Venous thrombosis

Apr 7, 2012 , MUDr. Ján Podhorec

zilni-tromboza.jpg - kopie
zilni-tromboza.jpg - kopie
Venous thrombosis is a condition where blood clots are formed most commonly in the deep veins of the lower extremities. Venous thrombosis is manifested by swelling and severe pain in the lower extremity. This disease is especially dangerous if a blood clot migrates from the legs into the lungs and gives rise to a serious and life-threatening condition - pulmonary embolism.

Venous thrombosis

Venous thrombosis is a condition where the vein is clogged by a blood clot. In the United Kingdom more than 63,000 people a year have venous thrombosis. Venous thrombosis is a problem that, despite extensive and modern treatment, can still cause the patient's death. Venous thrombosis commonly affects the so-called deep veins of the lower extremities. This does not mean that venous thrombosis can not occur in other veins, for example in the veins of the neck, or even the brain.

Causes of venous thrombosis

There are many causes leading to the formation of blood clots and thus the formation of venous thrombosis. They are especially increased blood clotting, slowing of blood flow and damage of the venous wall.

  • Increased blood clotting can be hereditary, when the patient suffers from a lack of various enzymes and clotting factors. However, this condition is possible to obtain in life. Some tumors can release substances that increase blood clotting. The same effect also has hormonal contraception.
  • The slowdown of blood flow occurs e.g. after prolonged immobilization of the patient whether in terms of standing, sitting, or lying in bed. Blood flow can be slowed down by a tumor, which oppresses the respective blood vessel.
  • Damage to the venous wall may occur after injury, injection, as a consequence of smoking, or after the introduction of catheters.

Symptoms of venous thrombosis

Venous thrombosis mainly affects the deep vein system of the lower extremities, but may occur in the veins of the arms, pelvis, or the chest. However, the most frequent is thrombosis of the lower limbs. Such a patient experiences sudden swelling of the legs, pain during rest and especially during exercise. It is caused by accumulation of blood, which has an impaired outflow. Skin at the site of thrombosis is warm and reddish. Moreover, significant pain is present.

Complications of venous thrombosis

Venous thrombosis is a serious condition that has a number of complications. The most dangerous of them is when the thrombus breaks loose and causes pulmonary embolism. Massive pulmonary embolism, where the main branch of the pulmonary artery is clogged is a fatal disease that can occur without previous symptoms. If repeatedly embolism of small thrombi occurs this may lead to the development of pulmonary hypertension. Another complication is damage of the veins in the area where the thrombus is attached and it can lead to varicose ulcers. Sometimes the blood clot disappears by itself without any effects.

Diagnosis of venous thrombosis

Diagnosis of venous thrombosis includes a detailed anamnesis and physical examination by a physician. It is based on the already mentioned symptoms. It is also possible to carry out specific tests that indicate the presence of venous thrombosis. An essential part of the diagnosis of venous thrombosis is blood analysis that focuses on the presence of D-dimers. From imaging methods ultrasound of the veins is used, which confirms or excludes the presence of blood clots. In difficult cases it is possible to use the so-called CT phlebography. It is a image of blood vessels using computerized tomography, which are pre-injected with a contrast agent.

Treatment of venous thrombosis

In the case the presence of venous thrombosis is confirmed it is necessary to initiate anticoagulant therapy as soon as possible. For this heparin is injected. If the blood clot is located in the abdomen, pelvis, or chest, transcatheter treatment is performed. This consists in the introduction of a catheter, e.g. a long, thin tube up to a blood clot that is mechanically and chemically disrupted. This type of treatment is not suitable for older patients or in the presence of associated diseases, since it increases the risk of bleeding. Even after this treatment heparin is injected. After stabilization the patients are transferred to warfarin, a drug in a pill form, which has an anticoagulant effect. These patients should visit the doctor every 4-6 weeks for blood analysis for blood clotting.

Prognosis of venous thrombosis

Although in recent years correct and early diagnosis and treatment of deep vein thrombosis significantly improved, the number of affected people almost unchanged. Long-term prognosis of patients with a history of deep vein thrombosis depends on many factors. Serious cases that get more complicated, can often lead to death. It is therefore necessary in the case of the above mentioned symptoms to visit a doctor immediately.

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