The Clinical Picture of Deep Vein Thrombosis Correlated to the Frequency of Pulmonary Embolism

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Abstract
Pain and swelling of the leg were studied in 27 patients with deep vein thrombosis (DVT). Of these, 23 were also examined for pulmonary embolism (PE) after 1 wk of heparin treatment. Scoring systems were constructed to quantitate pain, size of DVT and PE. A ratio between swelling and pain (S/P ratio) was calculated for each patient. Actual size of the DVT, as estimated with venous phlebography, was correlated to swelling (rs = 0.51, P < 0.01), S/P ratio (rs = 0.53, P < 0.01) and PE (rs = 0.57, P < 0.01). DVT with no pain at all, or just tenderness on palpation, were more often associated with PE (P < 0.05) and elevated blood pressure (P = 0.02) than DVT with pain on walking. A free floating proximal end of DVT proved unreliable for predicting PE. The risk of developing PE depends not only on DVT size, but also on factors related to pain.