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Deep Vein Thrombosis

Deep Vein Thrombosis

Deep Vein Thrombosis or DVT is a condition where blood clots are formed in a deep vein, typically in the leg. A blood clot in the deep vein of a leg is not dangerous as such. The possibility of pulmonary embolism must be ruled out when treating a case of deep vein thrombosis. A thrombus can form in the leg veins due to prolonged sitting, especially during airplane travel. Patients recovering in a hospital post surgery are also susceptible to DVT. Pregnant women and obese persons are at greater risk for developing DVT. Smokers and women on birth control pills are also likely to suffer this condition.

Typical symptoms of DVT include pain and swelling in the leg. The surface veins may appear dilated. The affected area is warm and tender. D-dimer is a blood test that is done to check for presence of a blood clot. A ultrasound can help determine a clot in the leg. CT scan or MRI scan are used to check for venous thrombosis

Superficial blood clots due to DVT can be treated with warm compress and anti-inflammatory medication. In some cases, blood thinning or anticoagulation medication may be needed. Warfarin or Enoxaparin are prescribed for anti-coagulation. The patient's INR or prothrombin time is measured to decide on the medication.

Persons who are at increased risk of developing DVT can take low dose aspirin before a long flight. Foot exercises can aid blood circulation. Compression stockings are used for those who are immobile due to surgery or ill health. If a person suffering from DVT develops symptoms such as chest pain or dizziness, it is necessary to see a doctor at once as it might be indicative of pulmonary embolism.

Pulmonary Embolism

When an artery in the lungs gets blocked, it is referred to as a medical condition of Pulmonary embolism. This condition can be life threatening. Often deep vein thrombosis(DVT) can lead to pulmonary embolism. The blood clots may originate in any other part of the body such as the arm, pelvis or legs. These clots travel through the bloodstream and enter the pulmonary arteries. Recent surgery or injury can lead to a blood clots. Persons with heart disease or those on estrogen therapy are at increased risk of pulmonary embolism. Typical symptoms experienced by those suffering from pulmonary embolism are chest pain, sudden shortness of breath and rapid heartbeat. A patient might have wheezing and weak pulse. The symptoms of pulmonary embolism depend on the extent and size of clots. Embolus can also be the result of fat from the bone marrow that has escaped into the bloodstream. It can also occur due to air bubbles formed during intravenous infusion or surgery. While large emboli cause considerable distress such as chest pain, smaller ones cause shortness of breath. Patients suffering from pulmonary embolism tend to have cough that produces sputum. There may be bluish discolaration on the skin and pain in the legs. Fainting spells or seizures might occur due to sudden decrease in oxygen-rich blood to the brain and other organs. Bluish tint on the skin (cyanosis) is observed when one or more large pulmonary arteries are obstructed.

Diagnostic procedures to detect pulmonary embolism:

Chest X-ray helps in identifying any lung infections

CAT scan

ECG

Perfusion Scan of the lung - This test helps in outlining the blood flow to the lungs and helps in detecting any obstructions.

V/Q scan involves a a nuclear ventilation-perfusion study of the lungs.

Pulmonary angiogram involves injection of a special dye into the pulmonary arteries to detect obstructive clots.

D-dimer test is a test that spots d-dimer molecules released by the clots.

One of the initial steps to help a person suffering from pulmonary embolism is administration of oxygen and analgesics. Oxygen is administered through a nasal cannulae or face mask. Blood clots are treated with anticoagulant drugs like heparin or warfarin. But the duration and dosage of anticoagulants needs to be monitored so that it does not result in bleeding in other body organs. Thrombolysis is a procedure whereby thromoblytic agents (clot-dissolving agents) are injected into the bloodstream to dissolve existing blood clots. Surgery (Pulmonary embolectomy) is often resorted to for removal of clots.