SEMIOLOGICAL ASPECTS OF VENOUS THROMBOEMBOLISM
DOI:
https://doi.org/10.63330/aurumpub.036-036Keywords:
Venous thromboembolism, Deep vein thrombosis, Pulmonary embolism, Semiology, Physical examination, Clinical propaedeuticsAbstract
Venous thromboembolism (VTE), which mainly includes deep vein thrombosis (DVT) and pulmonary embolism (PE), represents a significant cause of morbidity and mortality in both hospital and outpatient settings. Its clinical presentation is often nonspecific, making semiology a central element for initial diagnostic suspicion, risk stratification, and the definition of complementary procedures. However, isolated semiological findings have limited sensitivity and specificity and should be integrated with the clinical context, risk factors, and predictive scores. In DVT, pain, unilateral edema, increased local temperature, muscle stiffness, and superficial venous dilation predominate, while in PE, sudden dyspnea, pleuritic chest pain, tachypnea, tachycardia, hypoxemia, and signs of right ventricular overload stand out in severe cases. This article systematically reviews the main semiological aspects of venous thromboembolism (VTE), emphasizing anamnesis, physical examination, diagnostic limitations of clinical propaedeutics, and correlation with medical practice.
Downloads
References
WELLS, P. S. et al. Evaluation of D-dimer in the diagnosis of suspected deep-vein thrombosis. The New England Journal of Medicine, Boston, v. 349, n. 13, p. 1227- 1235, 2003.
WELLS, P. S. et al. Excluding pulmonary embolism at the bedside without diagnostic imaging: management of patients with suspected pulmonary embolism presenting to the emergency department by using a simple clinical model and D- dimer. Annals of Internal Medicine, Philadelphia, v. 135, n. 2, p. 98-107, 2001.
SIMEL, D. L. et al. Does this patient have deep vein thrombosis? JAMA, Chicago, v. 295, n. 2, p. 199-207, 2006.
STEIN, P. D. et al. Clinical characteristics of patients with acute pulmonary embolism: data from PIOPED II. The American Journal of Medicine, New York, v. 120, n. 10, p. 871-879, 2007.
RIGHINI, M. et al. Age-adjusted D-dimer cutoff levels to rule out pulmonary embolism: the ADJUST-PE study. JAMA, Chicago, v. 311, n. 11, p. 1117-1124, 2014.
OUDEGA, R. et al. The Wells rule does not adequately rule out deep venous thrombosis in primary care patients. Annals of Internal Medicine, Philadelphia, v. 143, n. 2, p. 100-107, 2005.
GEERSING, G.-J. et al. Safe exclusion of pulmonary embolism using the Wells rule and qualitative D-dimer testing in primary care: prospective cohort study. BMJ, London, v. 345, p. e6564, 2012.
VAN ES, N. et al. The original and simplified Wells rules and age-adjusted D-dimer testing to rule out pulmonary embolism: na individual patient data meta-analysis. Journal of Thrombosis and Haemostasis, Oxford, v. 15, n. 4, p. 678-684, 2017.
BERNARDI, E. et al. Diagnosis of deep-vein thrombosis. Thrombosis Research, New York, v. 163, p. 201-206, 2018.
KLINE, J. A. et al. Diagnosis and exclusion of pulmonary embolism. Thrombosis Research, New York, v. 163, p. 207-220, 2018.
Downloads
Published
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
