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suspected DVTFrom: James W. Banks, M.D. (jwbanks@roanoke.infi.net)Sun Oct 29 17:19:59 1995
I have an interesting case and wanted to see how others might handle it: 17 y.o. G1 P0 at approx 18 weeks has had intermittent cramps and pain in her calves for the past 10 days. Over the last 24 hours she has had continuous pain (a deep ache) in her right lower extremity, different from her "charlie horses". Painful to walk as well. No chest pain or dyspnea, no fever or other systemic symptoms. She has no significant past medical history. Her right calf measures 38 cm while her left measures 37 cm. There are no cords or erythema but a positive Homan's. Doppler flow studies are not available on Sunday evening. While I think she has a DVT, the picture surely is equivocal. We are admitting her and starting continuous IV Heparin. I thought about intermittent subcutaneous dosing until vascular lab is available for a more definitive non-invasive study. Would anyone handle this differently? James W. Banks, M.D. Assoc Director Medical Education Southeast Roanoke Family Medical Center 2145 Mount Pleasant Blvd., SE Roanoke, VA 24014 jwbanks@roanoke.infi.net (703) 427-3024 (office 1) (703) 992-4100 (office 2) (703) 992-6669 FAX
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