Question

A 35-year-old woman presents with a swollen, painful left calf after a long-haul flight. Her Wells score for deep vein thrombosis is 3 (DVT likely). She has no haemodynamic instability. According to NICE guidance, what is the most appropriate next step in her management?

Accepted Answer

Arrange an immediate Doppler ultrasound of the leg and give interim parenteral anticoagulation if imaging is delayed beyond 4 hours

Answer

Start therapeutic low molecular weight heparin and arrange a routine outpatient Doppler ultrasound in 2 weeks

Answer

Start aspirin and arrange an outpatient ultrasound within 1 week

Answer

Reassure the patient and arrange no further investigations as she is young and fit

Answer

Order a D-dimer test and await the result before considering imaging

Practice question

A 35-year-old woman presents with a swollen, painful left calf after a long-haul flight. Her Wells score for deep vein thrombosis is 3 (DVT likely). She has no haemodynamic instability. According to NICE guidance, what is the most appropriate next step in her management?