Overview
Clinical Meaning
Venous thromboembolism (VTE) encompasses deep vein thrombosis (DVT) and pulmonary embolism (PE) as manifestations of the same pathological process.
Venous thromboembolism (VTE) encompasses deep vein thrombosis (DVT) and pulmonary embolism (PE) as manifestations of the same pathological process. Virchow's triad defines the three etiological factors: venous stasis (immobilization, surgery, heart failure), endothelial injury (trauma, surgery, central lines), and hypercoagulability (inherited thrombophilia, cancer, pregnancy, OCP use). Diagnosis follows validated clinical decision algorithms. DVT Wells Score: active cancer (+1), paralysis/immobilization (+1), bedridden >3 days or surgery within 12 weeks (+1), localized tenderness along deep veins (+1), entire leg swollen (+1), calf swelling >3 cm vs asymptomatic leg (+1), pitting edema (+1), collateral superficial veins (+1), previously documented DVT (+1), alternative diagnosis as likely as DVT (-2). Score interpretation: ≤1 = DVT unlikely (proceed with D-dimer; if negative, DVT excluded); ≥2 = DVT likely (proceed directly to compression ultrasonography). PE Wells Score: clinical signs of DVT (+3), PE most likely diagnosis (+3), heart rate >100 (+1.5), immobilization/surgery within 4 weeks (+1.5), previous DVT/PE (+1.5), hemoptysis (+1), malignancy (+1). Score >4 = PE likely (proceed to CTPA); ≤4 = PE unlikely (D-dimer first). Age-adjusted D-dimer cutoff (age × 10 mcg/L for patients >50)...