Venous thrombosis

venous thrombosis is a life thretening disorder which attacks veins. thank you for your time reading these slides

1. VENOUS THROMBOSIS By IYUMVA Aimable BNS

2. Venous thromboembolism (VTE) is a blood clot in the vein. There is a higher chance of blood clotting in the veins because unlike arteries, veins don’t have a significant muscle lining and there is nothing pumping back blood to the heart except physiology. Therefore blood returns to the heart because the body’s large muscles squeeze the veins as they contract in their normal activity of moving the body.

3. Venous thromboembolism is related to 2 life-threatening conditions,ie ; Deep Venous Thrombosis(DVT)—A clot in the deep veins located in the arm or leg. Pulmonary Embolism(PE)---- A DVT clot that breaks free from a vein wall, travels to the lungs and blocks some or all of the blood supply. Other types of thrombosis include;- Cerebral Venous Thrombosis(CVT) Portal Vein Thrombosis Cavernous Sinus Thrombosis

4. Risk factors for thromboembolism Smoking Taking oestrogens or contraceptive pills Certain conditions eg cancer Autoimmune disorders eg systemic lupus erythematosus Obesity Recent surgeries, most commonly in the hip,knee or pelvis. Advancing age Genetic or inherited blood clotting disorders

5. Clinical presentation of venous thrombosis Oedema (most specific symptom) Leg pain Tenderness Warmth or erythema of the skin over the area of thrombosis Clinical symptoms of PE as the primary manifestation

6. Physical findings in DVT may include;- Calf pain on dorsiflexion of the foot( Homans sign) A palpable, indurated , cordlike,tender subcutaneous venous segment Variable discolouration of the lower extremity Blanched appearance of the leg due to oedema (relatively rare)

7. Diagnosis Physical findings on patient examination D- dimer testing(specific proteins released from the clot) Coagulation studies( eg prothrombin time and activated partial thromboplastin time) to evaluate for a hypercoagulable state.

8. MANAGEMENT Anticoagulation( mainstay of therapy) Heparins,eg Low-Molecular-Weight-Heparin(LMWH) eg enoxaparin and also using Unfractionated heparin(UFH) Warfarin Factor Xa inhibitors eg Fondaparinux,Rivaroxaban Various emerging anticoagulants

9. 2. Pharmacologic thrombolysis (for massive clots) 3. Endovascular and surgical interventions eg angioplasty, mechanical thrombectomy , stenting of venous obstructions(filter placed in the vein). 4. Physical measures eg elastic compression stockings and ambulation. 5. Doppler studies of the affected vessel.

10. Complications of DVT Pulmonary Embolism Post phlebitic syndrome NOTE;- 1.Diagnosis and treatment of a DVT is meant to prevent pulmonary embolism. A DVT itself in the leg or arm is not dangerous; it only becomes fatal if it dislodges and moves through the heart and lodges into one of the pulmonary arteries.

11. 2. Blood clots in the superficial veins do not pose a danger of causing pulmonary emboli because the perforator vein valves(between the superficial and deep veins) act as a sieve to prevent clots from entering the deep venous system. They are usually not at risk of causing pulmonary embolism.

12. REFERENCES emedicine.medscape.com www. heart.org www. medicinenet.com THANK YOU FOR LISTENING!!!!