Summary
Old age is an independent risk factor of venous thromboembolism. Nevertheless initial
symptoms are often attributed to existing cardiac or pulmonary comorbidity. Once deep
thromboembolism (DTE) is in focus, the synopsis of clinical findings and anamnestic
clues help to take further steps to establish or rule out the diagnosis (e.g. Wells
score). Treatment consists in oral anticoagulation, either by vitamin-k-antagonists
or by direct oral anticoagulants (“DOACs”). Strict compliance of patients or main
caregivers is essential in both cases. Simultaneous medication of platelet-inhibitingor
nonsteroidal anti-inflammatory drugs – often unknown self medication – results in
a raised bleeding risk and should be avoided. If longterm anticoagulation is mandatory,
a strategy of sequential dose-reduced anticoagulation can be considered, especially
in the case of increased bleeding-risk. Systemic fibrinolysis of pulmonary embolism
goes along with a very high bleeding risk in old age and should be performed only
in case of vital circulatory depression or failure.
Keywords
Venous thromboembolism - old age - geriatric patient - oral anticoagulants
