Deep Vein Thrombosis
Deep vein thrombosis is the development of single or multiple blood clots within the deep veins of the extremities or pelvis, usually accompanied by inflammation of the vessel wall. The major clinical consequence is embolization, usually to the lung, that is frequently life-threatening.
Causes of DVT include: venous stasis, injury to vessel wall, and abnormalities of coagulation.
Clinical risk factors include: Trauma, especially long bone fractures or crush injuries; Surgery, particularly hip surgery; Prolonged immobility (e.g. bed rest); Pregnancy, especially the puerperium; Indwelling central venous catheters; Oral contraceptive use (risk is confined to current usage and is proportional to estrogen content); and Extreme high altitude (> 14,000 feet)
Pathological risk factors include: Carcinoma; Deficiencies of endogenous anticoagulants (protein C, protein S, antithrombin III); Presence of anti-phospholipid antibodies (also known as lupus anticoagulant or anti-cardiolipin antibodies); Nephrotic syndrome; Polycythemia vera; Homocystinuria (rare); Campylobacter jejuni bacteremia (very rare); and Mutation on Factor V conferring resistance to activated protein C (most common risk factor for idiopathic DVT).
No specific laboratory test is available for DVT.
Protein C, protein S, antithrombin III and antiphospholipid antibodies can be measured in some laboratories. These are rare causes of DVT.
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