Uncommon series of subclavian vein thrombosis in Emergency Department

Abstract

IntroductionDeep vein thrombosis (DVT) is one of the two possible clinical manifestations of venous thromboembolism (VTE), and the other one is the pulmonary embolism. The most common reasons behind the upper limb DVT can be central venous catheterization, compression of subclavian vein or anatomical abnormalities.AimThe aim of this study is to stress the importance of accurate diagnosis of the relatively rare subclavian vein thrombosis (SCVT). Due to low specificity of the clinical signs and symptoms, a careful risk assessment of VTE is extremely helpful in successfully reaching a diagnosis.Case studyAuthors are presenting a series of 4 cases of diagnosis and initial treatment in Emergency Department (ED) of the patients presenting with common symptoms of upper limb with uncommon SCVT. All patients presented to ED, of which 3 were seen in ED of our hospital and 1 patient, who is co-author of the publication, had the same diagnosis in other ED allocated in another city.Results and discussionAmong the 4 patients only 1 has reached high risk in Caprini’s score and moderate in Wells score. In Padua scale patient did not reach high risk. In other patients risks in each score were low.ConclusionsIn most cases, the Wells, Padua, Caprini scores can be used to evaluate the risk of VTE; this diagnostic tool cannot be efficiently utilized in patients with local anatomical anomalies, which can lead to problems with diagnostics and treatment of such patients.