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Deep vein thrombosis and pulmonary embolism: Pathology review
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Hannah is a 42 year old woman who came to the emergency department due to pain in her right calf.
She reports flying from Japan back to the United States 2 days ago.
She denies fever, chills, or history of trauma to the leg.
She reports a 25 pack year smoking history for 20 years, and she takes oral contraceptive pills.
On physical examination, she is stable, and her BMI is 32.
Her right leg is shown in this image.
On laboratory investigation, her D-dimer levels are elevated.
People with varicose veins are also at risk of DVT, because incompetent venous valves prevent proper venous outflow, causing stasis.
Another similar cause is May-Thurner syndrome where the left iliac vein gets sandwiched between the right iliac artery anteriorly and the lumbar vertebrae posteriorly, which also leads to venous stasis.
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