Deep Vein Thrombosis and Thrombophlebitis: Signs and Symptoms
During the early stages of a DVT, only 25% to 50% of cases can be identified by clinical manifestations, such as dull aching or severe pain, swelling, or changes in skin temperature and color, specifically heat and redness.

Although edema in the vicinity of the clot may be present, it may be too deep to palpate. If the clot is in the calf (distal DVT), pain or tenderness of the calf may be felt with passive dorsiflexion of the affected foot (Homans’ sign). However, the sensitivity of this test is poor and often reflects a false-negative or false-positive finding. Only measurement by ultrasonography, venous duplex screening, or venography can confirm a DVT.

Pulmonary Embolism: Signs and Symptoms
As described previously, pulmonary embolism is a possible consequence of DVT. Risk factors for pulmonary embolism are similar to those already identified for DVT

The signs and symptoms of pulmonary embolism vary considerably depending on the size of the embolus, the extent of lung involvement, and the presence of coexisting cardiopulmonary conditions. The hallmark signs and symptoms are a sudden onset of shortness of breath (dyspnea), rapid and shallow breathing (tachypnea), and chest pain located at the lateral aspect of the chest that intensifies with deep breathing and coughing. Other signs and symptoms include swelling in the lower extremities, anxiety, fever, excessive sweating (diaphoresis), a cough, and blood in the sputum (hemoptysis).

When a patient presents with signs or symptoms of possible pulmonary embolism, immediate medical referral is warranted for a definitive diagnosis.

Chronic Venous Insufficiency: Signs and Symptoms

Dependent, peripheral edema occurring with long periods of standing or sitting is a common manifestation of chronic venous dysfunction. Edema decreases if the limb is elevated. Patients often report dull aching or tiredness in the affected extremity. If the insufficiency is associated with varicose veins, venous distention (bulging) also is notable. When edema persists, the skin becomes less supple over time and takes on a brownish pigmentation.

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