Today, in Part 3 of our three part series on Blood Clots and Your Vein Health, we will consider what should be done should you suspect a blood clot. Previous articles have already discussed prevention and have outlined the factors that can upset the body’s balanced coagulation system. If you have these factors, extra precaution and awareness is warranted. Previous history of a clot is also a risk factor.
Know the Signs and Symptoms of Blood Clots
The signs and symptoms of blood clot [thrombosis] are quite general. The area of a clot can be painful, tender, swollen, red and warm; or there can be any combination of these signs and symptoms. Unfortunately, any trauma or local inflammation [e.g. a wasp sting] could give the same clinical picture.
So, the first bit of advice is to consider your clinical situation [including past history] and have a high index of suspicion. If you think that a clot is possible, see a physician. Do not try to make the diagnosis on your own!
Using Ultrasound and Other Methods to Diagnosis Blood Clots
Studies have shown that experienced, well qualified physicians when presented with clinical situations that point toward possible thrombosis are right only 50% of the time! Since astute physicians have been proven to have a significant error rate when confronted with this situation, additional testing is mandatory to come to an accurate diagnosis.
One such test is a called a D-dimer. This is a blood test. It is valuable when the result is negative, indicating with high reliability that there is no clot. However, the best test is an ultrasound exam of the venous system.
An ultrasound device works just like the echo location found in dolphins and bats. The ultrasound machine emits a sound at a given frequency. The sound wave encounters various structures and bounces back to the machine. The make-up of the structures alters the frequency of the wave; different characteristics produce different frequencies. The machine’s computer creates an image based on the frequencies which can be interpreted by the physician. Thrombosis can be spotted using this method.
Treatment for Superficial Thrombophlebitis
Superficial Thrombophlebitis is the term used when the inflammation/clot formation is limited to the superficial venous system. Although this is usually not life threatening, it should not be ignored or taken lightly. If untreated the process may spread to other veins and even to the deep system or to major junctions between the superficial system and the deep system, putting the patient at risk for pulmonary embolus [clot to the lungs-see the last article].
Treatment for superficial thrombophlebitis includes appropriate compression stockings, drainage of thrombi, and aspirin or other anti-inflammatory drugs. Frequent ambulation is also recommended. In patients with extensive involvement or if the thrombus extends to a major junction with the deep system then systemic anti-coagulation is recommended.
Treating Deep Vein Thrombosis
Deep Vein Thrombosis [DVT] can be a life threatening problem. Depending on the severity of the problem, its location, and the patient’s past history, treatment can be quite variable. In mild cases outpatient systemic anticoagulation, coupled with graduated compression and walking is recommended. Anti-coagulation is continued for 2-3 months.
For more severe cases, hospitalization, leg elevation and bed rest may be required until appropriate anti-coagulation is established. Alternatively, injection directly into the clot with some of the new anti-thrombolytics may be indicated. Anti-coagulation for 3-6 months usually follows in these severe cases.
In conclusion, don’t treat potential blood clots lightly. Try to prevent them. If you suspect you might have one, seek a vascular specialist for advice.
Dr. Robert W. Ruess of Five Star Vein Institute can accurately diagnosis and properly treat all of your vein issues, including blood clots. Schedule your free vein consultation to find out if you are at increased risk for blood clots and your treatment options.