Thrombosis is a disease, in which blood clots are formed in the blood vessels, without any bleeding. Such a clot is called a ‘thrombus’. Thrombosis has the effect that the blood vessel is entirely or partially closed. Thrombosis in a vein can cause deep vein thrombosis in the leg or pulmonary embolism. Thrombosis in an artery can lead to a heart attack or cerebral infarction.
Cause
Risk factors for thrombosis in a vein (venous thrombosis) are:
- Undergoing surgery, especially surgery in which the hip or knee is replaced.
- Long-term bed rest.
- An accident.
- Cancer.
- Pregnancy or just given birth.
- Genetic predisposition to thrombosis.
- Using the contraceptive pill.
- Frequent flying.
Risk factors for thrombosis in an artery (arterial thrombosis) are:
- Atherosclerosis.
- Smoking.
- High cholesterol.
- High blood pressure.
- Diabetes.
- Genetic predisposition to thrombosis.
Symptoms
The signs and symptoms are partly dependent on the impact of the thrombosis:
- Deep vein thrombosis. If a blood clot closes the leg vein, blood can no longer flow through. This causes pain, swelling and red-purple coloring of the leg. If the thrombosis is not treated, a deep vein thrombosis may occur. Then the valves in the vein are damaged by long-term presence of a clot. As a result, the legs are often swollen and feeling tired. Once a person has deep vein thrombosis, this cannot heal anymore.
- Pulmonary embolism. There is pulmonary embolism when a blood clot gets stuck in the lungs. The resulting symptoms are shortness of breath, chest pain when coughing and sighing and coughing blood. In severe cases, pulmonary embolism may cause immediate death.
- Heart attack. In case of a heart attack, there is a blood clot in the heart. The symptoms can be: an oppressive and crushing pain behind the sternum, nausea, sweating, palpitations, dizziness, heart pounding and tendency to faint.
- Cerebral infarction. In case of a cerebral infarction, there is a blood clot in the brains. The following symptoms may occur: double vision, blindness to one or both eyes, talking gibberish, balancing problems, dizziness, inadequate coordination of arms and legs and a drooping corner of the mouth and/or crooked face.
Diagnosis
The diagnosis of deep vein thrombosis is made on the basis of the following examinations:
- Ultrasound and duplex examination in order to determine the speed and direction of the blood flow.
- D-dimer test: blood test into specific particles that are released during the development of a clot.
- Lung scan: when the doctor suspects that the patient has pulmonary embolism.
- Angiography: provides information when the duplex examination is unhelpful and also provides information on the severity of the thrombosis.
Treatment
The main purpose of the treatment of thrombosis is the prevention of serious consequences and ensure that the clot doesn’t grow further. The treatment includes:
- Anticoagulants. In case of deep venous thrombosis, anticoagulants are immediately prescribed. A major thrombosis or thrombosis in the pelvis usually requires hospitalization, which also applies to pulmonary embolism. Initially, a person receives an injection of heparin and anticoagulation tablets. Once the blood is sufficiently unclotted, tablets are given. Upon returning home, the thrombosis service will help the patient further.
- Elastic stockings. Wearing elastic stockings during the day should prevent the symptoms getting severe and won’t go away. The stockings prevent swelling of the leg and improves blood flow. This reduces the chance that the patient will get thrombosis again or, for example, a venous leg ulcer.
Prognosis
If anyone had thrombosis before, there is a greater chance of getting it again. Thrombosis may come back in the same place, but also in a different vein. Some people keep suffering from pain, swelling in the leg and a colored skin.
Considerations
The following precautions are important to prevent thrombosis in the future:
- Wear the prescribed elastic stockings.
- Take medications daily.
- Keep the body in motion in order to stimulate blood flow. Don’t sit or lie for too long in the same position.
- Put the affected leg higher and move the foot regularly.
- Quit smoking, because smoking makes the blood clot faster.
- Eat healthy and varied.
