Prevention
What are 5 preventative measures to decrease risk of DVT?
Any of the following:
Physical activity; maintain healthy weight; stay hydrated; avoid prolonged sitting or standing; elevate legs; compression stockings; healthy diet; avoid smoking and alcohol; manage chronic conditions; travel safely (vaccinations, etc.)
What percentage (+/- 5%) of all deaths in hospitals are due to PE?
10%
Prolonged immobility, such as bed rest during illness, long flights or car rides increase the risk of which condition?
Deep vein thrombosis
What class of drugs do warfarin, dabigatran and rivaroxaban come under?
DOACs: direct oral anti-coagulants
In Lisa's case: for next time, what are some key preventative measures that she can take to avoid DVTs in the future?
Stop smoking; healthy diet and exercise - maintain a healthy weight; compression stockings; staying hydrated; swap seats with husband (or climb over) - get up and walk around plane every 45-60 minutes; elevate legs.
What is the most common cause of VTE?
Hospitalisation, 52%
Among the various risk factors, which lifestyle-related element significantly contributes to the hypercoagulable state that leads to the development of clots in deep veins?
Obesity
What is the role of the inferior vena cava (IVC) filter in DVT?
The filter catches blood clots and prevents them from continuing up to the heart and lungs and causing a pulmonary embolism.
How does being overweight or obese increase the risk of DVT?
Increased weight/pressure on veins = blood flow impairment = poor circulation = blood pooling = clot formation = DVT.
Compression of the abdominal veins (from excess abdominal fat): compress veins in the abdomen, hinders blood flow from the lower body to the heart = increasing risk of a clot in the lower limbs.
What is the first symptom to present in ~25% of PE cases?
Sudden death
Which endocrine substance has the potential to elevate the susceptibility to DVT when utilised within specific contraception regimes?
Oestrogen
Name a commonly used anti-coagulant that is subcutaneously injected into the skin.
Low molecular weight heparin - subcut injection
OR
Fondaparinux - subcut injection
List 4 drugs that can be used to prevent DVT in patients that are at greater risk of developing blood clots.
Anti-coagulants: heparin, low molecular weight heparin, warfarin, DOACs (factor Xa inhibitors)
Thrombin inhibitors: fondaparinux, argatrobanAnti-platelets agents: aspirin
1/4600 = 0.0217%
What term, indicating a heightened tendency of the blood to coagulate abnormally, describes the underlying factor contributing to the formation of clots within deep veins?
Hypercoagulability or thrombophilia
What are ways DVT can be managed post treatement/surgery?
Compression stockings; avoid sitting for more than 2 hours at a time; managing weight and daily exercise; diet.
What is the meaning of life?
42
x/1000 adults present with VTE every year (+/- 5).
1/1000
Which genetic mutation impacts the resistance to activated protein C and increases the susceptibility to DVT?
Factor V leiden mutation
What are the contraindications associated with oral anti-coagulant drugs, administered for DVT?
Active major bleeding, severe renal impairment, prosthetic heart valves, pregnancy & breastfeeding/liver impairment.
Contraindication with anti-platelet drugs, NSAIDs & anti-fungal medications.