Thromboembolism

Venous thromboembolism (VTE) includes deep vein thrombosis (DVT) and pulmonary embolism (PE). A thrombus may remain in a deep vein, extend along the venous system, or detach and travel to the pulmonary circulation. The leg clot can therefore be clinically quiet while the embolic complication presents abruptly with hypoxemia, syncope, obstructive shock, or cardiac arrest. The central bedside model has two linked parts. First, ask why the clot formed: venous stasis, endothelial or vessel-wall activation or injury, and hypercoagulability often act together. Second, ask what the clot is doing now: causing local venous obstruction, impairing pulmonary circulation, or threatening hemodynamic stability. Treatment must reduce clot propagation and embolization without creating unacceptable bleeding risk. [1, 13, 14]