Question

A 45-year-old man is coming to the OPD with complaints of swelling in the right leg.
How will you treat a patient of DVT?

Hint:

For DVT treatment, anticoagulation therapy is the cornerstone, but compression stockings can also help manage symptoms and prevent complications. Consider thrombolytics or surgery in severe cases.

Answer 1

Step 1: Anticoagulation Therapy.
The mainstay of DVT treatment is anticoagulation therapy to prevent the clot from growing and to reduce the risk of pulmonary embolism. Commonly used anticoagulants include:
- Heparin (IV or subcutaneous): Often used initially due to its rapid onset.
- Warfarin (oral): Used for long-term therapy, but requires regular monitoring of the INR.
- Direct Oral Anticoagulants (DOACs): Such as rivaroxaban or apixaban, which are often preferred due to their ease of use and fewer monitoring requirements.

Step 2: Compression Stockings.
Compression stockings help reduce swelling and prevent the development of post-thrombotic syndrome. They should be worn continuously during the day, especially in the early stages of recovery.

Step 3: Thrombolytic Therapy or Surgery.
In cases of massive DVT or if the patient is at high risk for pulmonary embolism, thrombolytic therapy (e.g., tissue plasminogen activator) may be considered to break down the clot. In rare cases, surgical removal of the clot may be required.

Step 4: Lifestyle Changes.
Patients should be advised to avoid prolonged immobility and to increase their physical activity, as well as manage underlying risk factors such as obesity or smoking.

Step 5: Monitoring.
Frequent monitoring of the patient's response to anticoagulation therapy is necessary, especially if using warfarin, to ensure therapeutic levels are maintained.