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Saturday, January 22, 2011

DVT

DEFINITION:A blood clot (thrombus) in a deep vein in the thigh or leg. The clot can break off as an embolus and make its way to the lung, where it can cause respiratory distress and respiratory failure. Deep vein thrombosis is sometimes called the "economy-class syndrome." Even in young, healthy travelers, long stretches of time spent immobilized in the cramped seat of
an aircraft with very low humidity sets the stage for formation of a blood clot in the leg.
Abbreviated as DVT. ETIOLOGY:The following risk factors for DVT have been identified in many different epidemiologic studies: General Age Immobilization longer than 3 days Pregnancy and the postpartum period Major surgery in previous 4 weeks Long plane or car trips (>4 h) in previous
4 weeks Medical Cancer Previous DVT Stroke Acute myocardial infarction (AMI) Congestive heart failure (CHF) Sepsis Nephrotic syndrome Ulcerative colitis Trauma Multiple trauma CNS/spinal cord injury Burns Lower extremity fractures Vasculitis Systemic lupus erythematosus (SLE) and the lupus anticoagulant Behçet syndrome Homocystinuria Hematologic Polycythemia rubra vera
Thrombocytosis Inherited disorders of coagulation/fibrinolysis Antithrombin III deficiency Protein C deficiency Protein S deficiency Prothrombin 20210A mutation Factor V Leiden Dysfibrinogenemias and disorders of plasminogen activation Drugs/medications Intravenous drug abuse Oral contraceptives Estrogens Heparin-induced thrombocytopenia. SIGNS AND
SYMPTOMS: Swelling of the leg or along a vein in the leg Pain or tenderness in the leg, which you may feel only when standing or walking Increased warmth in the area of the leg that's swollen or in pain Red or discolored skin on the leg . DIAGNOSIS: Physically by doing homan's sign other methods are doppler ultrasonagraphy, venogram. Treatment and precautions:
Anticoagulants Heparin Intravenous heparin Oral coumarin Enoxiparin Thrombolysis in select patients Thrombolectomy followed by anticoagulation for massive clots where thrombolysis is contraindicated Inferior vena cava filters .

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