Deep Venous Thrombosis
Deep Venous Thrombosis is a condition wherein a blood clot develops in a deep vein that accompanies an artery, mostly in the lower limbs. Consequently, the clot affects blood circulation.
Usually thrombosis sets in when the coagulation function is impaired or imbalanced due to abnormalities in the blood, altered blood flow or damage to the blood vessels. Typically the main veins affected by deep venous thrombosis are inner thigh, calf, groin and lower abdomen. A person suffering from deep venous thrombosis is likely to experience pain and swelling in the affected limbs. The pain in the affected leg can become so severe that the person is unable to bear weight on it. This condition is different from arterial thrombosis where the clot forms in the arteries. The main risk factor associated with deep venous thrombosis is that the clot may break off and travel along the blood stream to lodge itself in the lungs, heart or brain. This disease is usually noticed in adults over 60 years.
Deep venous thrombosis is brought about by reduced blood flow or thickening of the blood. Persons who have undergone surgery and been given anti-clotting drugs are likely to develop this condition. Long car or plane journeys, fractures, birth control pills and surgery are potential conditions that may lead to this disease. Those with a history of polycythemia vera or hypercoagulability are more likely to suffer this condition. One of the potential dangers of deep venous thrombosis is pulmonary embolism. Pulmonary embolism is a serious, life-threatening condition where the embolism blocks or closes the artery in the lung. Another complication of deep venous thrombosis is post-thrombotic syndrome characterized by edema, hyperpigmentation and skin ulceration.
Some of the diagnostic tests that help detect deep venous thrombosis are ultrasound Doppler, venograpy of the legs and D-dimer blood test. The Doppler ultrasound aids in studying the reduced blood flow in the affected limbs. The venogram is a special x-ray that reveals any blood clot that is responsible for obstructed blood flow. The blood tests can reveal the clotting tendency. Heparin is an anticoagulant that has been intravenously given to a patient along with oral warfarin. These medications cause an increase in clotting time. But careful monitoring is of the essence so as to avoid risk of haemorrhage.
Plethysmography
Plethysmography is a diagnostic tool that is used to measure flow or pressure. Body plethysmography test involves sitting inside an airtight box and breathing to a particular volume. Blood pressure cuffs are placed around your arm and leg. The patient undergoing plethysmography test must remove clothing on arm and leg and refrain from smoking at least half hour prior to the test. The consequent expansion and decompression of the chest volume allows physicians to rule out any blockages in the limbs as it measures systolic blood pressure. Any abnormal readings can be indicative of arterial occlusive disease, vascular disease or blood clots or even deep venous thrombosis. This test is also referred to as arterial plethysmography and is a vital pulmonary function test. Plethysmography is often used to determine bronchial reactions to histamine or metacholine. But this test is not as accurate as arteriography.
Thrombophlebitis
Thrombophlebitis is derived from the word 'thrombo' which means clot. Phlebitis indicates a swollen or inflammed vein. Thrombophlebitis is a blood circulatory condition that is caused by blood clots. It occurs mostly in the legs. Thrombophlebitis can occur at a superficial or deeper level. Superficial thromboplebitis occurs more commonly and is seldom life threatening. On the other hand, deep venous thrombosis affects larger and deeper veins. Sometimes there may be a condition of both superficial and deep vein components. In cases where there is superficial thromboplebitis, care must be taken to ensure that it does not cascade into condition where the deep veins are involved. Most cases of superficial thrombophlebitis resolve by themselves in a couple of weeks. It is when the deeper veins are affected that the clot can hamper or even cut off the bloodstreem. The clot can travel through the blood and block circulation in vital organs such as the heart or lungs.
One of the common causes for thrombophlebitis is hospitalization due to surgery or bedrest. This is because thrombophlebitis is caused from long periods of inactivity. Long airplane journeys can reduce blood flow through the veins and lead to the formation of clots. Varicose veins, pregnancy or complication of IV tubes can lead to thrombophlebitis. Women using oral contraceptives or undergoing HRT are at increased risk of developing thrombophlebitis. If you have a family history of blood clots, you may be at risk of thrombophlebitis. When a patient suffers from thrombophlebitis, the leg veins become swollen and hard to touch. There is redness and swelling in the affected area. When a person suffers from superficial thrombophlebitis, he/she might feel a hard and tender cord barely under the surface of the skin.
Diagnostic tools such as Doppler ultrasound or blood coagulation studies help in examining a patient for thrombophlebitis. For mild cases of superficial thrombophlebitis, you can take analgesics to reduce pain and nonsteroidal anti-inflammatory drugs for inflammation. To reduce the pain or discomfort and the swelling, support stockings and elevation of the affected extremity are usually recommended. In cases of deep venous thrombophlebitis, thrombolytic drugs are prescribed to melt the clots. Antibiotics are prescribed to treat any infection. Supportive hose or stockings can help in reducing swelling. Keeping the leg elevated prevents excess fluid in the affected area. Application of moist heat on the affected area helps in reducing pain. In high-risk cases of deep venous thrombophlebitis, surgery is used to strip out the affected vein or bypass the clot. Anticoagulants or blood thinners to prevent new clots from forming.
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