More than 20% of the annual 600,000 new cases of deep vein thrombosis (DVT) are missed in the emergency room because symptoms are not clearly recognized, according to estimates. Awareness of DVT risk factors and symptoms can significantly reduce adverse events associated with this serious but under-diagnosed condition.
Each year in the United States, deep vein thrombosis (DVT) is diagnosed in approximately 600,000 new cases, presenting medical challenges to referring physicians, emergency room staff, and vascular specialists. Approximately one-third of people with DVT will develop pulmonary embolism (PE), a serious complication that kills approximately 200,000 people every year.7 Many others will suffer from post-thrombotic syndrome (PTS), a debilitating condition with serious adverse effects on a person’s health and quality of life.8
With accurate diagnosis and early treatment, the number of these adverse events can be significantly reduced and in many cases, even eliminated.
Symptoms of DVT
Because the symptoms of deep vein thrombosis (DVT) can mimic those of other disorders, it is under-diagnosed and under-treated. There may be minor symptoms or none at all. In fact, in approximately one-half of individuals with DVT, the symptoms are not quickly diagnosed.
A DVT can occur suddenly, with little warning, or it may develop gradually. It is a serious condition that can become a medical emergency. It should be treated promptly and appropriately.
The most common symptoms of DVT are:
- Sudden swelling in the leg or arm
- Limb pain, tenderness
- Pain upon touching the affected area
- Skin that is overly warm (or feverish) to the touch
- Significantly red skin color
- Lack of pulse in the extremities
Correctly diagnosing DVT is challenging because other conditions exhibit similar symptoms, including:
- Muscle strains
- Arterial insufficiency
- Edema due to congestive heart failure
- Stress fracture
- Renal failure
- Liver disease
- Arthritis
- Skin infections
- Achilles tendonitis
It is estimated that DVT is confirmed in only 20-30% of patients with clinically suspected DVT, but all patients with DVT are at risk for PE or PTS and their associated complications.7,8 Moreover, approximately 70% of patients with suspected DVT present with additional conditions (e.g., Achilles tendonitis, arterial insufficiency, arthritis, hematoma and stress fractures), further delaying a timely and accurate diagnosis.1
Referring physicians who are aware of the risk factors and common symptoms of DVT can have a significant impact on the outcomes of people with DVT by identifying at-risk patients and directing them to vascular specialists for timely diagnosis and treatment at an early stage.
In general, less invasive options are preferred for treating DVTs, ranging from the administration of anticoagulant (blood-thinning) or thrombolytic (clot-dissolving) medications to removal of the thrombus with a mechanical thrombectomy device. Combination therapy that uses mechanical thrombectomy to deliver localized thrombolytics has recently received considerable attention as a treatment for DVT.
1. Schreiber, D. Deep venous thrombosis and thrombophlebitis. www.emedicine.com/emerg/topic122.htm, updated October 2005
7.Prandoni P, et al. The long-term clinical course of acute deep venous thrombosis. Annals of Internal Medicine 1996; 125:1-7
8. Bernardi E, Prandoni P. The post-thrombotic syndrome: Risk factors and impact on the course of thrombolic disease. Journal of Thrombosis and Haemostasis 2005; 3:2671-76.