#238 DVT / PE Triple Distilled
The Curbsiders Internal Medicine Podcast
Anticoagulation in Special Populations
Discussion on the use of anticoagulation in morbidly obese patients, those with upper GI malignancies, advanced chronic kidney disease, and antiphospholipid syndrome, as well as the caution against routine use of IVC filters.
DVT / PE Triple Distilled! Our favorite VTE pearls summarized in this fast paced recap gleaned from our discussions with Dr Oren Friedman #92 Pulmonary Embolism for the Internist and hematologist, heavy metal enthusiast, Dr Michael Streiff #154 DVT and PE Master Class. Introducing our new Triple Distilled sub-series offering shorter episodes that reinforce and refresh key concepts from past shows along with any pertinent updates.
Listeners can claim 2 hours of Free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date).
Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com | Free CME!
Credits- Written and Produced by: Matthew Watto MD, FACP
- Cover Art by: Matthew Watto MD, FACP
- Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP
- Editor: Matthew Watto MD (written materials); Clair Morgan of nodderly.com
Sponsor: VCU Health CE
The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. Note: A free VCU Health CloudCME account is required in order to seek credit.
Time Stamps
- 00:00 Intro, disclaimer
- 01:40 Making the diagnosis of VTE
- 09:07 Triage and risk stratify Pulmonary Embolism
- 14:00 Anticoagulant choice; Duration of therapy after unprovoked DVT / PE
- 21:00 Workup for unprovoked DVT / PE; DOACs in special populations: at extremes of weight, advanced CKD and in antiphospholipid syndrome
- 28:22 IVC filters
- 30:20 Outro
Links
Check out the full show notes from previous Curbsiders’ shows covering VTE.
- Dr Oren Friedman #92 Pulmonary Embolism for the Internist
- Dr Michael Streiff #154 DVT and PE Master Class
Goals
Listeners will feel confident in the diagnosis and management of VTE
Learning objectives
After listening to this episode listeners will...
- Diagnose (VTE) DVT and PE using imaging, risk scores and clinical gestalt
- Risk stratify patients with pulmonary embolism
- Choose the appropriate initial anticoagulant for VTE
- Decide duration of anticoagulation for VTE
- Recall real risks and questionable benefits of IVC filters in DVT / PE
- Determine need for cancer or thrombophilia workup in unprovoked DVT / PE
Disclosures
The Curbsiders report no relevant financial disclosures.
Citation
Watto MF, Williams PN, Brigham SK, Watto MF. “#238 DVT / PE Triple Distilled”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list Final publishing date October 22, 2020.
Tags
Pulmonary embolism, vte, dvt, pe, heparin, anticoagulation, right ventricle, RV, left ventricle, LV, circulation, hypotension, shock, IVC filter, TPA, echocardiogram, CT scan, bleed, clot, deep, vein, thrombosis, DOAC, NOAC, anticoagulation, d-dimer, Wells, primary care, assistant, care, doctor, education, family, FOAM, FOAMim, FOAMed, health, hospitalist, hospital, internal, internist, meded, medical, medicine, nurse, practitioner, professional, primary, physician, resident, student
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