Presentation
If emboli form, break off, and travel distally, patients may present with subacute focal symptoms such as an individual digit with decreased pallor. 11 The most dangerous presentation is in patients who acutely form a completely thrombosed subclavian [clinicaladvisor.com]
After 10 days, she presented to accident and emergency department with acute discomfort and swelling of the left upper extremity. [ijcasereportsandimages.com]
Although most patients present with pain, swelling, parathesias, and prominent veins throughout the arm or shoulder, many patients will not display any local DVT symptoms. [the-hospitalist.org]
He presented to us with an acute onset (two days history) of left upper extremity pain, edema, and bluish discoloration. [cathlabdigest.com]
We present a 53 year-old female that complained of a progressive painful left lower neck swelling and redness for 2 days. [ispub.com]
Entire Body System
- Leg Swelling
[…] or arms: leg or arm swelling, pain, aching, heaviness, and cramping are some of the symptoms. [stoptheclot.org]
Post-phlebetic syndrome can cause lasting and possibly disabling pain, swelling and a feeling of heaviness in the affected leg. [mayoclinic.org]
Filter does not stop new clots from forming Graduated compression stockings The purpose of the stocking is to create a gentle pressure gradient up the leg to prevent blood from pooling and clotting and to reduce leg swelling The length of time of wearing [ksi.uconn.edu]
Use of drugs that cause dependent edema (eg, dihydropyridine Ca channel blockers, estrogen, high-dose opioids), venous hypertension (usually due to right heart failure), and hypoalbuminemia typically cause symmetric bilateral leg swelling; however, swelling [merckmanuals.com]
Interruption of the saphenous vein with obstructed concomitant deep veins will rapidly cause severe distal swelling of the leg and graft occlusion within days. [intranet.tdmu.edu.ua]
- Gangrene
In advanced cases of arteriosclerosis, a thrombus may fill up whatever channel remains through a vessel, completely blocking off circulation and causing gangrene. [medical-dictionary.thefreedictionary.com]
Gas gangrene. Investigations [ 6 ] Ultrasound (compression with either Doppler or colour Doppler) is recommended as the investigation of choice. [patient.info]
Venous gangrene may result. Rarely, venous clots can become infected. [merckmanuals.com]
Abnormalities such as a laterally inserting costoclavicular ligament or cervical rib (10%) can compress the subclavian vein, predisposing to thrombosis. 4 Complications include post-phlebitic limb syndrome from resultant valvular incompetence, venous gangrene [vasculardiseasemanagement.com]
- Arm Pain
Patients present with symptoms and signs of an upper limb deep vein thrombosis (i.e. arm pain and swelling). Compression of the subclavian vein when it passes through the costoclavicular space is the most favored mechanism of thrombosis. [radiopaedia.org]
The pain was not eased with analgesia or any re positioning of the arm. He also described a now constant sensory loss in his lower arm and hand in a widespread diffuse pattern. [thesports.physio]
- Unconsciousness
For unconscious patients, a sysolic of 60-70mmHg is adequate in the absence of significant brain injury. [trauma.org]
In unconscious patients, this examination is the only way to reveal indications of arterial damage. Diagnostics Investigations beyond the physical examination of the patient should be done only in stable patients. [intranet.tdmu.edu.ua]
- Noncompliance
DOACs do not require monitoring, and noncompliance will not be readily apparent. Direct oral anticoagulants. [clevelandclinicmeded.com]
Cardiovascular
- Hypertension
治療 P.68 第10章 腎血管性高血圧 (renovascular hypertension) 第10章 腎血管性高血圧 (renovascular hypertension) P.77 I. 原因 P.77 II. 治療 P.77 1. 手術適応 P.77 第11章 動脈瘤 (aneurysm) P.81 I. 原因 P.81 II. 病理 P.81 III. [molcom.jp]
A 44-year-old male with a past medical history of non-ischemic cardiomyopathy, hypertension, hyperlipidemia, chronic kidney disease, and obstructive sleep apnea, underwent implantable cardioverter defibrillator (ICD) implantation one year ago for primaryprevention [cathlabdigest.com]
Long-term complications include recurrent VTE, postpulmonary embolism syndrome, chronic thromboembolic pulmonary hypertension, and postthrombotic syndrome (PTS). [clevelandclinicmeded.com]
Causes include hardening of the cerebral arteries, hypertension, complications of syphilis or other infections, dehydration, diabetes mellitus, or a violent injury. [medical-dictionary.thefreedictionary.com]
His medical history consisted of hypertension, gout, and benign prostatic hyperplasia. He had no history of venous thromboembolism and no family history of thrombophilia. The patient was up to date on his cancer screenings. [acphospitalist.org]
