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Chapter 74: Venous Thromboembolism

DOI:

10.1891/9780826171481.0074

Authors

  • Berrios-Colon, Evangelina, PharmD, MPH, BCPS, CACP | 
  • Arcebido, Rebecca, PharmD, BCACP

Abstract

Venous thromboembolic disease encompasses two closely linked conditions: deep vein thrombosis (DVT) and pulmonary embolism (PE). Venous thromboembolism (VTE) is relatively rare in the general population in the absence of predisposing conditions. Patients with DVT frequently complain of calf pain. DVT is suggested by unilateral leg swelling, warmth, or erythema. A major respiratory consequence of PE is increased alveolar dead space due to obstruction of blood flow leading to segments of lung with high ventilation relative to perfusion. The most common signs of a PE are tachypnea and tachycardia. Nuclear lung scan is the most widely used imaging technique in the diagnosis of PE. Anticoagulation is the mainstay of treatment for both DVT and PE unless contraindicated by the presence of active bleeding or a bleeding disorder. Intravenous unfractionated heparin (UFH) is one of the options for initial therapy for both acute DVT and PE.