DVT & Pulmonary Embolism

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About DVT & Pulmonary Embolism

Deep vein thrombosis (DVT) and pulmonary embolism (PE) represent a spectrum of venous thromboembolism, where blood clots form in deep veins and can travel to pulmonary circulation. DVT most commonly occurs in lower extremity veins, while PE results from embolic migration of thrombi to pulmonary arteries, potentially causing life-threatening respiratory and cardiovascular compromise.

Pathophysiology

Venous thromboembolism develops through Virchow's triad: venous stasis, endothelial injury, and hypercoagulability, leading to fibrin-rich clot formation in deep veins. When thrombi dislodge from their origin (commonly lower extremity or pelvic veins), they travel through venous circulation to pulmonary arteries, causing mechanical obstruction and release of vasoactive mediators that increase pulmonary vascular resistance and right heart strain.

Clinical Reasoning

DVT presents with unilateral leg swelling, pain, warmth, and erythema, while PE manifests with acute dyspnea, chest pain, tachycardia, and potential hemodynamic instability depending on clot burden. Risk stratification using clinical prediction rules (Wells score), D-dimer testing, and imaging studies (ultrasound for DVT, CT pulmonary angiography for PE) guide diagnostic approach and anticoagulation decisions to prevent clot extension and recurrence.

References

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Imaging Reasoning

CT Pulmonary Angiography

Key imaging focus: Filling defects in pulmonary arteries, RV strain signs, Hampton hump, Westermark sign on CXR

📚 Radiopaedia Cases →
  1. Deep Venous Thrombosis. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK507708/
  2. ASH VTE Guidelines. Blood Adv 2020. https://doi.org/10.1182/bloodadvances.2020003411
  3. ASH 2020 Guidelines for VTE Management. Blood Advances. https://doi.org/10.1182/bloodadvances.2020001830
  4. CHEST Guideline: Antithrombotic Therapy for VTE. Chest. https://doi.org/10.1016/j.chest.2021.07.055
  5. ESC Guidelines for Pulmonary Embolism. European Heart Journal. https://doi.org/10.1093/eurheartj/ehz405

Related Topics

DVT & VTEPulmonary EmbolismVenous Thromboembolism