Venous Thrombosis: Causes, Symptoms & Treatment

Thrombosis is not only a particularly painful affair, it can also severely limit the health of the person affected. However, not only is venous thrombosis dangerous in itself, it also carries the risk of pulmonary embolism, which can be fatal without prompt treatment.

What is venous thrombosis?

Thrombosis is a vascular disease, which can be fatal due to possible subsequent complications. Thrombosis most often occurs in veins, the arteries that carry blood to the heart. Arteries, which carry blood away from the heart, are rarely affected. In general, however, thrombosis can occur in all vessels. However, deep leg veins are particularly at risk. The blood of the affected person clumps together and unimpeded blood flow is no longer possible. Instead, the clots can be carried on by the bloodstream, where they often clog pulmonary vessels and seriously threaten the affected person’s life.

Causes

The formation of the blood clot, called a thrombus, has several causes. Particularly frequently listed is damage to the vessel wall, as well as slowed blood flow or an increased risk of clot formation due to altered blood pooling. Lack of exercise, obesity, tobacco use, low fluid intake, and injury, as well as bed confinement and certain medications, can also promote the development of venous thrombosis.

Symptoms, complaints, and signs

Thrombosis can occur in any region of the body. Depending on the location, symptoms may remain very mild or cause life-threatening complications. In many cases, tiny clots do not cause serious symptoms. If characteristic features nevertheless appear, extreme caution is required. Typical are unusual feelings of tension in the limbs, which sometimes seem painful. Slight swelling of the extremities and protruding of superficial veins due to the backlog of blood can also be observed. A distinct feeling of warmth develops in the affected area. A clear difference to other regions can be perceived by affected persons by mere laying on of hands. Due to oxygen deficiency, discoloration of the surrounding skin areas occurs. Reddish or blue areas with a shiny surface are considered a serious warning sign of venous thrombosis. Pressure pain on the inside of the foot, also Payr’s sign, as well as calf pain when bending the foot (Homans’ sign) indicate venous occlusion of the leg. Blood clots do not always externalize to such a marked extent. Therefore, the absence of these symptoms should not be considered a criterion for exclusion. An urgent emergency arises when there is rapid onset of shortness of breath with accompanying chest pain. Pulmonary embolism may be present. Severe palpitations and dizziness to the point of fainting are the result. The enormous stress increases the chance of heart failure. But thromboses in other areas are also extremely dangerous. Immediate notification of the emergency physician remains unavoidable under such circumstances.

Diagnosis and progression

Thrombosis is based on the development of blood clotting. Blood clotting is a natural process the body uses to try to protect it. To prevent bleeding after injury, the body ensures that the blood clots. This clots and closes the wound. In the case of thrombosis, there is no wound that needs to be treated, but blood still clots without a blood vessel being injured. The clots that form prevent the blood from flowing smoothly and there is a risk of pulmonary embolism. During thrombosis, there is usually damage to the vessel wall, which occurs due to the accumulation of blood fat, calcium and connective tissue. These deposit on the vessel wall and form a natural obstruction within the vein. If the deposit, which is called plaque, breaks up, the body reacts with a clotting reaction and the vessel is closed. This process leads to heart attack in arterial thrombosis. In venous thrombosis, the plaque may be carried on by the blood and clog other vessels during its course.

When should you see a doctor?

In the case of venous thrombosis, treatment by a doctor is always necessary. It is usually not possible for this disease to heal on its own, so treatment by a doctor is always necessary.The earlier a doctor is consulted, the better the further course of this disease usually is. The affected person should therefore contact a doctor at the first symptoms and signs of venous thrombosis and initiate treatment. A doctor should be consulted if there is severe pain in the legs. The legs themselves often feel very heavy, so that the affected person also suffers from restrictions in their movement. Swelling in the legs can also indicate venous thrombosis if it does not disappear on its own and persists over a longer period of time. In many cases, the legs turn blue or red. Venous thrombosis can be recognized and treated by a general practitioner or by an internist. The further course depends strongly on the time of diagnosis, so that a general prediction is not possible. Possibly the life expectancy of the affected person is also limited by this disease.

