Iliofemoral Deep Venous Thrombosis During Pregnancy
A 24-year-old female who was 32 weeks pregnant presented to the emergency department at 7 p.m. with a swollen, painful left lower extremity. Her left leg had become progressively more symptomatic during the past 48 h. During the past 24 h, she began feeling lethargic, had slight shortness of breath, and began to experience right chest discomfort with deep breathing.
Upon physical examination, her heart rate was 106/min, respiratory rate was 18/min, and blood pressure was 112/70. Her lungs were clear, and her abdomen was appropriate for her gestational age.
She had a swollen left leg from the foot to the inguinal ligament, which had a bluish hue. She had pain upon palpation of the left femoral vein. Her arterial examination was normal.
A venous duplex was ordered and scheduled to be performed in approximately 3 h.
Obtain an immediate ventilation/perfusion lung scan.
Perform a venogram.
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