What Is Thrombosis?

Thrombosis is a serious medical condition characterized by the formation of a blood clot, or "thrombus," in a blood vessel or the heart. This can interrupt normal blood flow and lead to life-threatening complications such as stroke or heart attack. In this blog, we will detail the types of thrombosis and the causes, symptoms, risk factors, diagnosis, and treatment of the potentially deadly condition.

As defined by the National Library of Medicine (NIH), thrombosis is a blood clot within blood vessels that limits the flow of blood and is broadly classified into two main types: venous and arterial. Acute venous and arterial thromboses are the most common cause of death in developed countries.

Venous thrombosis occurs when a blood clot forms in a vein and includes subtypes such as deep vein thrombosis (DVT) and pulmonary embolism (PE). DVT typically occurs in the leg or pelvis, while PE occurs when a clot from elsewhere in the body travels to the lungs. Arterial thrombosis, on the other hand, occurs when a clot forms in an artery and can lead to conditions such as heart attack or stroke.

Prompt medical attention is crucial for both types to avoid complications, including death. Treatment may include using anticoagulants.

What are the symptoms of thrombosis?

The symptoms of thrombosis can vary depending on the location of the clot. For deep vein thrombosis (DVT), symptoms may include pain, swelling, and tenderness in one leg, often in the calf or thigh, as well as a heavy ache and warm skin in the affected area. In some cases, DVT can occur without noticeable symptoms. Arterial thrombosis symptoms may include pain and swelling in one leg, chest pain, or numbness on one side of the body.

What are the causes of thrombosis?

The leading causes of thrombosis include:

1. Damage to the endothelial lining of the vessel wall. According to the National Library of Medicine (NIH), endothelial cells are a layer of single cells that line all blood vessels and regulate exchanges between the bloodstream and the surrounding tissues. Signals from endothelial cells organize the growth and development of connective tissue cells that form the surrounding layers of the blood vessel wall.
2. A hypercoagulable state. The Cleveland Clinic defines this blood clotting disorder as making the body more likely to cause blood clots than normal.
3. Arterial or venous blood stasis. Refers to the slowing or stagnation of blood flow in the arteries or veins. Blood stasis can contribute to the formation of blood clots by allowing blood to pool and potentially form a clot. According to the scientific and medical publication ScienceDirect, venous stasis is related to developing venous thrombosis, where stasis, often due to immobility or impaired blood flow, plays a significant role in the disease process.
4. Venous thrombosis. Causes include disease or injury to the leg veins, immobility, certain medications, obesity, inherited disorders, autoimmune disorders, and other factors.
5. Arterial thrombosis. Causes include hardening of the arteries (arteriosclerosis) and various risk factors such as smoking, diabetes, high blood pressure, high cholesterol, and lack of activity.

What is the difference between deep vein thrombosis and pulmonary embolism?

Deep vein thrombosis (DVT) is when a blood clot develops in the deep veins, usually in the lower extremities. On the other hand, a pulmonary embolism (PE) occurs when a part of the DVT clot breaks off and travels to the lungs, which can be life-threatening. DVT and PE together are known as venous thromboembolism (VTE). DVT typically presents with symptoms such as pain, swelling, and tenderness in the affected leg, while PE symptoms include shortness of breath, chest pain, and coughing up blood.

What are the common symptoms of deep vein thrombosis and pulmonary embolism?

The common symptoms of deep vein thrombosis (DVT) and pulmonary embolism (PE) are as follows:

Symptoms of deep vein thrombosis

• Pain or tenderness in one of the legs, usually the calf or thigh
• Swelling and warmth in the affected area
• Redness or discoloration of the overlying skin
• A feeling of heaviness or aching in the affected area
• Change in skin color on the leg, such as red or purple, depending on the color of the skin
• A feeling of warmth on the affected leg
• Can also be present without noticeable symptoms

Symptoms of pulmonary embolism

• Sudden shortness of breath
• Chest pain or discomfort that worsens when taking a deep breath or when coughing
• Feeling lightheaded or dizzy
• Fainting
• Rapid pulse
• Rapid breathing
• Coughing up blood

It's important to note that the symptoms of DVT and PE can occur without noticeable symptoms. If you experience any of the symptoms mentioned above, it's crucial to seek medical attention promptly, especially if you have multiple risk factors for DVT or PE.

What are the risk factors for developing deep vein thrombosis and pulmonary embolism?

