Doctors need to keep an eye out for deep vein thrombosis

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The non-specific nature of the signs and symptoms of deep vein thrombosis (DVT) means doctors must keep an eye out for the potentially deadly condition, according to a review by Aussie researchers. DVT symptoms include leg pain, swelling, redness and enlarged veins, so there are many other possible alternative diagnoses. But, as around one in twenty people with DVT dies within 30 days, doctors must be sure to identify and treat the condition as early as possible, the authors say.

Journal/conference: MJA

Link to research (DOI): 10.5694/mja2.50201

Organisation/s: The University of Western Australia, Fiona Stanley Hospital, Perth, WA.

Funder: No information provided.

Media Release

From: The University of Western Australia

STUDY URGES GPS TO BE ON ALERT FOR DEEP VEIN THROMBOSIS

General practitioners and physicians are being urged to keep a careful eye on the potentially deadly condition of deep vein thrombosis because the signs and symptoms of DVT are non-specific and often difficult to diagnose, according to a review published today in The Medical Journal of Australia.

The review, led by The University of Western Australia’s Professor Graeme Hankey, found that clinical presentation of DVT was often “non-specific” and accurate diagnosis required careful integration of clinical assessment, evaluation of pre-test probability and objective diagnostic testing.

Professor Hankey, a world-leading expert on stroke research, said signs and symptoms of DVT included localised pain, swelling, redness and dilated veins close to the surface of the skin.

The researchers said anticoagulation remained the gold standard treatment for DVT.

“The choice of anticoagulant should consider medical issues such as efficacy, safety, renal and hepatic function, and concurrent medications,” Professor Hankey said.

“In addition, practical issues such as availability, familiarity of use, patient preference and cost should be considered.”

Compression stockings have been shown to have a beneficial effect after diagnosis. In rare cases, devices to stop blood clots, treatment to dissolve blood clots or surgery to remove blood clots may be considered.

Situations which are likely to impact the choice of anticoagulant agent and duration of treatment include DVT which occurs in pregnant women, patients with cancer, DVT of the lower leg, recurrent DVT, autoimmune disorders such as antiphospholipid syndrome or those with superficial vein thrombosis, Professor Hankey said.

“The diagnosis of DVT requires a high index of suspicion because symptoms and signs are often non-specific,” he said. “Anticoagulation continues to be the cornerstone of therapy. The optimal anticoagulant and duration of therapy are determined by the clinical assessment.”

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