Deep vein thrombosis

Description

Deep vein thrombosis – a condition that occurs when a blood clot (thrombus) forms in one or more of the deep veins of the body, usually in the legs.Deep vein thrombosis can cause pain and swelling in the legs, but can occur and asymptomatic.

Deep vein thrombosis develops, if you have certain diseases that affect blood clotting.Deep vein thrombosis also occurs if you do not move for a long time, for example, after surgery or trauma.

Deep vein thrombosis – a serious disease, as blood clots in the veins can break off at flow system enter the lungs, causing the development of pulmonary embolism.

symptoms

Symptoms and signs of deep vein thrombosis:

• Swelling of the affected leg.Rarely can occur edema of both feet.
• Pain in the legs.The pain often occurs in the calves and can be felt as a spasm or tenderness.Sometimes thrombosis occurs without noticeable symptoms.

When to see a doctor

If you develop symptoms of deep vein thrombosis, contact your doctor to determine the tactics of action.

If you develop a clinical picture of pulmonary embolism (PE) – you require immediate medical attention.

Symptoms of pulmonary embolism:

 

• Unexplained sudden onset of shortness of breath
• Chest pain, discomfort that gets worse with a deep breath or cough
• Dizziness, fainting
• rapid pulse
• Coughing blood

Causes

Deep vein thrombosis occurs when a blood clot formed in the veins.Their formation can be caused by various factors that disrupt the normal circulation.

Risk factors

Many factors increase the risk of deep vein thrombosis (DVT), and the more of them you have, the higher the risk.For example:

• Hereditary diseases of the blood coagulation system.Some people inherited disease which leads to an easier clotting.The hereditary disease may not cause problems until it is combined with one of the other risk factors
• Paralysis, a long stay in the hospital. When the legs remain motionless for long periods, the calf muscles do not contract, blood flow is impeded thereby, increasing the risk of developing blood clots.
• Damaged during the operation. Venous injury or surgery may increase the risk of blood clots.
• Pregnancy. During pregnancy increases pressure on the veins of the pelvis and lower extremities.Women with hereditary disorders of the coagulation system are in high-risk groups.The risk of thrombosis is maintained for up to six weeks after delivery.
• Hormone replacement therapy, oral contraceptives (OCs). OK, and hormones can increase the blood’s ability to clot.
• Overweight, obesity. Excess weight increases the pressure on the veins of the pelvis and lower extremities.
• Smoking. Smoking affects the clotting mechanisms and blood circulation, which can increase the risk of DVT.
• Cancer. Some forms of cancer increase the number of triggering clotting substances in the blood.Some forms of treatment of cancer also increases the risk of thrombosis.
• Heart failure. People with heart failure are at greater risk of developing DVT and pulmonary embolism.Because people with heart failure functional activity of the heart and lungs have reduced symptoms caused by even a small thromboembolism, can be quite noticeable.
• Inflammatory diseases of the gastrointestinal tract. Crohn’s disease and ulcerative colitis increase the risk of DVT.
• Personal or family history of deep vein thrombosis, pulmonary embolism. If someone in your family develop data syndromes, you are at risk.
• Age. Age older than 60 years increased the risk, although DVT can develop at any age.
• Sitting for a long time,such as while driving or flights. When your legs remain still for hours, calf muscles do not contract, which normally ensures the normal circulation of the blood.Blood clots can form in the legs, if the calf muscles do not work for a long time

complications

With regard to complications, you can say that they are related to pulmonary embolism.

Pulmonary embolism (PE)

PE occurs when blood flow in the pulmonary artery is blocked by a blood clot, which is delivered to the bloodstream from another part of the body, usually from the deep veins of the legs.

PE can lead to death.Therefore, it is important to be under observation for symptoms of thromboembolism and seek emergency medical attention if they develop.Symptoms:

• Unexplained sudden onset of shortness of breath
• Chest pain, discomfort that gets worse with a deep breath or cough
• Dizziness, fainting
• rapid pulse
• Coughing blood
• Post-thrombotic syndrome (PTS)

Frequent complication that develops after deep vein thrombosis – a condition known as post-thrombotic syndrome.several signs and symptoms are combined in the syndrome, including:

• Swelling of the legs
• Pain in the feet
• Livor
• Trophic ulcers

This syndrome is caused by damage to the vascular wall of a blood clot.Damage reduces blood flow in the affected area.PTS symptoms may develop within a few years after the occurrence of deep vein thrombosis.

How to prepare for reception of the doctor?

Typically, patients do not have time for special preparation for treatment to the doctor about deep vein thrombosis.DVT is treated as a medical emergency, so it is important to seek help quickly.

If you have time before applying a good idea – to prepare some information.Here are some points to help you prepare and know what to expect from the doctor.

what can you do

• Write down all the symptoms that you are experiencing,including those that may seem unrelated to DVT.
• Record any important personal information, especially if you have a family history of diseases of the blood coagulation system.
• Make a list of medications, vitamins and supplements that you take.
• Bring a family member or friend, if possible.Sometimes it can be difficult to remember all the information provided during the treatment.Someone who will take you may remember something that you missed or forgot.
• Be prepared to talk about hospitalizations,illnesses, operations, injuries in the past three months, or recent travel more than six hours at a time.
• Write down questionsyou want to ask the doctor.

