Patient Story
Thomas Jameson, 69, presented with acute right lower extremity pain and swelling that began two days prior to admission. Initially attributing the symptoms to a muscle strain, he delayed seeking care until he developed shortness of breath, prompting a visit to the emergency department. His medical history includes hypertension, Type 2 diabetes, and atrial fibrillation, diagnosed six months ago. A former smoker who quit a decade ago, he lives alone but receives occasional assistance from a home health aide.
On arrival, a venous Doppler ultrasound confirmed a deep vein thrombosis (DVT) in the right popliteal and posterior tibial veins. A CT pulmonary angiogram showed no evidence of pulmonary embolism. ECG demonstrated atrial fibrillation without acute ischemic changes. Given his history of atrial fibrillation and cardiovascular risk factors, he was admitted for anticoagulation therapy with IV heparin.