(Circulation. 1996;93:2212-2245.)
© 1996 American Heart Association, Inc.
Articles |
Management of Deep Vein Thrombosis and Pulmonary Embolism
A Statement for Healthcare Professionals From the Council on Thrombosis (in Consultation With the Council on Cardiovascular Radiology), American Heart Association
Key Words: thrombosis • embolism • AHA Medical/Scientific Statements
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Introduction |
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Deep vein thrombosis (DVT) is a common but elusive illness that can result in suffering and death if not recognized and treated effectively. DVT occurs in
2 million
Americans each year. Death can occur when the venous thrombi break off
and form pulmonary emboli, which pass to and obstruct the
arteries of the lungs. DVT and pulmonary embolism (PE) most
often complicate the course of sick, hospitalized patients but may also
affect ambulatory and otherwise healthy persons.1 2 3 4 It is
estimated that each year 600 000 patients develop PE and that 60 000
die of this complication.5 6 7 This number exceeds the
number of American women who die each year from breast cancer. PE is
now the most frequent cause of death associated with
childbirth.8 Women are a prime target for PE, being
affected more often than men.
Deep vein thrombosis is a major complication in orthopedic surgical
patients and patients with cancer and other chronic illnesses. DVT can
be a chronic disease. Patients who survive the initial episode of DVT
are prone to chronic swelling of the leg and pain because the valves in
the veins can be damaged by the thrombotic process, leading to venous
hypertension. In some instances skin ulceration and impaired mobility
prevent patients from leading normal, active lives. In addition,
patients with DVT are prone to recurrent episodes. In those instances
in which DVT and PE develop as complications of a surgical or medical
illness, in addition to the mortality risk, hospitalization is
prolonged and healthcare costs
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