Venous Thrombosis vs Arterial Thrombosis - Differential Diagnosis Framework



VENOUS THROMBOSIS



 • Acquired Risk Factors:

	- >48 hours of immobility

	- Hospital admission

	- Surgery

	- Malignancy

	- Previous thromboembolism



 • Inherited Thrombophilia:

	- Factor V Leiden mutation

	- Prothrombin gene mutation (G20210A)

	- Protein S deficiency

	- Protein C deficiency

	- Antithrombin deficiency

	- Homocysteinemia

 • Hematological:

	- HIT, PNH, Myeloproliferative disease, Hyperviscosity, TTP, APLS

 • Malignancy

 • Surgery

 • Trauma

 • Compression: Paget-Schroetter, May-Thurner

 • Intravenous Drug Use

 • Pregnancy

 • Drugs:

	- Oral and transdermal contraceptives

	- HRT

	- Tamoxifen

	- Bevacizumab

	- Glucocorticoids

	- Testosterone

	- Coumadin skin necrosis

 • Nephrotic Syndrome, Ischemic Liver, IBD

 • COVID-19

 • Fat Emboli



ARTERIAL THROMBOSIS



Arterial Embolism

 • Thrombus or plaque originating from aneurysms or atherosclerotic lesions (atheroemboli)

 • Aorta

	- Aortic dissection

	- Aortic mural thrombus

 • Paradoxical Embolism

 • Cardiac:

	- Atrial thrombus - atrial fibrillation

	- Left ventricular thrombus

	- Debris from prosthetic valves

	- Infected cardiac valves (septic emboli)

	- Myxoma

 • Cholesterol Emboli



Arterial Thrombosis:

 • Atherosclerotic plaque

 • Dissection

 • Aneurysm

 • Hypercoagulability:

	- Malignancy

	- Antiphospholipid antibodies (APLS should be considered in all cases of arterial thrombosis in young patients (<50 years) without cardiovascular risk factors)

	- Hyperhomocysteinemia

	- Heparin-induced thrombocytopenia

	- Disseminated intravascular coagulation and other causes of purpura fulminans

	- COVID-19

	- PNH

	- Vasculitis

 • Injury

 • Thrombosis Following Intervention

 • In-Situ Thrombosis



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