Suggest test to diagnose deep vein thrombosis

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Posted on Thu, 9 Apr 2015 in Blood Disorders
Question: DVT i need to rule this out..please advise what the systems are and what specific bloods tests are necessary and. which imaging or diagnostic tests should be carried out in hospital for my elderly immobile mother 79..i understand her heart is high and it could be trying to clear the body of blood clots..she is on no medication at all..we are concerned about P Embolism..her crp and esr are very very high..
doctor
Answered by Dr. Hardik Sanghvi 1 hour later
Brief Answer:
Contrast venography/ colour doppler sonography

Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern.
Your mother is immobile so there is a risk of deep vein thrombosis.
D dimer is used as screening test for deep vein thrombosis. It is also positive in other conditions like cancer but its negative value is helpful in rule out the deep vein thrombosis.

Contrast venography is specific test and it has high specificity. However it is invasive test.
Other options are colour doppler sonography, ct scan or MRI. All are able to detect deep vein thrombosis with high specificity.

You should go for these investigations to diagnose deep vein thrombosis. You can go with any of this option according to need and convenience.

Her crp and esr is akso raised so you should also investigate for that.

Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Hardik Sanghvi 3 hours later
can you advise what type of SPECIFIC blood tests I can request. She does have raising white blood cell count and high urea. At the moment she is in the hands of a Geriatrician and on no anticoagulants or no compression socks..However I shall request these test you have suggested as i am determined to ensures no episodes or occurrence of DVT. and if discovered i can have blood clots treated immediately..thank you
doctor
Answered by Dr. Hardik Sanghvi 1 hour later
Brief Answer:
d dimer is a blood test to detect DVT

Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern.
D dimer is the blood test required to detect deep vein thrombosis.
Other tests are contrast venography or colour doppler sonography as I said.
If she has dvt then she should start anticoagulant immediately. So ask your doctor to investigate for that.

She may also have some infection, because she has high wbc count and crp. Please send me her complete blood count,renal function test and all other reports so that I can help you further.
Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. Hardik Sanghvi 44 hours later
I have some results inr 1.1 and pt time 11 i was told these are normal. But my mum is not normal as she has been IMMOBILE for about 6 months and is on NO medication... I can see pitted eodema on both legs now ..
doctor
Answered by Dr. Hardik Sanghvi 12 minutes later
Brief Answer:
Your PT and INR are normal.

Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern.
Your prothrombin time (PT) and INR is normal. Prothrombin time may be variable from lab to lab but INR is standard for all. Your INR is 1.1 and it is completely normal. INR is increased if she is on anticoagulant. But she is not taking any medicine so obviously INR is not increased.
If she has DVT then she should start anticoagulant and INR should be remain in between 2 to 3.
Pitting edema on both leg can be due to kidney disease or some cardiac problem.
For that you should go for complete kidney function test and echocardiography.
As you said earlier that she has high urea level which suggest her kidney disease.
So you should go for complete kidney function test for that and d dimer test for DVT.

Consult your doctor go for testing. You should not wait because she can go in renal failure.
Hope I have answered your question. If you have doubts then feel free to ask me. Thanks for using health care magic.
Wish you a very good health.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Hardik Sanghvi 25 minutes later
why would a geritrician request a inr and pt blood test..is it because he suspect DVT , if he did wouldn't he go strait to a d dimer or ultrasound...im trying to underxtand the relavence of a inr and pt blood test...is he thinking she is a bleeding risk..please doctor this is important as i dont want DVT or my mother to suffer from PE pulmoray embolism. Her egsr kidney is >90 above ive been told her renal is ok.
doctor
Answered by Dr. Hardik Sanghvi 14 hours later
Brief Answer:
He thinks that she is at bleeding risk.

Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern.
PT and INR are prescribed to check bleeding risk or anti coagulant effectiveness.
she is not taking anti coagulant drug so purpose of pt and inr may be bleeding risk. If she is suffering from some coagulation disorder then pt is helpful. Your doctor doesn't suspect DVT. Still if you want to rule out DVT then you can go for d dimer test. There is no harm in that.
Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic.
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Hardik Sanghvi 43 minutes later
Thank you for your detailed answer .. So would i be correct in saying that my mother is NOT a bleeding risk based on her INR and PT results..so then we could now start anti coagulants to prevent VTE..
doctor
Answered by Dr. Hardik Sanghvi 8 minutes later
Brief Answer:
Yes she is not at bleeding risk right now.

Detailed Answer:
Hi, dear
I have gone through your question. I can understand your concern.
Your mother is not at bleeding risk right now according to her PT and INR results.
If needed she can start prophylactic anticoagulant treatment according to her doctor's advice.
If she starts treatment then she should check her INR regularly. And her INR should not go beyond 3.

Hope I have answered your all queries. If you still have any questions then feel free to ask me anytime. I will be happy to answer.
Thanks for using health care magic. Wish you a very good health.
Above answer was peer-reviewed by : Dr. Shanthi.E
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Dr. Hardik Sanghvi

Hematologist

Practicing since :2008

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