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Health & Wellness
 CaribbeanChoice : General Discussion : Health & Wellness
Message Icon Topic: What Is Deep Venous Thrombosis Post Reply Post New Topic
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saajida
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Quote saajida Replybullet Topic: What Is Deep Venous Thrombosis
    Posted: 19 June 2007 at 11:36am
A deep venous thrombosis (commonly called DVT) is a blood clot (also called a thrombus) that forms inside deep veins in your legs or pelvis. The clot blocks blood flow and causes pressure to build up in the vein. If part of the clot breaks away, it may move through your bloodstream to your lungs. If the clot blocks one or more of the blood vessels in your lungs, it is called a pulmonary embolism.
 
DVT is a common medical problem. About 1 out of every 2,000 people develops this type of blood clot each year. Most of these clots occur when blood flow in the veins of the legs is slowed, usually as a result of inactivity. Ordinarily, as you walk around, your leg muscles squeeze your veins and keep blood flowing back to the heart. But if you are inactive for many hours such as during a long airplane flight or while recovering from an operation or stroke blood flow in the veins of your legs may slow so much that clots form.
 
Certain people are more likely to get blood clots, including:
  • People with some medical problems, including cancers and inherited abnormalities of the blood-clotting system
  • People on certain medications, such as birth control pills and hormone therapy
  • Pregnant women
  • People who are very overweight
  • People with heart failure
Anyone who develops DVT is at risk of developing a pulmonary embolism. More than 500,000 Americans develop this life-threatening problem each year.
 
A pulmonary embolism can lead to a sudden and sometimes very dramatic decrease in blood flow through the lungs. The decrease in blood flow can reduce the amount of blood flowing to your heart and the rest of your body, which can cause a drop in blood pressure and lead to fainting spells and even sudden death.
 
The blood flow decreases not only because a blood clot is blocking blood flow, but the blockage damages the walls of the lung's blood vessels (pulmonary arteries). The damage releases chemicals that cause multiple blood vessels to constrict (clamp down).
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Quote saajida Replybullet Posted: 19 June 2007 at 11:38am

                                          Symptoms of DVT

Some blood clots in the leg veins do not cause any symptoms. However, when the blood clots involve larger veins, they generally cause redness, warmth, tenderness, swelling (edema), and a sensation of heaviness in the leg, particularly when you've been standing. You can check for edema by pressing your finger into your lower leg. If you have edema, the pressure from your finger will create a small dent in your lower leg for several seconds.
 
A pulmonary embolism may not cause any symptoms, mild symptoms, or serious symptoms that indicate a life-threatening emergency. Symptoms tend to be more severe when the blood clot is larger. Symptoms with a larger clot include sudden shortness of breath and chest pain. The pain tends to be knife-like, and often is worse when you take deep breaths. If the pulmonary embolism is very large, symptoms may be more dramatic, such as a fainting spells, severe shortness of breath, and coughing up blood. A large pulmonary embolus can cause sudden death.
 
When to Call a Professional
  • Call your doctor or go to a hospital emergency room immediately if you develop shortness of breath or sharp chest pain.
  • Call your doctor if you have swelling, pain, redness or warmth in one leg.
  • If you had a LENI test that was inconclusive and your doctor asked you to return in three or four days for another test, call your doctor sooner if your leg swelling worsens.
Expected Duration
If you have a DVT or pulmonary embolism, your symptoms should improve within a few days after starting treatment with blood-thinning medication. However, you will need to take medication for at least three to six months to prevent more blood clots from forming. Most people recover completely, but some people who had a very large pulmonary embolism or who already had lung disease will continue to have lung problems. Some people who have had a DVT develop a long-term problem with swelling of their legs called post-phlebitic syndrome. These people often need to wear special stockings that help squeeze blood back toward the heart.


 

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Quote saajida Replybullet Posted: 19 June 2007 at 11:39am
                                          Diagnosing DVT 

To diagnose DVT, your doctor will examine your legs to check for swelling and tenderness. He or she will ask about your symptoms and risk factors.

