Samwel Mikaye on Understanding, Diagnosing, and Managing Deep Venous Thrombosis (DVT)
Samwel Mikaye, Chief Executive Officer at Samik Medical Center, shared in the Laboratory Professionals International group on LinkedIn:
”Deep venous thrombosis (DVT) is the formation of a blood clot (thrombus) in the deep veins, most often in the legs.
It is a serious condition because the clot can dislodge and travel to the lungs, causing a pulmonary embolism (PE).
Key Points on DVT
1. Risk factors (Virchow’s triad):
• Stasis of blood flow – prolonged immobility, surgery, paralysis, long flights.
• Endothelial injury – trauma, surgery, indwelling catheters.
• Hypercoagulability – pregnancy, oral contraceptives, cancer, inherited clotting disorders.
2. Clinical features:
• Swelling of the leg (usually unilateral).
• Pain, tenderness (especially calf tenderness).
• Warmth and redness of the skin.
• Dilated superficial veins.
• Some cases are silent (no obvious symptoms).
3. Diagnosis:
• Duplex Doppler ultrasound (first-line).
• D-dimer (sensitive but not specific, useful to rule out).
• Venography (rarely used, gold standard).
4. Complications:
• Pulmonary embolism (life-threatening).
• Post-thrombotic syndrome (chronic swelling, pain, skin changes).
5. Management:
• Anticoagulation (mainstay):
• Low molecular weight heparin (LMWH), unfractionated heparin, then transition to oral anticoagulants (warfarin or DOACs like rivaroxaban, apixaban).
• Compression stockings to prevent post-thrombotic syndrome.
• IVC filter only if anticoagulation is contraindicated.
• Mobilization and hydration as prevention.”
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