DVT( Deep Vein Thrombosis)
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Deep vein thrombosis (DVT) is diagnosed through special investigations like venous duplex ultrasound since symptoms can be non-specific or absent. Treatment involves anticoagulation which carries risk, so diagnosis must be reasonably certain. Hospitals often use modified Wells scores to determine if further imaging is needed, but these can be unreliable for inpatients. Prophylaxis against DVT includes mechanical methods like compression stockings or pneumatic compression, but pharmacological methods using low molecular weight heparin are more effective at reducing risk while carrying a higher risk of bleeding complications.
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Risk factors include recent surgery, cancer, trauma, lack of movement, obesity, smoking, hormonal birth control, pregnancy and the period following birth, antiphospholipid syndrome, and certain genetic conditions. Genetic factors include deficiencies of antithrombin, protein C, and protein S, and factor V Leiden mutation. The underlying mechanism typically involves some combination of decreased blood flow rate, increased tendency to clot, and injury to the blood vessel wall.
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Clinical assessment and D-dimer tests have limited accuracy in diagnosing DVT due to non-specific signs and symptoms. Duplex ultrasonography is the primary diagnostic test due to its accuracy, lack of radiation exposure, and cost-effectiveness. It can identify thrombi based on increased echogenicity, diameter and lack of compressibility of veins. MRV and CT venography are alternatives but provide less accuracy for calf veins and involve contrast or radiation. Plethysmography and contrast venography are less commonly used due to limitations and risks. Early and accurate diagnosis of DVT is important for optimal treatment outcomes.
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This document provides an overview of peripheral vascular diseases (PVD), including definitions, pathophysiology, causes, clinical examination, investigations, management, and specific conditions like atherosclerosis, thromboangitis obliterans (Buerger's disease), Raynaud's disease, acute arterial disease, and gangrene. It describes the clinical features, risk factors, and pathology of different types of PVD and provides guidance on evaluating patients through history, physical examination, tests, and setting treatment plans which may involve lifestyle changes, medications, procedures like angioplasty, or surgeries such as bypass or amputation.
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Varicose veins are dilated, elongated superficial veins caused by venous hypertension. They most commonly occur in males in India and affect the left lower limb. The superficial venous system can become incompetent due to family history, pregnancy, aging, deep vein thrombosis, oral contraceptives or obesity. Treatment options include compression stockings and bandages, sclerotherapy using chemicals to obliterate veins, and high ligation and stripping surgery to remove veins. Nursing care focuses on leg elevation, walking exercises, and wearing compression stockings after treatment.
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Acs0606 Venous Thromboemboli
This document discusses venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolism (PE). Some key points:
- DVT occurs in about 2.5 million Americans annually and risks of PE are reduced with prophylaxis for high-risk patients, like those having surgery.
- Prophylaxis methods discussed include anticoagulants like heparin, low molecular weight heparin, and fondaparinux as well as compression devices.
- Superficial thrombophlebitis is differentiated from DVT and algorithms are provided for evaluating and treating sterile vs. septic superficial phlebitis.
Contemporary Perspectives on the Diagnosis and Management of Hypertrophic Car...
Hypertrophic cardiomyopathy (HCM) is a cardiovascular disorder with genetic predisposition. The number of treatment modalities has grown in the contemporary era, with use of pharmacotherapy, device therapy, and surgical intervention, though with the relative paucity of data derived from randomized trials. Its clinical course and prognosis are relatively good. The ongoing quest is to establish the optimal treatment strategy in patients with HCM. This is of direct relevance in reducing the mortality burden associated with sudden cardiac death primarily secondary to dysrhythmias. This review summarizes the clinical features, course, and management of HCM. In particular, we highlight advances in cardiac magnetic resonance imaging assessment of HCM and how risk stratification criteria for suitability of implantable cardioverter defibrillators differ between continents.
DVT.pptx
Deep vein thrombosis (DVT) occurs when a blood clot forms in a deep vein, usually in the legs. It can be classified as proximal or distal based on location. Risk factors include age, immobilization, surgery, cancer, prior history of DVT, and genetic factors. Symptoms range from mild leg pain and swelling to severe cases involving skin discoloration. Diagnosis involves a clinical probability assessment, D-dimer testing, and ultrasound imaging of the legs. Treatment consists of anticoagulation medications to prevent clot propagation and reduce risk of pulmonary embolism, with options including heparin, low molecular weight heparin, and novel oral anticoagulants.
