What is venous thromboembolism?
the term Venous thromboembolism (VTE) encompasses two basic clinical entities, the Deep Vein Thrombosis (DVT), which is the formation of a thrombus, which are clots within a vessel, in the deep veins, most commonly in the lower limbs and the Pulmonary Embolism (PE), which occurs when a thrombus, or a piece of it, breaks off and migrates to the lung.
How is pulmonary embolism related to DVT?
A Pulmonary embolism is the most feared acute complication of TVP, as it can quickly lead the patient to sudden death. Furthermore, the TEV can lead to chronic complications, such as SPost-Thrombotic syndrome (chronic pain and swelling), through the formation of varicose veins, to the appearance of ulcers in the lower limbs and chronic pulmonary hypertension, extremely disabling conditions.
What are the risk factors for Venous Thromboembolism?
Several acquired or genetic diseases and some clinical situations are associated with Venous Thromboembolism and, therefore, the risk of pulmonary embolism. Among them, we can highlight:
- Cancer and chemotherapy;
- Surgeries (especially major orthopedic and oncological surgeries);
- Prolonged hospital stays (clinical or surgical);
- Major orthopedic trauma;
- Age over 40 years old;
- Overweight and obesity;
- Life habits such as a sedentary lifestyle and smoking;
- I use hormones (combined oral contraceptives and hormone replacement therapy);
- Pregnancy and postpartum;
- Acquired or genetic thrombophilia;
- Long-term air travel (over six hours).
In addition to these, a personal or family history rich in cases of TVP or EP, it is also considered an important risk factor for its development.
What are the signs and symptoms of Deep Vein Thrombosis?
The signs and symptoms of Deep Vein Thrombosis (DVT) can manifest as:
- Edema (swelling), most common sign;
- Pain (most common symptom);
- Increase in local temperature;
- Dilation of superficial veins;
- Feeling of heaviness;
- Muscle stiffness in the affected limb;
- Flushing (redness) or Cyanosis (purple color).
How to diagnose VTE?
When experiencing any of the signs and symptoms of Deep Venous Thromboembolism (TVP) or Pulmonary Embolism (PE)the key is to seek guidance from a medical specialist.
Failing this, you should look for a Emergency Service nearest, where you can undergo complementary imaging exams, such as, for example, Doppler ultrasoundfor TVP it’s at CT pulmonary angiography for PE or laboratory (D-Dimer) that can help define or exclude the diagnosis, and guide appropriate treatment to alleviate symptoms and prevent acute and chronic complications.
What is the treatment for VTE?
A base do treatment of venous thromboembolism they are the anticoagulant medicationsorally or parenterally (subcutaneously or intravenously) for a minimum period of three to six months.
The need for hospitalization for initial treatment is at the discretion of the medical team, as there are more critical situations, in which there is a need to use medications that dissolve clots (thrombolytics), but with a greater risk of bleeding.
The duration of treatment It is normally defined by evaluating the initial episode, the associated risk factors, the patient’s profile and the risk of recurrence or bleeding during treatment.
How to prevent Venous Thromboembolism
To prevent Venous Thromboembolism (VTE) It is important to change lifestyle habits:
- Immediate and definitive cessation of smoking;
- Abolition of a sedentary lifestyle, with regular physical activity, preferably supervised;
- Progressive reduction in body weight, until the elimination of overweight or obesity.
In the case of future exposure to a situation where there is known to be risk of VTELike for example, pregnancy, surgery, or long-term air travela consultation with a specialist doctor must be scheduled for guidance and the definition of prophylactic measures, such as, for example, elastic stockings and/or with Devices pneumatic compression intermittent, which increase the speed of blood flow in the leg veins, associated or not, to anticoagulant medications (pharmacoprophylaxis).
In situations where there is a need for hospitalization, for clinical or surgical reasons, the attending medical teams must usually and systematically assess the risk and benefit of subjecting the patient to treatment or not. TEV prophylaxis. If the patient or a family member has not noticed this concern, it should be questioned for their own protection.
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