ABSTRACT
A thorough history should either establish the likelihood of Deep venous thrombosis (DVT), including risk factors, or aim to provide an alternative diagnosis. DVT results from a complex series of events involving coagulation factors, platelets, red blood cells and the vessel wall. In older patients a history of stroke, cardiac failure, dehydration, drug history and recent surgery should be sought. The complications of DVT can be life threatening; therefore a range of investigations are needed to confirm or refute the diagnosis. Most patients are successfully managed in the community. It is important to remember that clinical examination is not a reliable way to diagnose DVT. The differential diagnoses are extensive, and difficulties arise because DVT can complicate many of these conditions. D-dimers are variable-sized segments of cross-linked fibrin that are found in the circulation when fibrin is degraded by plasmin.