Musculoskeletal
- Leg Cramp
Examples of symptoms and signs of a DVT in a leg are: Swelling A gradual onset of pain Redness Leg cramps... [emedicinehealth.com]
Skin
- Erythema
[…] cerebral thrombosis arterial thrombosis of a cerebral vessel, which may cause stroke syndrome ; see also thrombosis. deep venous thrombosis (DVT) venous thrombosis of one or more of the deep veins of the lower limb, characterized by swelling, warmth, and erythema [medical-dictionary.thefreedictionary.com]
[…] doctor immediatrly if you have any of the following signs or symptoms: Edema (swelling) of the leg or along a vein in the leg Pain and tenderness in the leg, which you may only feel when standing or walking Warmth in the swollen area of the leg Fever Erythema [ksi.uconn.edu]
Pain, tenderness, redness (erythema), and bulging of the vein are common symptoms of phlebitis. The redness and tenderness may follow the course of the vein under the skin. Low grade fever may accompany superficial and deep phlebitis. [medicinenet.com]
When present, symptoms and signs (eg, vague aching pain, tenderness along the distribution of the veins, edema, erythema) are nonspecific, vary in frequency and severity, and are similar in arms and legs. [merckmanuals.com]
Physical exam was remarkable for a swollen right upper extremity with erythema and slight induration in the more proximal region of the limb. The remainder of his exam was normal. [acphospitalist.org]
- Hyperpigmentation
Figure 1 Figure 1: Left Anterior Cervical and Shoulder view (Image depicts skin hyperpigmentation, erythematous edema, along with prominent superficial venous congestion) Discussion Deep vein thrombosis (DVT) usually presents with pain, swelling, and [ispub.com]
[…] population, suggesting that this population should be considered for prolonged treatment if the bleeding risk is acceptable. 39 Other prediction tools include the Vienna prediction model and the clinical decision rule “Men continue and HER DOO2”—ie, HER = hyperpigmentation [clevelandclinicmeded.com]
- Skin Ulcer
[…] toes/fingers, foot/hand or diffusely of leg/arm skin dryness eczema hardening of the skin formation of varicose veins skin ulcer (stasis ulcer) “atrophie blanche” or “white atrophy (description in text) “dermatoliposclerosis” (description in text) FINDINGS [stoptheclot.org]
Workup
Occult cancers may be present in patients with apparently idiopathic DVT, but extensive workup of patients for tumors is not recommended unless patients have major risk factors for cancer or symptoms suggestive of an occult cancer. [merckmanuals.com]
Serum
- Thrombocytosis
[…] bedrest; endothelial injury, e.g., after surgery or trauma; hypercoagulability, e.g., factor V Leiden or deficiencies of antithrombin III, protein C, or protein S; congestive heart failure; estrogen use; malignancy; nephrotic syndrome; obesity; pregnancy; thrombocytosis [medical-dictionary.thefreedictionary.com]
[…] thrombocytopenia, trauma, renal diseases, pulmonary hypertension, congenital heart disease, sepsis, traumatic and nontraumatic intracranial hemorrhage in newborns, paroxysmal nocturnal hemoglobinuria, vasculitis such as that caused by Beh0et disease, thrombocytosis [tanzariello.it]
Treatment
For the treatment of VTE, rivaroxaban is given orally at 15 mg twice a day for the initial 21 days of treatment, followed by once daily at 20 mg per day for long-term treatment. [clevelandclinicmeded.com]
Dabigatran 150 mg po bid is given only after an initial 5 to 7 days of treatment with LMWH. Duration of treatment varies. [merckmanuals.com]
TREATMENT Contemporary treatment of PSS varies widely in medical practice. There is no strict consensus on treatment and there are several strategies in parallel use, however most cases rely on conservative treatment. [aspetar.com]
Treatment with blood thinners usually lasts for 6 months, however – If your blood clot occurred after a short-term risk like surgery, treatment time may be shorter If you have a history of blood clots, treatment time may be longer Thrombin inhibitors [ksi.uconn.edu]
She should continue warfarin treatment for at least three months, with a goal INR of 2.0 to 3.0, similar to treatment for LEDVT. The ultimate treatment duration with warfarin follows the same guidelines as treatment with a LEDVT. [the-hospitalist.org]
Prognosis
Treatment and prognosis The thrombus is treated with anticoagulation and catheter-directed thrombolysis, after which surgical decompression is performed. [radiopaedia.org]
What are the symptoms, treatment, and prognosis for phlebitis? Pain, swelling, redness, and tenderness are some common symptoms of phlebitis. [medicinenet.com]
