The Curbsiders Internal Medicine Podcast #154 DVT and PE Master Class with Michael Streiff MD
Jun 10, 2019
Dr. Michael Streiff, an expert in DVT and PE, discusses the diagnosis and management of venous thromboembolism. Topics include treatment options, unique cases, heavy metal concerts, career advice, and diagnostic criteria for DVT using Wells score and D-dimer testing.
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Approach to Upper Extremity DVT
- Anticoagulate upper extremity proximal DVTs, especially with catheter lines present.
- Investigate thoracic outlet syndrome in unprovoked upper extremity DVTs.
Whole Leg vs Proximal Ultrasound
- Prefer whole leg ultrasounds in the US to capture distal DVTs; Europeans often do proximal only.
- If only proximal ultrasound done, obtain serial ultrasounds to detect progression.
PE Diagnosis and Risk Assessment
- Use CT pulmonary angiogram for suspected PE with symptoms like hypoxia and chest pain.
- Use PESC or Hestia scores to assess risk and guide discharge decisions.