Symptoms of postthrombotic syndrome
The postthrombotic syndrome can occur in various forms. The symptoms range from rather slight swelling with only a slight feeling of tension to weeping skin areas (eczema) and open ulcers, especially on the lower leg. The symptoms of the postthrombotic syndrome result from the long-lasting disturbance in the flow of blood from the extremities.
At the beginning of the postthrombotic syndrome, there is a feeling of heaviness in the extremities, a feeling of tension or pain, water retention (edema) and also a reduction in mobility. The water retention can occur after standing for a long time in the evening, after heavy strain or permanently. Skin changes can be visually detected.
The skin is usually tense and shiny. If the syndrome is more advanced, the skin becomes thinner and more vulnerable due to an undersupply. Due to the lack of nutrients, wound healing disorders and chronic ulcers can follow.
Pain in postthrombotic syndrome
The pain that occurs in postthrombotic syndrome can range from mild tension pain to severe, persistent pain with dilated ulcers, often on the lower leg. The pain may be located in a specific area of the leg, such as only in the calf, or it may extend over the entire leg. In most cases, these pains are described by the patient as dull-pulling.
The tension pain is usually accompanied by a feeling of heaviness in the legs.The term “Claudicatio venosa” describes pain that occurs in a postthrombotic syndrome during movement and only subsides slowly when the patient is subsequently at rest (difference to arterial occlusion). At rest, the blood can be pumped sufficiently through bypass circuits via the veins to the heart. However, when the patient moves, more blood is pumped through the arteries, which then also enters the venous system. This increased volume is then difficult to pump via the bypass and causes pain.
Chronic venous insufficiency
Chronic venous insufficiency can be the result of deep vein thrombosis and thus part of the postthrombotic syndrome, or it can occur as primary varicosis (predisposed formation of varicose veins). This leads to a functional disorder of the venous valves, which normally ensure that the blood does not sink into the legs but can flow back to the heart. This results in swelling in the legs, especially in the feet and lower leg. The symptoms such as oedema, skin changes with itching and scaling up to ulcers and wound healing disorders are similar to those of the postthrombotic syndrome.
