Wednesday, July 26, 2023

What is thrombosis?

 Thrombosis is the formation of a blood clot, either partial or complete, within blood vessels, whether venous or arterial, limiting the natural flow of blood and resulting in clinical sequelae

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 Venous thrombosis is when the blood clot blocks a vein, while arterial thrombosis is when the blood clot blocks an artery
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 Deep vein thrombosis (DVT) is a blood clot in a vein, usually in the leg, and it can be dangerous
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 Symptoms of DVT in the leg include throbbing pain, swelling, and warm skin around the painful area
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 Phlebitis (fle-BYE-tis) means inflammation of a vein, and thrombophlebitis is due to one or more blood clots in a vein that cause inflammation
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 Superficial phlebitis usually develops after you’ve had a mild trauma to one of your veins, such as having an IV line
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 Symptoms of phlebitis include pain, swelling, redness, and warmth around the affected area
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 Pulmonary embolism (PE) is a blood clot that develops in a blood vessel in the body, often in the leg, and it then travels to a lung artery where it suddenly blocks blood flow
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 Symptoms of acute PE include chest pain, shortness of breath, cough with blood, lightheadedness, and fainting
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The causes and risk factors of thrombosis include endogenous patient characteristics such as obesity and genetic factors, and triggering factors such as surgery, immobility, or pregnancy
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 Venous thrombosis may be caused by disease or injury to the leg veins, while arterial thrombosis may be caused by a hardening of the arteries, called arteriosclerosis
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 Risk factors convincingly demonstrated for venous thromboembolism (VTE) include increasing age, prolonged immobility, malignancy, major surgery, multiple trauma, prior VTE, and chronic
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 Genetic conditions that increase the risk of blood clot formation, certain medicines such as birth control pills and estrogen replacement therapy, obesity, enlarged veins in the legs, and cigarette smoking are also risk factors for pulmonary embolism
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Doctors diagnose thrombosis through physical examination, medical history, and diagnostic tests such as ultrasound, CT scan, MRI, and blood tests
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 Treatment for thrombosis depends on the location and severity of the clot. Preventive strategies such as using pneumatic devices and prophylactic anticoagulation are a standard of care in hospital medicine, and such strategies are based on identifying the underlying risk factors in an individual patient
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 Treatment for DVT includes anticoagulant medication, compression stockings, and in some cases, surgery
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 Treatment for phlebitis includes medication, compression stockings, and in some cases, minimally invasive surgery
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 Treatment for PE includes anticoagulant medication, thrombolytic therapy, and in some cases, surgical procedures such as pulmonary thromboendarterectomy
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If you think you have DVT, ask for an urgent GP appointment or call 111. If you have symptoms of DVT like pain and swelling of the leg, along with either breathlessness or chest pain, phone 999 or go to A&E immediately
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 If you have symptoms of acute PE, such as chest pain, shortness of breath, cough with blood, lightheadedness, and fainting, it's important to call your doctor immediately or go to the emergency room
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Thrombosis is the formation of a blood clot, either partial or complete, within blood vessels, whether venous or arterial, limiting the natural flow of blood and resulting in clinical sequelae[15]. Venous thrombosis is when the blood clot blocks a vein, while arterial thrombosis is when the blood clot blocks an artery[5]. Deep vein thrombosis (DVT) is a blood clot in a vein, usually in the leg, and it can be dangerous[3]. Symptoms of DVT in the leg include throbbing pain, swelling, and warm skin around the painful area[3]. Phlebitis (fle-BYE-tis) means inflammation of a vein, and thrombophlebitis is due to one or more blood clots in a vein that cause inflammation[2]. Superficial phlebitis usually develops after you’ve had a mild trauma to one of your veins, such as having an IV line[12]. Symptoms of phlebitis include pain, swelling, redness, and warmth around the affected area[7]. Pulmonary embolism (PE) is a blood clot that develops in a blood vessel in the body, often in the leg, and it then travels to a lung artery where it suddenly blocks blood flow[4]. Symptoms of acute PE include chest pain, shortness of breath, cough with blood, lightheadedness, and fainting[13]. 

