Last reviewed: November 2017
Last updated: December  2017

Summary

Definition

History and exam

Key diagnostic factors

  • previous VTE, thrombophilia, malignancy, postoperative setting, trauma, and indwelling central catheter
  • chronic medical conditions, paresis, increasing age, obesity, estrogen-containing birth control pills and HRT, varicose veins, pregnancy and up to 6 week postpartum, first-degree relative with a history of VTE, extended travel, and admission to intensive care

Risk factors

  • previous VTE (DVT and/or PE)
  • thrombophilia
  • malignancy
  • postoperative setting
  • trauma
  • indwelling central catheter (upper or lower extremity)
  • immobility
  • myeloproliferative diseases
  • congestive heart failure
  • chronic obstructive pulmonary disease
  • inflammatory bowel disease
  • neurologic disease with extremity paresis
  • increasing age
  • obesity
  • estrogen-containing birth control pills, HRT, and androgen deprivation therapy
  • hx of varicose veins
  • pregnancy/postpartum
  • extended travel
  • lower leg immobility
  • first-degree relative with a history of VTE
  • admission to intensive care

Diagnostic investigations

1st investigations to order

  • CBC
  • serum creatinine
  • INR
  • PTT
Full details

Investigations to consider

  • serum antiplatelet factor 4 antibodies
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Attending Physician

Assistant Professor

University of Montreal

Montreal

Canada

Disclosures

NR declares that she has no competing interests.

Vicky Tagalakis

Associate Professor

General Internal Medicine Program Director

McGill University Division of Internal Medicine

Centre for Clinical Epidemiology of the Lady Davis Institute for Medical Research

Jewish General Hospital

Montreal

Canada

Disclosures

VT declares that she has received an investigator-initiated grant from Sanofi-Aventis. She has also received consultancy fees from Bristol-Myers Squibb, Leo Pharma, Pfizer, and Sanofi-Aventis. VT is an author of a reference cited in this monograph.

Resident in Internal Medicine

Sacred Heart Hospital

University of Montreal

Montreal

Canada

Disclosures

VBD declares that he has no competing interests.

Peer reviewers VIEW ALL

Clinical Director

Acute Medicine

Associate Medical Director

Consultant Emergency Medicine

Guy's and St Thomas' NHS Foundation Trust

Clinical Lead and Consultant

Accident Emergency Medicine

St Thomas' Hospital

London

UK

Disclosures

AP declares that he has no competing interests.

Hematologist

Thrombosis Fellow

University of Ottawa

Ottawa Health Research Institute

Ottawa

Canada

Disclosures

SS declares that he has no competing interests.

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