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Venous thromboembolic disease

Venous thromboembolic disease refers to the process characterised by the formation of a thrombus (blood clot) in the deep vein system that can grow or fragment, interrupting the normal circulation of blood and causing various alterations. 

The main manifestations of thromboembolic disease are deep vein thrombosis (DVT) and pulmonary embolism. DVT occurs when a thrombus or blood clot forms inside a deep vein, usually in the legs (although it can also occur in the arms, abdomen, ilium, vena cavas, etc.), obstructing normal blood circulation in these veins. 

Description

 

A thrombus that forms in a deep vein can become fragmented or rupture and break off. The detached embolism travels through the veins towards the heart, reaching the lungs through the pulmonary veins. The clot stops in the lungs and obstructs the interior of one or more pulmonary arteries, preventing blood from passing. This process is known as pulmonary embolism (PE).

 

Symptoms

 

Vein trombosis:

- Swelling or inflammation of the affected leg

- Pain or sensitivity in the leg, often starting in the lower leg

- Increased temperature in the leg

- Changes in skin colour (reddened or bluish, shiny)

 

Pulmonary embolism :

- Shortness of breath or sudden onset drowning (dyspnoea).

- Increased breathing rate

- Increased heart rate

- Acute chest pain

- Dry cough with blood

- Loss of consciousness (syncope) 

 

Who is affected by the condition?

Incidence (number of cases/year) of venous thromboembolic disease in the general population, including any of its manifestations, is estimated to be between one or two cases for every 1,000 people in Spain. This means that there are more than 80,000 cases a year in Spain, with about 70% of these being deep vein thrombosis and the rest being pulmonary embolism. 

 

Diagnosis

DVT:

The patient’s symptoms are analysed, as well as conducting a blood test and imaging tests. The most commonly used test of choice is Doppler ultrasound (eco-Doppler), an imaging technique that allows the deep veins to be seen and confirms or rejects the diagnosis.

PE:

If suspicions point to a possible pulmonary embolism, the diagnosis will be confirmed using tests such as a chest CT (scan) or pulmonary scintigraphy.

 

Typical treatment

When a clot is produced, whatever type it may be, the main aim of treatment is to dissolve the thrombosis and re-establish blood flow to avoid further complications.

Anticoagulants are the treatment of choice for venous thromboembolic disease. Anticoagulants are medication that modify blood clotting so that a thrombus or clot does not form inside the blood vessels, helping to break up clots that have already formed.

 

Typical tests

Laboratory tests such as D-dimer. Imaging tests such as Doppler ultrasound, CT and pulmonary scintigraphy.

THROMBOPHILIA BLOOD TEST in some cases, a blood test is also performed to determine if the patient has any alterations in their clotting proteins that may predispose them to thrombosis.

 

Prevention

Knowing the risk factors of venous thromboembolic disease is crucial to be able to act and control this risk. One of the cheapest and most effective recommendations that helps to prevent possible thromboembolic episodes is walking, as moving around helps avoid clot formation.

 

 

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