Thrombosis: Symptoms, Diagnosis & Treatment!
In a thrombosis, a blood clot forms in a vein and hinders the reflux of the blood to the heart. This usually manifests itself through pain and a swelling in the affected area. It is important to distinguish between different types of thrombosis. For a blood clot can in principle arise in every blood vessel of the body and even in the heart – with different consequences.
Thrombosis in veins or arteries
If a blood clot forms in an artery, one speaks of arterial thrombosis, which is a common cause of a heart attack or stroke. In thrombosis, a thrombosis of the superficial and the deep veins is distinguished.
A thrombosis of the superficial veins is also called venous inflammation (thrombophlebitis) and is often caused by varicose veins or inflammation of venous catheters. Through veins, the clot can enter the deep veins. In the following, a deep venous thrombosis is meant when a thrombosis is mentioned.
Thrombosis in the leg particularly frequently
Thrombosis is particularly common in the leg veins, but other vessels in the body may also be affected. Rare is thrombosis in the arm or pelvis. The symptoms are basically similar regardless of the affected area.
If the clot dissolves from the vessel wall, a dangerous pulmonary embolism can develop. Therefore, it is important to interpret signs of venous thrombosis properly and to seek a doctor quickly.
Symptoms are not always clear
In thrombosis, a vein is partially or completely closed by a blood clot. This results in a more or less pronounced blood accumulation, which can be caused by pain, as well as by a swelling and overheat.
Not infrequently, the typical signs are missing: some patients only experience a slight pressure sensitivity or symptoms that resemble a muscle soreness. Even classic “thrombosis” symptoms such as calf pain during the onset of the foot or pain on pressure on the sole of the foot can be observed only in some cases.
In addition, the following symptoms may indicate thrombosis:
- Skin staining (cyanosis)
- visible, prominent veins on the skin
- plump, shining skin with tension
- Pain in compression of the calf with both hands
- Increases heart rate
In case of thrombosis, consult a doctor
If you notice symptoms that may indicate thrombosis, you should consult a doctor as soon as possible. Especially after a long journey by car, bus, train or aeroplane, it is important to pay attention to possible signs of thrombosis. For long sitting without sufficient movement pauses increases the risk for the formation of a thrombosis.
Diagnosis by ultrasound
If a thrombosis is suspected, the physician first ascertains the patient’s condition and asks the patient about various risk factors and symptoms. In combination with a physical examination and a blood test, he can thus determine the probability for the presence of a thrombosis.
The diagnosis is then ensured by so-called compression sonography. The physician examines with the ultrasound device whether the vein is compressible and whether the blood flow is impaired. In the case of unclear cases, an x-ray image with contrast medium (phlebography) is additionally performed, as a rule, thrombosis can be reliably detected.
Treatment: coagulation inhibition and thrombolysis
Thrombosis is most frequently treated with anticoagulant drugs (anticoagulants). Usually, heparin is used, which is injected either under the skin or in a vein. This prevents growth and spread of the blood clot and significantly reduces the risk of pulmonary embolism.
A so-called thrombolysis is more rarely performed. The blood clot is dissolved by means of active substances such as streptokinase or urokinase and the vein is thereby re-opened. However, with this method, the risk of internal bleeding is higher than in the treatment with anticoagulant medication.
Therefore, risk and benefit are carefully weighed before thrombolysis. It is most commonly used when a pelvic vein or several veins are affected at the same time (multiple day thromboses) and the thrombosis is not older than seven days.
In both methods, a longer-term coagulation inhibition is started with so-called vitamin K antagonists such as Marcumar®, in order to reduce the risk of renewed thrombosis (recurrence).
Operation rarely necessary in thrombosis
An operative removal of the blood clot using a catheter is very rarely necessary. An operation is performed only when a thrombosis has formed in the vena cava, or when the arteries of the affected arm or leg are constricted by thrombosis.
Although thrombolysis may be necessary but cannot be performed due to counter-indications such as previous injuries or bleeding, surgery may be considered.