The causes and risk factors of thrombosis include endogenous patient characteristics such as obesity and genetic factors, and triggering factors such as surgery, immobility, or pregnancy[6]. Venous thrombosis may be caused by disease or injury to the leg veins, while arterial thrombosis may be caused by a hardening of the arteries, called arteriosclerosis[5]. Risk factors convincingly demonstrated for venous thromboembolism (VTE) include increasing age, prolonged immobility, malignancy, major surgery, multiple trauma, prior VTE, and chronic[11]. Genetic conditions that increase the risk of blood clot formation, certain medicines such as birth control pills and estrogen replacement therapy, obesity, enlarged veins in the legs, and cigarette smoking are also risk factors for pulmonary embolism[4]. 

Doctors diagnose thrombosis through physical examination, medical history, and diagnostic tests such as ultrasound, CT scan, MRI, and blood tests[1]. Treatment for thrombosis depends on the location and severity of the clot. Preventive strategies such as using pneumatic devices and prophylactic anticoagulation are a standard of care in hospital medicine, and such strategies are based on identifying the underlying risk factors in an individual patient[1]. Treatment for DVT includes anticoagulant medication, compression stockings, and in some cases, surgery[3]. Treatment for phlebitis includes medication, compression stockings, and in some cases, minimally invasive surgery[12]. Treatment for PE includes anticoagulant medication, thrombolytic therapy, and in some cases, surgical procedures such as pulmonary thromboendarterectomy[4]. 

If you think you have DVT, ask for an urgent GP appointment or call 111. If you have symptoms of DVT like pain and swelling of the leg, along with either breathlessness or chest pain, phone 999 or go to A&E immediately[3][8]. If you have symptoms of acute PE, such as chest pain, shortness of breath, cough with blood, lightheadedness, and fainting, it's important to call your doctor immediately or go to the emergency room[13].

Citations:
[1] https://www.ncbi.nlm.nih.gov/books/NBK470215/
[2] https://www.webmd.com/dvt/phlebitis
[3] https://www.nhs.uk/conditions/deep-vein-thrombosis-dvt/
[4] https://www.hopkinsmedicine.org/health/conditions-and-diseases/pulmonary-embolism
[5] https://www.hopkinsmedicine.org/health/conditions-and-diseases/thrombosis
[6] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2020806/
[7] https://www.osmosis.org/answers/phlebitis
[8] https://www.nhsinform.scot/illnesses-and-conditions/blood-and-lymph/deep-vein-thrombosis
[9] https://www.medicalnewstoday.com/articles/complications-of-pulmonary-embolism
[10] https://my.clevelandclinic.org/health/diseases/22242-thrombosis
[11] https://www.ahajournals.org/doi/full/10.1161/01.CIR.0000078469.07362.E6
[12] https://www.aurorahealthcare.org/services/heart-vascular/conditions/phlebitis
[13] https://my.clevelandclinic.org/health/diseases/16911-deep-vein-thrombosis-dvt
[14] https://www.mayoclinic.org/diseases-conditions/pulmonary-embolism/symptoms-causes/syc-20354647
[15] https://www.ncbi.nlm.nih.gov/books/NBK538430/
[16] https://www.heart.org/en/health-topics/venous-thromboembolism/risk-factors-for-venous-thromboembolism-vte
[17] https://www.mayoclinic.org/diseases-conditions/thrombophlebitis/symptoms-causes/syc-20354607
[18] https://www.stoptheclot.org/learn_more/signs-and-symptoms-of-blood-clots/
[19] https://www.healthline.com/health/pulmonary-embolism-complications
[20] https://thrombosis.org/patients/what-is-thrombosis/
[21] https://www.worldthrombosisday.org/know-thrombosis/risk-factors/
[22] https://www.healthline.com/health/phlebitis
[23] https://www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/pulmonary-embolus
[24] https://www.mayoclinic.org/diseases-conditions/deep-vein-thrombosis/symptoms-causes/syc-20352557
[25] https://www.cdc.gov/ncbddd/dvt/facts.html
[26] https://www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/thrombophlebitis
[27] https://www.nhlbi.nih.gov/health/pulmonary-embolism
[28] https://en.wikipedia.org/wiki/Thrombosis
[29] https://my.clevelandclinic.org/health/diseases/17523-superficial-thrombophlebitis
[30] https://www.ncbi.nlm.nih.gov/books/NBK560551/
[31] https://www.healthdirect.gov.au/thrombosis
[32] https://my.clevelandclinic.org/health/diseases/23311-thrombophlebitis
[33] https://emedicine.medscape.com/article/300901-clinical

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