Management of deep vein thrombosis in the emergency department

Deep vein thrombosis (DVT) can present with a variety of nonspecific signs and symptoms, and can involve the upper or lower extremities. Management of patients with DVT has changed markedly over the last 10 years, moving from hospital admission for initiation of anticoagulation to outpatient management. Diagnosis requires a risk stratification process involving clinical decision rules, D-dimer testing, and ultrasonography. Once the diagnosis is confirmed, the patient should be engaged in shared decision-making regarding treatment options. Recurrent DVT, as well as managing DVT in pregnant women, the elderly population, and patients with malignancies are also discussed.