Venous Thromboembolism: Diagnosis and Treatment

Abstract

Venous thromboembolism includes deep venous thrombosis and pulmonary embolism. Deep venous thrombosis is the formation of thrombi (blood clots) in the deep veins of the vascular system of the members. The blood clot can break in the deep veins of the limbs and reach the pulmonary arteries, causing a pulmonary embolism. Venous thromboembolism is a common cause of death and it is associated with high intrahospital mortality and costs. However, it is also the most preventable cause of hospital deaths. Clinical presentations of deep vein thrombosis are wide, and the most common complaints are the affected limb pain, edema, erythema, or cyanosis. Clinical presentation of pulmonary embolism varies, the most common symptoms and signs are tachypnea, dyspnea or pleuritic pain and leg pain or swelling in the lower limbs are common. Diagnosis is based according to specific clinical situations with different strategies as: risk stratification using Wells preclinical score, serum levels of D-dimer, and/or an imaging method. Treatment aims to prevent progression of the thrombus; to reestablish blood flow when needed; to reduce complications, morbidity, and mortality associated; and also to avoid recurrence of thromboembolic events. Practitioners need to apply clinical and pharmacological interventions and, eventually, surgery to achieve these goals.