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Phlebitis & Thrombosis
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Phlebitis is inflammation in a vein. Thrombosis is when a blood clot forms. When both of these occur together, it is called thrombophlebitis.
Signs & Symptoms
• Superficial phlebitis (SP) occurs just under the skin’s surface. The affected area is swollen and feels warm and tender. At times, a hard ropy vein is felt. This type seldom showers clots into the bloodstream.
• Deep-vein thrombosis (DVT) occurs within a muscle mass (commonly the leg). It is apt to release showers of clots (emboli) that often go to the lung (pulmonary emboli). The symptoms may resemble those of SP; the limb may swell and/or the muscle involved may ache. Often, DVT symptoms are silent and can’t be seen. In silent DVT, the first symptoms may be from a blood clot to the lung. These include sudden shortness of breath and severe problems breathing; sudden chest pain; and/or collapse.
Causes, Risk Factors & Care
Phlebitis is usually caused by infection, injury, or poor blood flow in a vein. It is common in women over age 50. Conditions that can lead to SP and/or DVT include:
• Inactivity. This could result from prolonged bed rest, a sedentary job, or a long trip, especially in a cramped space, such as sitting in the economy class section of a plane.
• Varicose veins
• Being overweight, in poor physical condition, or older in age
• Estrogen therapy
• Trauma to an arm or leg. Examples are a fall or injury to the vein, such as from injections or IV needles.
• Heart failure or a heart attack
• Some cancers
A doctor needs to diagnose SP with or without DVT or DVT alone. Treatment for SP alone includes resting the affected limb, warm compresses, and pain relievers.
Treatment for DVT includes blood thinning medicine, possible hospitalization, and surgery if a blood clot to the lung has occurred.
Prevention
• Avoid sitting or standing for long periods without moving around.
• Inform your doctor if you have a history of varicose veins, superficial phlebitis (SP), or deep-vein thrombosis (DVT) and take estrogen.
• Don’t sit with your legs crossed. Don’t wear tight garments below the waist, such as knee-high hosiery.
• On trips, drink a lot of fluids (no alcohol) and move about at least every hour. While sitting, exercise the legs.
• If you’re confined to a bed or a chair, stretch often. Push with the feet, pretending you’re pressing on a gas pedal and then release it. Do this with one foot, then the other.
• Avoid tobacco.
Self-Care
It is best to let your doctor diagnose if you have phlebitis or thrombosis. If SP is diagnosed, you may be told to follow these self-care measures:
• Wear elastic support stockings as prescribed by your doctor.
• Rest the affected limb as advised. Elevate it when you rest.
• Apply moist, warm compresses to the area of pain.
• Take an over-the-counter medicine for pain and inflammation. Take the one your doctor advises.
• Don’t massage or rub the limb.
• Don’t sit or stand for long periods of time. When you sit, elevate the limb. Continue with your regular activities, though, as much as you can.
• Follow “Prevention” measures in this topic.
When to Seek Medical Care
Contact Doctor When:
You have 1 or more of these problems:
• Redness, pain, and a burning feeling in the leg
• Swelling and the feeling of a cordlike vein beneath the skin along the length of the vein
Get Immediate Care When:
• You have symptoms of a blood clot to the lung:
– Sudden onset of chest pain with calf pain
– Sudden shortness of breath and severe problems breathing
– Rapid heartbeat
– Cough with bloody sputum (sometimes)
– Chest pain in a person who has had a recent operation or illness that has kept them in bed
• You have symptoms of deep-vein thrombosis (DVT):
– Swelling and warmth in the leg
– Pain in the ankle, calf, or thigh that does not go away with rest
– The affected skin area is red and tender.
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