Disorders of coagulation or thrombosis - venous thromboembolic events, such as deep vein thrombosis and pulmonary embolism and complications
Description
- DVT and PE are one disease - ~50% of proximal DVT have asymptomatic PE
- Proximal DVT = popliteal or above. Distal (calf) = below
- Only proximal DVT reliably embolises; isolated distal DVT may be surveilled rather than anticoagulated
- Unusual sites: cerebral venous sinus, splanchnic, upper limb (catheter- or thoracic-outlet-related)
Provocation - determines duration of therapy, not initial treatment
| Examples | Recurrence after stopping | |
|---|---|---|
| Major transient | Surgery >30 min under GA, immobility >=3 days, caesarean | ~3%/yr |
| Minor transient | Oestrogen, pregnancy, long-haul flight, minor surgery, leg injury | ~5%/yr |
| Unprovoked | Nothing identified | ~10% at 1 yr, ~30% at 5 yr |
| Persistent | Active cancer, antiphospholipid syndrome, IBD | Highest |
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