The risk factors for developing deep vein thrombosis (DVT) and pulmonary embolism (PE) include:

Age: Being older than 60 increases the risk of DVT, but it can occur at any age.

Immobility: Extended periods of limited mobility, such as during long-distance travel or bed rest, can increase the risk of DVT.

Surgery and trauma: Recent surgery, particularly orthopedic surgery or trauma, can increase the risk of blood clots.

Medical conditions: Certain medical conditions, such as cancer, heart failure, and inflammatory bowel disease, can increase the risk of blood clots.

Pregnancy and postpartum: Pregnancy and the postpartum period are associated with an increased risk of blood clots.

Hormone therapy: The use of estrogen-containing contraceptives or hormone replacement therapy can increase the risk of blood clots.

Genetic factors: Inherited conditions that affect blood clotting, such as factor V Leiden mutation or prothrombin gene mutation, can increase the risk of blood clots.

Obesity: Being overweight or obese increases the risk of DVT and PE.

Smoking: Smoking affects how blood flows and clots, which can increase the risk of DVT.

Cancer: Some cancers increase substances in the blood that cause the blood to clot. Some types of cancer treatment also increase the risk of blood clots.

Heart failure: Heart failure increases the risk of DVT and PE

Because these risk factors can increase the likelihood of developing DVT and PE, it's essential to be aware of them—especially if you have more than one of these risk factors.

How are deep vein thrombosis and pulmonary embolism diagnosed?

Deep vein thrombosis (DVT) and pulmonary embolism (PE) are diagnosed using a combination of clinical assessment, D-dimer blood test, and imaging studies. Clinical features of DVT include swelling, pain, warmth, and superficial venous dilation of the lower limb, while PE may present with or without symptoms of DVT, in addition to chest pain and breathlessness.

Non-invasive compression ultrasonography is used as the first line for diagnosing DVT, while computed tomography (CT) pulmonary angiography is the standard imaging procedure for PE diagnosis.

Center for Vein Restoration Offers DVT Rule-Out Services

To avoid a long and expensive visit to the emergency room, Center for Vein Restoration (CVR) provides a DVT rule-out service for individuals who suspect they have a DVT. This comprehensive approach includes a scan, anticoagulation treatment, education, and follow-up if necessary. You can contact the DVT hotline at 877-SCAN-DVT (877-722-6388) for more information and to schedule an appointment.

How do you treat deep vein thrombosis and pulmonary embolism?

Treating DVT and PE typically involves using anticoagulant medications (blood thinners) to prevent the existing blood clot from growing larger and reduce the risk of new clots forming. The most frequently used injectable anticoagulants are unfractionated heparin, low molecular weight heparin (LMWH), and fondaparinux. Oral anticoagulants, such as warfarin, apixaban, rivaroxaban, dabigatran, and edoxaban, are also commonly used for the long-term treatment of DVT and PE.

According to Cleveland Clinic, in some cases, thrombolytic therapy may be considered for patients with massive proximal lower extremity thrombosis or iliofemoral thrombosis ("iliofemoral" refers to the iliofemoral ligament, which is a thick and very tough triangular capsular ligament of the hip joint situated anterior to the joint) associated with severe symptoms or limb-threatening ischemia. Additionally, the use of inferior vena cava filters may be indicated in certain situations.

What to do if you suspect thrombosis

If you suspect thrombosis, it is crucial to seek immediate medical attention. Symptoms may include swelling, pain, redness in the affected area, shortness of breath, or chest pain if a clot travels to the lungs. Do not ignore these signs; instead, seek prompt medical attention at a nearby emergency room or a Center for Vein Restoration (CVR) vein clinic near you. Timely intervention is vital to prevent complications such as pulmonary embolism or stroke.

Avoid self-diagnosis and let healthcare professionals evaluate and determine the appropriate course of action for your specific situation.

Who is Center for Vein Restoration?

Center for Vein Restoration (CVR) is nationally recognized as the clinical leader in treating chronic venous insufficiency. CVR is America's largest physician-led vein center, with 110+ centers (and growing!) and 70+ active physicians conducting 200,000 patient interactions annually.

CVR accepts many insurances, including Aetna, Amerigroup, Anthem, Blue Cross/Blue Shield, Cigna, MultiPlan, Medicaid, Medicare, and more.

Call 240-965-3915 to speak to a Patient Services Representative or schedule your consultation online at a CVR near you today.