To be aware that rapid diagnosis of venous thromboembolism is vital because mortality rates are still significant To become familiar with various invasive and noninvasive diagnostic procedures and their variable accuracy To learn when the use of anticoagulants is and is not appropriate The authors disclose no financial interests in this article. Accuracy in the diagnosis of venous thrombophlebitis is often dependent on the degree of clinical suspicion before testing. In this article, the authors examine important risk factors for this often deadly disease and describe the invasive and noninvasive tests available. They also define the circumstances in which each procedure is appropriate.
Most deaths occur when the diagnosis is either delayed or never made.
However, both procedures are invasive and expensive and require the skills of experienced physicians and support staff. Issues in the treatment of VTE will be discussed in a symposium in the September 15 issue of postgraduate medicine. The degree of clinical suspicion for VTE determines the extent of diagnostic evaluation. In many published studies, the degree of clinical suspicion has been assigned informally by physicians. Formal scoring systems may be particularly useful in selecting patients in whom clinical suspicion is low and who may need only minimal further evaluation.