Treatment and therapy

Affected individuals suffering from venous thrombosis should seek medical treatment as soon as possible. The primary goal of therapy is to dissolve the existing blood clot in the affected blood vessel, allowing blood to flow freely through the body again. The restoration of blood flow is called thrombolysis. To ensure the success of thrombolysis, it is important to start the treatment early; it is only effective within the first stages of venous thrombosis. Drug used to perform thrombolysis is, for example, heparin. It reduces blood clotting and at the same time can ensure that blood clots that have already formed are dissolved before they clog the entire vein. If the thrombosis has completely built up, this therapy is no longer necessary. Instead, there is now the possibility of surgically removing the blood clot. The affected area is opened, and the clots are surgically removed. If the area of the affected vessel is too large, a balloon catheter is used. In this, a catheter with a small balloon is inserted into the vein and inflated after the vessel blockage is reached. If the physician now pulls the catheter back toward the opening site, he or she can remove the clotted blood at the interface and thus restore further unobstructed blood flow. In another type of treatment, the vein is opened and the clotted blood is forced out of the vein by applying gentle pressure. The main goal of thrombosis treatment is not only to remove the clotted blood, but also to prevent the process from recurring. For this purpose, the patient is injected with heparin for a week, after which he must take blood-thinning medication for at least three months. Examples include phenprocoumon and vitamin K antagonists. In addition, affected individuals are advised to wear compression stockings, which are essential for the rest of their lives after a pulmonary embolism.

Prevention

Thrombosis can be prevented by regular exercise, a healthy diet with few animal products, which are deposited on the walls of blood vessels in the form of high blood lipid levels. Obesity and diabetes should be treated. It can also be helpful to shower the limbs alternately hot and cold, which promotes blood circulation. Tobacco, birth control pills, and prolonged standing and sitting should be avoided. A high fluid intake in the form of water as well as unsweetened teas can also have a preventive effect.

Aftercare

After treatment for venous thrombosis, the patient should maintain a balanced diet. Usually, no special diet is recommended. However, he should pay attention to an adequate amount of vegetables and fruits in order to consume an adequate amount of vitamins and fiber. A sufficient amount of food, which serves as a source of carbohydrates, is also important in this regard. It should be noted that there is no excessive intake of vitamin B12. This is especially important if the patient is taking medication to promote blood clotting. Therefore, it is best not to take any vitamin preparations that contain vitamin B12. The same applies to vitamin K. In addition to diet, exercise also plays an essential role. Sports or regular exercise in the form of walks are advisable. Endurance sports such as swimming or hiking are best suited here. For competitive athletes, however, the intensity of sport should be discussed with the doctor.Regular exercise results in improved function of the circulatory system and blood vessels. However, in the case of thrombosis of the deep-seated leg and pelvic veins, bed rest should be observed immediately after treatment.

What you can do yourself

In the case of venous thrombosis, affected persons can contribute to the improvement themselves. Above all, animal fats should be avoided in the diet for this purpose. This applies especially to cream, sausage and cheese. Refined sugar, alcohol and high amounts of table salt in the diet should also be avoided. It is also recommended to use vegetable fat instead of butter. If affected persons are overweight, they should eat calorie-reduced food until normal weight has been regained. There are also currently studies showing that taking folic acid and vitamin B can reduce the risk of venous thrombosis through their lowering effect on homocysteine levels. As home remedies, rubs with rubbing alcohol and cold applications have proved particularly effective. These are, for example, treading water, dew walking or, in winter, snow walking. Cold showers several times a day and cold washing of the whole body with plain water or vinegar water also help to alleviate the symptoms. A cold foot bath lasting about 2 minutes in the morning after getting up is also very good. In addition to all this, regular active vascular training should take place. This can be achieved through sports and exercise and is the cheapest and simplest treatment for venous thrombosis. Especially before going to bed, the legs should get some exercise. The best way to do this is to take a leisurely walk.