Question

A 48-year-old woman presents with a swollen, painful left calf after a long-haul flight. Her Wells score for deep vein thrombosis is 3. She has no active bleeding or contraindications to anticoagulation. Ultrasound is not immediately available. What is the most appropriate next step?

Accepted Answer

Arrange a proximal leg vein ultrasound within 4 hours and give a therapeutic dose of a DOAC while awaiting imaging

Answer

Arrange an ultrasound within 24 hours and give prophylactic-dose low-molecular-weight heparin

Answer

Discharge with oral aspirin and review in 1 week

Answer

Give immediate thrombolysis with Alteplase

Answer

Avoid anticoagulation until ultrasound confirms DVT

Practice question

A 48-year-old woman presents with a swollen, painful left calf after a long-haul flight. Her Wells score for deep vein thrombosis is 3. She has no active bleeding or contraindications to anticoagulation. Ultrasound is not immediately available. What is the most appropriate next step?