Venous Thromboembolism Manifestations
E. A and B - Deep Vein Thrombosis and Pulmonary Embolism are the manifestations of venous thromboembolism.
Definition of VTE
Venous thromboembolism (VTE) is broadly defined to include deep venous thrombosis (DVT) and pulmonary embolism (PE) as its primary clinical manifestations 1, 2. These two conditions represent different presentations of the same disease process, where DVT is the formation of thrombi in deep veins (most commonly in the legs or pelvis), and PE develops when these thrombi dislodge and travel through the heart to the pulmonary arteries 3.
Why Myocardial Infarction is NOT Part of VTE
- Myocardial infarction is an arterial thrombotic event, not a venous thrombotic event 1
- While patients with VTE have an increased risk of subsequent myocardial infarction and stroke, these arterial events are separate cardiovascular conditions that share some common risk factors (smoking, obesity, hypercholesterolemia, hypertension, diabetes) but are not manifestations of VTE itself 1
- VTE and myocardial infarction may be viewed as part of the broader cardiovascular disease continuum, but this represents an indirect association mediated by effects of coronary artery disease, not a direct manifestation 1
Clinical Relationship Between DVT and PE
- In most cases, PE is a consequence of DVT 4, 3
- In 70% of pulmonary embolism cases, the thrombus originates from lower extremity DVT 5
- Untreated DVT leads to pulmonary embolism in 50-60% of cases with associated mortality of 25-30% 5
- PE and DVT share the same predisposing factors and are considered two clinical presentations of the same underlying disease process 4
Additional VTE Manifestations Beyond DVT and PE
While the question focuses on the three options provided, it's worth noting that comprehensive guidelines define VTE more broadly to include superficial vein thrombosis (SVT) and splanchnic vein thrombosis (SPVT) as well 1. However, among the answer choices provided, only DVT and PE are correct manifestations of VTE.