Abstract
Pulmonary embolism is a serious, life-threatening condition and most commonly derives from deep vein thrombosis of the lower extremities. Once deep vein thrombosis (DVT) reaches a proximal vein (i.e., popliteal vein or higher), pulmonary embolism reportedly occurs in up to 50% of patients. Case Presentation. We report on an inpatient with major depressive disorder in a catatonic state in whom an asymptomatic proximal deep vein thrombosis of 11 × 70 mm was detected through routine screening, using doppler ultrasound scanning. Anticoagulant therapy was immediately started and continued for three months, which resulted in resolution of the deep vein thrombosis. Discussion. To our knowledge, this is the first description of asymptomatic proximal DVT that was detected in a psychiatric inpatient setting. In light of the reported causal relationship between DVT and pulmonary embolism, screening for DVT can be of high clinical value in patients with psychiatric disorders, especially when their physical activity is highly compromised.
Highlights
Pulmonary embolism (PE) is a serious, life-threatening condition and most commonly derives from deep vein thrombosis (DVT) of the lower extremities [1]
This is the first description of asymptomatic proximal DVT that was detected in a psychiatric inpatient setting
There has been no systematic survey on the incidence of DVTs in psychiatric settings, it is very likely to be high, considering the lowered physical activity level of patients with psychiatric disorders
Summary
Pulmonary embolism (PE) is a serious, life-threatening condition and most commonly derives from deep vein thrombosis (DVT) of the lower extremities [1]. DVTs have been reported to occur in up to 10–40% of hospitalized patients with a physical morbidity [2], and approximately 70–80% of such DVTs are asymptomatic [3]. We have been conducting a routine screening of DVTs for inpatients who have been bedridden (i.e., deeply sedated or catatonic) for ≥2 days since October, 2009. In this screening, a D-dimer level is measured for all these patients when they are ambulant, and doppler ultrasound scanning is performed when the level is higher than 0.5 μg/dL. We report on a patient with major depressive disorder in whom an asymptomatic proximal DVT was detected through routine screening
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