Prognosis Associated with significant morbidity and mortality due to potential risks of pulmonary embolism, post-thrombotic syndrome and loss of vascular access. About 10-20% develop pulmonary embolism [ 9 ]. [patient.info]
The prognosis is poor but not so grave as before antibiotic therapy. thrombosis, coronary, n thrombosis of the coronary artery; also called heart attack and coronary occlusion. thrombosis formation, development, or presence of a thrombus. [medical-dictionary.thefreedictionary.com]
However, its presence should alert hospitalists to the patient's potentially poorer prognosis and prompt evaluation for occult malignancy if no risk factor is present. [the-hospitalist.org]
Etiology
Diligent searches for underlying etiology may be prompt due to the association of malignancies presenting in such a matter in adults. [ispub.com]
There were diagnostic difficulties in determining the definitive etiology of the axillary vein thrombosis. [ingentaconnect.com]
Etiology Trauma (particularly after an operation and parturition), cardiac and vascular disorders, obesity, hereditary coagulation disorders, age over 65, an excess of erythrocytes and of platelets, an overproduction of fibrinogen, and sepsis are predisposing [medical-dictionary.thefreedictionary.com]
Etiology Twenty percent of cases of upper-extremity DVT are of primary etiology. [acphospitalist.org]
Hence, there is an urgent need for increasing physician awareness about risk factors, etiology and the management of this unique and relatively infrequent disorder. [westjem.com]
Epidemiology
Epidemiology of lower limb musculoskeletal trauma with associated vascular injuries in a tertiary care institute in India. Indian J Orthop. 2017;51:199-204. doi: 10.4103/0019-5413.201702. [ Links ] [scielo.org.co]
Deep vein thrombosis of the axillary-subclavian veins: epidemiologic data, effects of different types of treatment and late sequelae. Eur J Vasc Surg 1988; 2:161. Isma N, Svensson PJ, Gottsäter A, Lindblad B. [jmscr.igmpublication.org]
Record: found Abstract: found Article: not found Deep vein thrombosis of the axillary-subclavian veins: epidemiologic data, effects of different types of treatment and late sequelae. Upper extremity deep venous thrombosis (DVT) is uncommon. [scienceopen.com]
Epidemiology [ 1 ] There is a low incidence of about 1 per 100,000 people per year. 4-10% of all deep vein thromboses (DVTs) occur in the upper extremity. [patient.info]
Lindblad B, Tengborn L, Bergqvist D: Deep vein thrombosis of the axillary-subclavian veins: epidemiologic data, effects of different types of treatment and late sequelae. Eur J Vasc Surg 1988;2:161–165. [karger.com]
Pathophysiology
In the ED, about half of all patients with PE have a heart rate greater than 100 beats/min. 11 Tachycardia from PE probably results from impaired left ventricular filling, leading to a pathophysiologic process that parallels that of hemorrhagic shock. [clinicalgate.com]
Critical review of pathophysiologic mechanisms in thoracic outlet syndrome (TOS). Acta Neurochir Suppl 2007; 100:137. Mustafa S, Stein PD, Patel KC, et al. Upper extremity deep venous thrombosis. Chest 2003; 123:1953. Paget, J. [jmscr.igmpublication.org]
[…] described are estrogen ingestion, pregnancy, intravenous catheters, anti-neoplastic agents, and pacemakers. [2] Although, early clinical recognition of UEDVT is important, diagnosis may be difficult because of its indeterminate cause and indistinct pathophysiology [jmedsoc.org]
Pathophysiology is unclear, but edema may increase soft-tissue pressure beyond capillary perfusion pressures, resulting in tissue ischemia and wet gangrene. [merckmanuals.com]
Pathophysiology The main pathophysiological issue after vascular injuries to the extremities is ischemia. The process is identical to what happens during acute leg ischemia due to embolization. [intranet.tdmu.edu.ua]
Prevention
How can you prevent phlebitis? Simple measures can be taken to prevent phlebitis, although, sometimes it cannot be avoided. [medicinenet.com]
The authors found that ultrasound was more cost-effective than VCF, with a cost per PE prevented of $46,3000 versus $97,000. [east.org]
They probably play a role in the prevention of stasis and should be combined with other methods to prevent thromboembolism. [medical-dictionary.thefreedictionary.com]
Diagnosis is usually confirmed with an ultrasound. [7] These DVTs have the potential to cause a pulmonary embolism. [8] Diagnosis [ edit ] Duplex ultrasonography MR Venography Prevention [ edit ] Preventing the development of blood clots in the upper [en.wikipedia.org]
Prevention Sitting during a long flight or car ride can cause your ankles and calves to swell and increases your risk of thrombophlebitis. To help prevent a blood clot: Take a walk. [mayoclinic.org]