Deep Vein Thrombosis (DVT)
Deep Vein Thrombosis, popularly known as DVT is the coagulation of blood in the extremities that can cause impaired blood circulation and pulmonary edema. DVT ensues once a blood clot (thrombus) forms within some of the body’s main veins, which happens commonly in the legs, producing discomfort or swelling (Gibson et al., 2021). Deep Vein Thrombosis can also occur if a person has some medical issues that influence blood coagulation.
Pulmonary Embolism (PE)
Pulmonary Embolism, also referred to as PE transpires when a blood clot (thrombus) becomes trapped inside the pulmonary artery and prevents blood flow. PE is often caused by a thrombus that forms in the deep vascular system of the lower limbs. Nevertheless, it is uncommon for it to begin in the pelvic, renal, or upper extremity vessels or the heart’s right chambers (Thrombosis Canada, 2021). Large thrombi might attach at the bifurcation of the main pulmonary vein or the lobar tributaries after going to the lung, causing hemodynamic damage.
Difference Between DVT & PE
On the one hand, DVT is a disorder whereby a blood lump develops in a deep blood vessel, typically in the leg. DVT can occur when sitting or lying down for long durations, such as after surgical recovery or a lengthy aircraft journey. When a person does not move sufficiently, the blood circulation in their legs decreases and collects, resulting in blood clots. On the other hand, PE develops when a clot breaks off and passes through the circulation to the lungs (Gibson et al., 2021). The lump has the potential to stop a blood artery in the lungs, causing harm to them.
Signs and Symptoms Associated with DVT
DVT causes various signs and symptoms, including swelling in the afflicted leg, but inflammation in both legs is uncommon. Pain, usually in the calf, one might also feel like cramping or some discomfort, with red or darker skin surrounding the painful area and a sense of warmth in the involved leg (Thrombosis Canada, 2021). Other aspects include, warm skin and distended veins that are firm or painful when touched surround the painful region.
Causes of DVT
DVT is induced mainly by damage to a vein caused by surgery or trauma and swelling due to infection or injury. Other factors include vein injury, remaining immobilized for an extended period, which leads to slow blood flow, inhibiting anti-clotting agents in the body from effectively mixing in the bloodstream. Chronic health issues may further increase the risk of DVT. These conditions include heart, lung, and gastrointestinal disorders (Gibson et al., 2021). People who have coagulation issues are also more likely to get DVT.
Furthermore, being older, notably over 75 years old, obese, and overweight, raises DVT risk. Since there are fewer motions, both the veins and the blood flow diminish. Pregnancy increases a woman’s risk of DVT, which can last for up to six weeks following birth (Thrombosis Canada, 2021). similar to consuming hormones, the threat is tied to the surge in estrogen while a woman is pregnant and a body function that works to protect the person from having too much loss of blood at childbirth.
What Look for if Suspected of DVT/PE During Physical Examination
There are several aspects to look for during physical examination. Body temperature, heartbeat rate and rhythm, sinus tachycardia or breathing rate, and blood pressure level are vital indications for DVT. Furthermore, lower-extremity DVT is primarily left-sided, above-knee DVT is 2- to 3-fold more common and occurs equally in males and females alike. The prevalence rises with age, notably among those over 60-65 years, especially in women (Thrombosis Canada, 2021). DVT can also impact the skin, causing discoloration, itching, and the development of a rash. Extreme conditions of the post-thrombotic syndrome could also result in the creation of chronic wounds.
A blood clot in the abdomen also develops in the vessels that evacuate blood from the intestines, resulting in severe stomach discomfort, vomiting, nausea, and diarrhea. When blood clots accumulate within blood arteries, however, they may restrict blood circulation, a disease known as thrombosis (Gibson et al., 2021). If an arterial clot breaks loose and passes through the bloodstream, it could also produce blockages that damage the heart, lungs, and other organs. This obstruction can also create significant issues, such as lung damage and reduced oxygen levels in the body, which can shut down these organs.
Medical Tests for DVT
Several medical tests could be conducted to confirm the diagnosis of DVT, including duplex ultrasonography. This is an imaging technique that utilizes sound waves to examine blood circulation and can reveal obstructions or clotting in deep veins. It is the most often used imaging diagnostic to detect DVT. Other tests comprise A D-dimer blood test, which detects compounds in the blood produced when coagulation breaks up. Antiphospholipid Antigens, as well as Prothrombin Time and International Normalized Ratio, also referred to as PT/INR test are among the other tests available (Thrombosis Canada, 2021). Antithrombin, Lupus Anticoagulant Testing, and Protein S and Protein C assays are also performed.
Common Medications for DVT and their Actions
Anticoagulants, often known as blood thinners, are the most commonly prescribed medicines for DVT therapy. These are medications that slow blood coagulation, making blood less liable to clot. Anticoagulants are classified into two types, including warfarin (Coumadin) and heparin. A doctor could also recommend a vena cava filter to treat both DVT and PE. In this procedure, the surgeon inserts a filtration system within inferior vena cava, which is the central vessel that returns blood to the heart from the body (Gibson et al., 2021). The filtering does not prevent clots from developing, but it can collect clots before reaching the lungs.
References
Gibson, C., Zorkun, C., Goel, K., Cadet, J., & Halaby, R. (2021). Deep vein thrombosis physical examination. Wikidoc.org. Web.
Thrombosis Canada. (2021). Thrombosiscanada.ca. Web.