemierre syndrome]] | |||
* Septic [[pelvic thrombophlebitis]] | |||
Thrombosis is also associated with impaired quality of life, particularly when post-thrombotic syndrome develops<ref name="pmid15911732">{{cite journal| author=Kahn SR, Ducruet T, Lamping DL, Arsenault L, Miron MJ, Roussin A et al.| title=Prospective evaluation of health-related quality of life in patients with deep venous thrombosis. | journal=Arch Intern Med | year= 2005 | volume= 165 | issue= 10 | pages= 1173-8 | pmid=15911732 | doi=10.1001/archinte.165.10.1173 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15911732 }} </ref>. Death occurs within one month of an episode in about 6% of those with DVT and 10% of those with PE | Thrombosis is also associated with impaired quality of life, particularly when post-thrombotic syndrome develops<ref name="pmid15911732">{{cite journal| author=Kahn SR, Ducruet T, Lamping DL, Arsenault L, Miron MJ, Roussin A et al.| title=Prospective evaluation of health-related quality of life in patients with deep venous thrombosis. | journal=Arch Intern Med | year= 2005 | volume= 165 | issue= 10 | pages= 1173-8 | pmid=15911732 | doi=10.1001/archinte.165.10.1173 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15911732 }} </ref>. Death occurs within one month of an episode in about 6% of those with DVT and 10% of those with PE | ||
==References== | ==References== | ||
Revision as of 16:31, 14 May 2012
Editors-in-Chief: C. Michael Gibson, M.S., M.D. Associate Editor-In-Chief: Ujjwal Rastogi, MBBS [1]
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Overview
Thrombus formation usually starts in the calf veins, then progresses to the proximal veins and then ultimately to the pulmonary artery leading to pulmonary embolism. Most of the times, calf DVT's are assymptomatic.
Natural History
- Untreated proximal DVT
- Clinical PE occur in 1/3rd to 1/2 patients.
- Subclinical PE occurs in another 1/3rd.
- Untreated PE tends to recur in days to weeks.
- Post-phlebitic syndrome(10-30% of DVT)
- Pain, edema, skin discoloration, and ulceration associated with chronic venous insufficiency.
Death occurs in about 6 percent of DVT cases within one month of diagnosis. [1]
According to a study done on 826 patients in Medical University of Vienna the risk of recurrence was almost four times as great among men as among women.[2]
Complications
Proximal vein thrombosis is responsible for more than ninety percent of acute pulmonary embolism which has high mortality if not treated promptly. [3]
The major outcomes of venous thrombosis are
- Recurrence,
- Major bleeding due to anticoagulation,
- Death.
Other complications include:
- Post-thrombotic syndrome,
- Phlegmasia alba dolens,
- Phlegmasia cerulea dolens,
- Lemierre syndrome
- Septic pelvic thrombophlebitis
Thrombosis is also associated with impaired quality of life, particularly when post-thrombotic syndrome develops[4]. Death occurs within one month of an episode in about 6% of those with DVT and 10% of those with PE
References
- ↑ White RH (2003). "The epidemiology of venous thromboembolism". Circulation. 107 (23 Suppl 1): I4–8. doi:10.1161/01.CIR.0000078468.11849.66. PMID 12814979.
- ↑ Kyrle PA, Minar E, Bialonczyk C, Hirschl M, Weltermann A, Eichinger S (2004). "The risk of recurrent venous thromboembolism in men and women". N Engl J Med. 350 (25): 2558–63. doi:10.1056/NEJMoa032959. PMID 15201412. Review in: ACP J Club. 2004 Nov-Dec;141(3):78
- ↑ Galanaud JP, Sevestre-Pietri MA, Bosson JL, Laroche JP, Righini M, Brisot D, Boge G, van Kien AK, Gattolliat O, Bettarel-Binon C, Gris JC, Genty C, Quere I (2009). "Comparative study on risk factors and early outcome of symptomatic distal versus proximal deep vein thrombosis: results from the OPTIMEV study". Thromb. Haemost. 102 (3): 493–500. doi:10.1160/TH09-01-0053. PMID 19718469. Retrieved 2011-12-14. Unknown parameter
|month=ignored (help) - ↑ Kahn SR, Ducruet T, Lamping DL, Arsenault L, Miron MJ, Roussin A; et al. (2005). "Prospective evaluation of health-related quality of life in patients with deep venous thrombosis". Arch Intern Med. 165 (10): 1173–8. doi:10.1001/archinte.165.10.1173. PMID 15911732.