Prepare a list of questions can help to spend more time with the doctor.For DVT questions may be as follows:

• What are the most likely reasons for my condition?
• What examinations do I need?
• What treatment is best?
• What level of physical activity do I need now?Can clots disappear?
• Should I restrict physical activity or travel plans?
• What are the alternatives to the primary approach that you recommend?
• I have other chronic diseases.How can I treat them together?
• Do you have any brochures or printed material that I can take with me?What sites do you recommend?

 

What should I expect from a doctor

Your doctor is likely to ask you a series of questions, such as:

• When did you begin experiencing symptoms?
• Have you had any recent periods of low activity, such as long sitting or lying down?
• Your symptoms bother you always, or are they coming?
• How strong are your symptoms?
• What, if any, it improves your symptoms?
• What, if any, aggravates your symptoms?
• Do you have any family history of diseases associated with thrombosis?

Diagnostics

For the diagnosis of DVT doctor will ask you a few questions to the account of your symptoms.You will also be subjected to a physical examination for swelling, soreness or change in skin color.Based on the probability of thrombosis, the doctor may prescribe a further examination, including:

• US. The device, similar to the wand (transducer) is placed on that part of the body where it can be a blood clot, and examined it with the sound waves.As you progress through the waves and their return back to the sensor, the computer generates a dynamic image of the waves on the screen.The thrombus may be visible in the image.

Sometimes it takes the ultrasonic series of studies in order to ensure that thrombus does not increase in size or that new thrombi are formed.

• . Blood tests Almost all people who have undergone DVT have increased levels of the substance, which is formed from the decay of blood clots – D-dimer.
• Phlebography.Contrast is injected in the veins of the legs.With the help of X-rays generated image vascular veins of the legs, which are trying to detect blood clots.However, the diagnosis can be confirmed and less invasive methods – such as ultrasound.
• CT or MRI. And computed tomography, and magnetic resonance imaging can provide an image of the veins and show whether there is blood clots.Sometimes thrombi found in the study for other reasons.

Treatment

The goal of treatment of deep vein thrombosis is to prevent thrombus growth and detachment, which may lead to the development of PE.Thereafter, the purpose is to reduce the likelihood of rethrombosis.

Treatment options:

• Krovorazzhizhayuschie drugs.The drugs for treatment of DVT include anticoagulants are sometimes referred krovorazzhizhayuschimi preparations in all cases where it is possible.This drug, which reduces the blood’s ability to clot.Although they do not destroy existing blood clots may prevent the increase and reduce the risk of further blood clots

Generally, treatment begins with heparin infusion for several days.After initiation of the administration of heparin, the treatment may be continued with other injectable forms anticoagulants such as enoxaparin, fondaparinux or dateparin.Other anticoagulants used in the form of tablets – warfarin, rivaroxaban.Latest krovorazzhizhayuschie drugs in the near future may acquire additional effects.

You may need to receive these funds for three months or longer.If you are assigned to anticoagulants, it is important to take them strictly in the mode in which the appointed doctor.Anticoagulants have significant side effects when too small or a large reception.

You may need periodic blood tests to assess clotting properties.Pregnant women should not take certain anticoagulants.

• Thrombolytics. If you have expressed deep vein thrombosis or pulmonary embolism, or when other drugs do not work, you may need other medicines.

One group of such drugs – thrombolysis.These drugs, called tissue plasminogen activators, used for destruction of thrombi and can be administered through a catheter inserted in the place of thrombosis.This type of medication can cause severe bleeding and is usually used only for life-threatening conditions.For these reasons, it is used only thrombolytics ICU in hospitals.

• Installing filters. If you can not use blood thinners in the vena cava (v.cava) special filter can be installed.Cava filter prevents the ingress of the separated blood clot in your lungs.
• Compression garment.Its use is aimed at preventing edema associated with venous thrombosis.Socks are worn on the legs at the level of the foot to the upper third of the thighs.

pressured them helps reduce the likelihood that blood begins to stagnate and curdle.Wear stockings data on a daily basis for two to three years, if possible.Wearing compression hosiery can prevent the development of PTS.

Changes in lifestyle and home treatment

After receiving treatment for DVT should monitor their diet and checked for signs of increased bleeding, and at the same time take steps for the prevention of recurrent thrombosis.It should be:

• See your doctor regularly to check whether or not to change or modify the treatment.If you are taking warfarin, you need to donate blood for the assessment of clotting functions.
• Take your medications exactly as prescribed. If you have had an episode of DVT, take anticoagulants for at least 3-6 months.
• Watch out for vitamin K intake, if you are taking warfarin.Vitamin K can alter the effect of warfarin.Green leafy vegetables are rich in vitamin C. Talk with your doctor or nutritionist about diet for the duration of warfarin.
• Watch for excessive bleeding, which can be a side effect of krovorazzhizhayuschih funds.Talk to your doctor about activities that can lead to bruises or cuts, as even minor damage can be a serious danger when taking krovorazzhizhayuschih funds.
• Proceed. Early activation after being in bed, for example after operation, it minimizes the risk of deep venous thrombosis.
• Wear a compression garment to prevent clotting, if the doctor recommends it to you.