Based on the findings, your doctor may order an ultrasound of your legs to look for blood flow problems in your veins. This procedure is called a lower extremity non-invasive test, or LENI. If the LENI shows evidence of a blood clot, your doctor will diagnose DVT. If the test is negative, it does not mean that there is no clot. It may be too early to see the full effect of the clot. In this situation, your doctor may ask that you return in three to four days for a repeat LENI.

If your doctor suspects you have a pulmonary embolism, he or she will first try to determine if you have DVT. If the LENI shows one or more blood clots in your leg veins, and you have symptoms of a pulmonary embolism, an embolism is the most likely diagnosis. Other possible tests include a computed tomography (CT) scan of the chest and a special type of lung scan that uses a small amount of radioactive tracer to detect differences in lung blood flow. If your doctor is still unsure about the diagnosis after these tests have been done, he or she may order a test called a pulmonary angiography. In this procedure, a small tube is threaded into the arteries of the lung and dye is injected to help identify blood clots.

Your doctor may order a blood test called a D-dimer test, which tests for levels of a chemical called D-dimer that increases when blood clots are being formed in the body. An abnormally high level of D-dimer does not automatically mean a diagnosis of pulmonary embolism. However, when a D-dimer blood test is normal in someone at low risk for pulmonary embolism, the test indicates that pulmonary embolism is very unlikely.




Edited by saajida - 19 June 2007 at 11:40am
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Quote saajida Replybullet Posted: 19 June 2007 at 11:42am
                                       
                           Treating DVT
The main treatment for a DVT or pulmonary embolism is a medication called heparin, which thins your blood and helps break up blood clots and prevent new ones from forming. There are two main types of heparin an older type that is best administered by a constant infusion given intravenously (into a vein) and a newer type called low-molecular-weight heparin that is injected under the skin once or twice per day.
 
If you have a DVT without a pulmonary embolism, you may be able to be treated at home with injections of a low-molecular-weight heparin. If you and your doctor determine that you need to start therapy in the hospital, the type of heparin used is determined by many factors, such as body weight, kidney function and other circumstances. If you have a pulmonary embolism, you will probably be hospitalized and treated with either type of heparin, as indicated for your personal situation.
 
You also will start taking warfarin (Coumadin), a blood-thinning medication that comes in pill form. Warfarin takes a few days to start working. Once a blood test shows that it's effective, you will stop taking heparin. You will continue taking warfarin for several months or longer.
 
During the first few weeks that you take warfarin, you will continue to need frequent blood tests to make sure you are taking the right amount. Once your blood test results consistently show that you are taking the right amount of medication, blood can be drawn once a week and eventually once every two to four weeks.
 
Treatment with warfarin usually lasts three to six months, but more recent research indicates that the risk of recurrent blood clots is high and it may help for patients to continue to take warfarin at a lower dose.
 
Some foods especially green, leafy vegetables that contain large amounts of vitamin K can alter the blood-thinning action of warfarin. Ask your doctor or pharmacist for a list of these foods. You can continue to eat these foods as long as you eat approximately the same amount of them each day because then the effect on your medication will be the same every day.
 
Other medications can also affect how warfarin works in your body, so tell any doctor who is prescribing medications for you that you are taking warfarin.
 
Prognosis
Without treatment, a pulmonary embolism can be deadly. With appropriate and timely treatment, the outlook is very good.
 
Once you develop a DVT or pulmonary embolism, you are usually more likely to develop a second blood clot. This is because the original blood clot damaged some of your leg veins. Now, your blood does not move as quickly or smoothly through these veins, raising your risk of a new blood clot. However, if there is a clear reason that the blood clot formed, such as a long bed rest after surgery or an injury that damaged your blood vessels, your risk of developing more blood clots is relatively low unless you are forced to be inactive again or have another injury.
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