Thrombo embolic prophylaxis.ppt
The document discusses thromboprophylaxis in surgery. It notes that venous thromboembolism (VTE) is a common cause of mortality worldwide. Risk factors for VTE include surgery, trauma, immobility, cancer, pregnancy, and genetic factors. The primary goals of pharmacologic VTE prophylaxis are to prevent fatal pulmonary embolism and reduce mortality in surgical and ICU patients. Effective prophylaxis includes early ambulation, mechanical methods like compression stockings, and anticoagulant medications, which reduce VTE risk by 50-80% with a modest bleeding risk increase. Prophylaxis aims to identify high-risk groups like hip surgery patients.
Venus obstructive outflow
This document summarizes venous thromboembolism (VTE), specifically deep vein thrombosis (DVT). It discusses how DVT is typically treated with anticoagulation to prevent further clotting, but this does not restore vein function. The document then focuses on how thrombolysis can restore flow and improve outcomes by reducing postthrombotic syndrome and recurrent DVT. For patients with iliofemoral DVT, thrombolysis often reveals underlying venous outflow obstructions that require treatment, such as with stents, to prevent reclotting and improve patency. The document provides guidance on indications for venous stenting after thrombolysis and the technique for performing stent placement.
Cardiac imaging in prosthetic paravalvular leaks
Prosthetic paravalvular leaks (PVL) is an uncommon but serious complication after surgical valve replacement. Although surgery has been the traditional treatment of choice in hemodinamically significant PVL, percutaneous transcatheter closure is emerging as a novel and less invasive option for patients with high operative risk. Cardiac imaging, especially two- and three-dimensional transoesophageal echocardiography, plays an essential role in the diagnosis, guidance of intervention and subsequently in the evaluation of the outcomes of the procedure. The aim of this manuscript is to review the role of cardiac imaging techniques in the interventional management of patients with symptomatic PVL.
Cardiac imaging in prosthetic paravalvular leaks
This document discusses cardiac imaging techniques used in the diagnosis and treatment of prosthetic paravalvular leaks (PVLs). Echocardiography, especially 3D transoesophageal echocardiography (TEE), plays a key role in initially diagnosing PVLs, guiding percutaneous closure procedures, and evaluating outcomes. While transthoracic echocardiography is often first used, TEE is needed to confirm clinically significant leaks. Additional techniques like CT, MRI, and angiography can provide further detail. Intraprocedural imaging with TEE and fluoroscopy helps interventional cardiologists properly position closure devices and confirm adequate sealing of leaks.
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Deep Venous Thromboembolism in Gynecological Malignancies
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Contemporary Perspectives on the Diagnosis and Management of Hypertrophic Car...
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DVT( Deep Vein Thrombosis)
- 2. Definition
- 3. Introduction
- 4. Aetiology
- 5. Pathology
- 6. Diagnosis
- 8. The diagnosis of DVT and pulmonary embolus should be established by special investigations as the symptoms and signs are non-specific and may be absent. In addition, treatment with anticoagulation is not without risk and the diagnosis must be made with reasonable certainty. Many centres direct investigations based upon the modi- fed Wells score, with further imaging dictated by these results. These scores can be unreliable though, especially in hospital inpatients, and should only be considered a guide. Venous duplex ultrasound is commonly performed to look for evidence of thrombosis throughout the deep or superficial venous system.
- 9. D-dx
- 10. Prophylaxis Prophylactic methods can be divided into mechanical and pharmacological. Mechanical Prophylaxis 1. compression stockings and external pneumatic compression 2. electronic nerve stimulators More recent emerging evidence is casting some doubt on the benefit of mechanical prophylaxis in surgical patients. Pharmacological methods are more efective than mechanical methods at risk reduction, although they carry an increased risk of bleeding. In the absence of renal impairment, most centres currently use LMWH given subcutaneously. This is given once daily, does not require monitoring and has a lower risk of bleeding complications.
- 11. Treatment
- 12. Thank You