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Pharmacist

Chapter 35

Thromboembolic Diseases

Card 1 of 17VTE Foundations
Chapter Opening
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Virchow's triad drives clot formation

Venous Thromboembolic Disease (VTED)

VTED occurs when one or more elements of Virchow's triad are present, resulting in deep venous thrombosis (DVT) and/or pulmonary embolism (PE). The triad is: vascular injury, venous stasis, and a hypercoagulable state (decreased protein C, protein S, or antithrombin). Annual VTE events exceed 600,000, with about 296,370 deaths.

Every risk factor for clotting maps onto one leg of Virchow's triad. Understanding the triad explains why surgery, immobility, and cancer all raise VTE risk.

Virchow's Triad (VTED)

Vascular injury

Surgery, trauma, central catheters

Venous stasis

Immobility, long travel, heart failure

Hypercoagulability

Low protein C/S, low antithrombin, factor V Leiden

DVT

Deep venous thrombosis (usually the leg)

PE

Pulmonary embolism -- can be fatal

Cancer/estrogen

Malignancy, oral contraceptives, HRT, SERMs


๐Ÿ“– โ€œVTED = Virchow's triad (vascular injury, venous stasis, hypercoagulable state: low protein C/S or antithrombin) -> DVT and/or PE. >600,000 VTE events/year, ~296,370 deaths. Risk: surgery, trauma, immobility, malignancy, estrogen, age >40, pregnancy.โ€