Venous thromboembolic disease in the elderly patient: atypical, subtle, and enigmatic.

Venous thromboembolic disease (VTE) is a common medical condition in the geriatric population. Risk factors include congestive heart failure, cancer, orthopedic conditions such as hip fractures, and other debilitating diseases. Clinical presentations of patients who have VTE may be subtle and atypical. Traditional vital sign abnormalities found in patients who have VTE may be absent in the older patient, and presentations such as isolated syncope without chest pain or dyspnea are common. This article provides information that will allow primary care providers to increase their rate of detection of VTE, particularly pulmonary embolism. By having an appreciation for the subtle and atypical presentations of VTE, they will be in a position to significantly lower morbidity and mortality in older patients.