Tainter Christopher R, Huang Alan W, Strayer Reuben J
Department of Medicine, University of California, San Diego, San Diego, California.
Elmhurst Hospital Center, Mount Sinai School of Medicine, New York, New York.
J Emerg Med. 2015 Feb;48(2):158-60. doi: 10.1016/j.jemermed.2014.10.006. Epub 2014 Nov 13.
Isolated distal deep vein thrombosis (DVT) is not traditionally viewed as a potentially life-threatening condition. There are conflicting recommendations regarding its evaluation and treatment, and wide variability in clinical practice. The presentation of this case highlights the fatal potential of this condition.
This is the report of a previously healthy young woman who presented to the emergency department with calf pain concerning for a DVT. She received two radiologist-performed duplex ultrasound examinations of the affected extremity, both of which were negative, but suffered a sudden cardiac arrest several hours after the second study. Autopsy attributed the death to DVT and pulmonary embolism. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: This case highlights the risk for fatal pulmonary embolization, even after normal serial ultrasound examinations to exclude DVT.
孤立性远端深静脉血栓形成（DVT）传统上不被视为一种潜在的危及生命的疾病。关于其评估和治疗存在相互矛盾的建议，临床实践差异很大。本病例的呈现突出了这种疾病的致命潜力。
这是一名既往健康的年轻女性的报告，她因小腿疼痛至急诊科就诊，怀疑患有DVT。她接受了两次由放射科医生进行的患侧肢体双功超声检查，结果均为阴性，但在第二次检查后数小时突然心脏骤停。尸检将死亡归因于DVT和肺栓塞。急诊医生为何应知晓此事？：本病例突出了即使在系列超声检查结果正常以排除DVT后仍存在致命性肺栓塞的风险。
