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NICE consultation: Venous thromboembolic diseases: diagnosis, management and thrombophilia testing (2019)

For Venous thrombotic event, Deep vein thrombosis (DVT) and Pulmonary embolism

The National Institute for Health and Care Excellence (NICE) have started a consultation on the diagnosis, management and thrombophilia testing in patients with venous thromboembolic diseases.

This guideline covers diagnosing and managing venous thromboembolic diseases in adults. It aims to support quick diagnosis and effective treatment for people who develop deep vein thrombosis (DVT) or pulmonary embolism (PE). It
also covers testing for conditions that can make a DVT or PE more likely, such as thrombophilia (a blood clotting disorder) and cancer.

Who is it for?
  • Adults (18 and over) with suspected or confirmed DVT or PE, their families and carers
  • Healthcare professionals in primary, secondary and tertiary care
  • Commissioners and providers of venous thromboembolism services
  • First-degree relatives of people with inherited thrombophilia or other venous thromboembolic diseases
This guideline will update NICE guideline CG144 (published June 2012, updated November 2015).

The draft guidance consultation period will run from 27 November 2019 to 24 December 2019 with an expected publication date of 30 March 2020.

About venous thromboembolic diseases

Deep vein thrombosis
DVT (deep vein thrombosis) is a blood clot in a vein, usually the leg. DVT can be dangerous. Get medical help as soon as possible if you think you have DVT.

Symptoms of DVT in the leg are:
  • throbbing or cramping pain in 1 leg (rarely both legs), usually in the calf or thigh
  • swelling in 1 leg (rarely both legs)
  • warm skin around the painful area
  • red or darkened skin around the painful area
  • swollen veins that are hard or sore when you touch them
These symptoms also happen in your arm or tummy if that's where the blood clot is.

A DVT is more likely to happen if you:
  • are over 60
  • are overweight
  • smoke
  • have had DVT before
  • take the contraceptive pill or HRT
  • have cancer or heart failure
  • have varicose veins
There are also some temporary situations when you're at more risk of DVT. These include if you:
  • are staying in or recently left hospital – especially if you cannot move around much (like after an operation)
  • are confined to bed
  • go on a long journey (more than 3 hours) by plane, car or train
  • are pregnant or if you've had a baby in the previous 6 weeks
  • are dehydrated
  • Sometimes DVT can happen for no obvious reason
Pulmonary embolism
A pulmonary embolism is a blocked blood vessel in your lungs. It can be life-threatening if not treated quickly.

Consult your doctor if:
  • you feel pain in your chest or upper back
  • you have difficulty breathing
  • you're coughing up blood
These can be symptoms of pulmonary embolism.

You may also have pain, redness and swelling in 1 of your legs (usually the calf). These are symptoms of a blood clot, also called deep vein thrombosis (DVT).

Thrombophilia
Thrombophilia means that blood has an increased tendency to form clots.

You're more likely to develop a blood clot in one of the large veins in your leg (deep vein thrombosis) or a pulmonary embolism, where the blood clot breaks off, travels in the circulation and lodges in the arteries supplying the lungs.

Sources
NHS website for deep vein thrombosis, pulmonary embolism & thrombophilia
Contains public sector information licensed under the Open Government Licence v3.0.
Accessed 28/11/19
Links available in External Resources

© NICE [2019]

Venous thromboembolic diseases: diagnosis, management and thrombophilia testing (2019). In development [GID-NG10087]. Expected publication date: 30 March 2020
Available from: See Link below. All rights reserved. Subject to Notice of rights
NICE guidance is prepared for the National Health Service in England. All NICE guidance is subject to regular review and may be updated or withdrawn. NICE accepts no responsibility for the use of its content in this product/publication.

The information provided by NICE was accurate at the time this article was issued.


NICE: Venous thromboembolic diseases: diagnosis, management and thrombophilia testing (2019)

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About Venous thrombotic event About Deep vein thrombosis (DVT) About Pulmonary embolism