Our patient has a confirmed proximal DVT and we recognised the important points in the clinical evaluation by looking for provoking factors:
- Family history
- Periods of immobility
- Recent surgery or hospital stays
- Hormonal therapy or pregnancy
- Nephrotic syndrome
- Autoimmune or other inflammatory disorder
In our patient nothing obvious came to light. He’d been on a short train journey and his cousin also had a DVT – neither enough to make us wonder about a convincing risk factor.
He needs treatment for the DVT. His renal and liver function are normal.
- How do you decide which anticoagulant to use?
- What risks and side effects would you tell him?
- What investigations may you wish to perform to look for causes of VTE?
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