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heart diseases

Clinical Signs Of Thrombosis and Treatment


Thrombi cause clinical menifestations either by obstructing arteries and veins and formation of emboli

Clinical Manifestations due to Venous Thrombi.

(1) superficial Venous Thrombi
     It occurs commonly in saphenous veins especially when there are varicosities.
     Clinical manifestations include;
  • Local congestion and swelling
  • Pain tenderness along the course of veins
  • Varicose ulcer
One thing which is peculiar to venous thrombi is that they don't embolize.

(2) Deep Venous Thrombi.
       They occur in deep veins of leg. for example femoral, popliteal and iliac veins
       Clinical manifestations include;
  • Edema of foot and ankle
  • Pain and tenderness on compression of calf muscles, This is also called "Homan's sign"
  • They may embolize and may cause pulmonary embolism and infarction.
(3) Thrombophelebitis and phlebothrombosis.
     Both terms refer to pain, tenderness, and edema due to vascular stasis, edema and distension of the
    affected vessel at local site of thrombus formation. this usually follows administration of cannula.

(4) Milk Leg
      It refers to painful white legs that occur in the third trimester of pregnancy

(5) Migratory Thrombophlebitis (Trausseau's Sign)
     It refers to appearance of thrombi in one vein that disappears and then re-appear in another vein. it occurs in visceral cancer especially some abdominal neoplasms.

Clinical Manifestations Due To Arterial Thrombosis.
Arterial thrombi develop in following conditions
  1. Atheroseclerosis
  2. Aortic aneurysms 
  3. Reumatic heart disease
  4. Myocardial infarction
Clinical conditions:
  1. Complete or partial obstruction of blood vessels and consequent infarction or ischemia of the organ supplied.
  2. Fragmentation of thrombi which embolize to the vessels of brain, kidney, spleen and legs with resultant infarction of these organs.
Treatment:

        Anticoagulants such as warfarin and haparin are commonly used to treat thrombosis. Warfarin is also used prophylactically to decrease the risk of post surgical thormbosis. (DVT etc). In case of Fresh thrombus streptokinase or alteplase are given.

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