pulmonary thrombosis

pulmonary thrombosis 


 Venous thrombosis of the legs, pulmonary embolism
Definition

Venous thrombosis of the legs: is characterized by the formation of a blood clot
Thrombosis is characterized by the formation of a blood clot, also called thrombus, within a blood vessel, which leads to obstruction or occlusion of the vessel concerned.

Among the venous thromboses, those of the legs and pelvis are the most frequent. When a thrombus comes off, it can cause a life-threatening pulmonary embolism. Risk factors include prolonged sitting, varicose veins, and certain inherited blood disorders.
causes
Slowing of the blood circulation, by resting after surgery or during prolonged sitting.
Changes in blood composition, such as after taking oral contraceptives or while taking estrogen.
Alterations in the vascular wall.
Bed rest, especially after recent operations.
Some procedures are associated with a greater risk of thrombosis, such as knee or hip operations and interventions in the small pelvis.
Presence of cancer.

Risk factors
Smoking
Family predisposition
Hereditary factors, such as protein C or protein S deficiency
infections
Immobility during travel and after surgery or accident.
Disorders (symptoms)
Superficial thrombosis:
Sensation of heaviness, pain in the leg
Redness and feeling of swelling and heat in the leg, which can be palpable

Deep thromboses:
Possible increase in leg volume
Sensation of heaviness, pain in the leg
Can not be palpated
Pulmonary embolism:
Cough accessSudden chest pain, dyspnea
Constrictive pain, anxiety, agitation.
Swelling of the veins of the neck
Fast pulse
Oxygen deficiency, with bluish discoloration of the lips, skin and finger nails (cyanosis)
Falling blood pressure up to cardiovascular shock, depending on the size of the embolism
Exams (diagnosis)
Anamnesis taking into account the patient's symptoms
Examination of blood gases and oxygen saturation
Blood tests, analysis of oxygen uptake, examination of blood coagulation with dosage of D-dimer, calculation of the overall risk by taking into account the different risk factors.
Ultrasound of the veins of the leg.
Helical CT, a specialized examination to identify pulmonary vessels when pulmonary embolism is suspected
Echocardiogram (echocardiogram), if there is suspicion of pulmonary embolism.
Therapeutic options
Venous thrombosis is a medical emergency requiring immediate management. Treatment is a function of the location and importance of thrombosis. Its main goal is to restore venous circulation as quickly as possible.

Drugs: administration of anticoagulants such as heparin and vitamin K antagonists (oral anticoagulants). The biological test adapted to follow this treatment is the Quick test. The duration of treatment is about 3 months.

Until the deflation of the leg: compresses.
To support the veins: medical compression stockings.

The treatment of pulmonary embolism is similar. In case of large thrombi or embolism in the main pulmonary artery thrombolytic administration to dissolve the thrombus or thrombus ablation by surgery (thrombectomy) are indicated. Another possibility is the bypass of the artery obstructed by a venous bypass. In case of pulmonary embolism, the anticoagulant treatment will be longer than for venous thromboses.

In case of repeated thrombosis despite medical treatment, implantation of a filter may be indicated (cave umbrella) to prevent thrombi from reaching the lungs.

After surgery, a rapid resumption of mobility is very important.

Complementary treatments in case of pulmonary embolism, in a hospital environment:
bed rest, analgesics, oxygen delivery
Possible complications
When properly treated, thromboses often heal without serious complications. In case of recurrent thrombosis, a complete medical assessment is necessary.
In case of thrombosis, the biggest risk is that a blood clot breaks off and obstructs another artery, which can cause a cerebral infarction. At the level of the heart, the appearance of atrial fibrillation can be observed; this is why the administration of anticoagulant treatments must be prolonged.
Patients who have had thrombosis have a greater risk of presenting another thrombosis. Another risk is the persistence of peripheral venous weakness manifested by the appearance of edema, varicose veins, skin inflammations and ulcers.

Complications in case of pulmonary embolism
Pleurisy
Pulmonary infarction with respiratory failure (cough with blood sputum)
Pneumonia
Impairment of the heart muscle (right heart failure)
Preventive measures
Physical activity and heavy drinking are the most effective preventive measures. During travel, compression stockings are recommended for people at risk. The attending physician will decide on the possible introduction of preventive treatment.
After surgery or pregnancy, patients must start walking as soon as possible.
Prevention of thrombosis by drug treatment or compression stockings
Elimination or reduction of risk factors.