Venous thrombosis is a blood clot that develops in the veins. The two most common types of venous thrombosis are deep vein thrombosis (DVT) and pulmonary embolism (PE).

Deep Vein Thrombosis
Pulmonary Embolism

Deep Vein Thrombosis - Deep vein thrombosis, or DVT, is a blood clot in the veins of the body. The deep veins pass through the center of the leg and are surrounded by muscles. DVTs usually occur in the legs, particularly in the groin, calves, or behind the knee. DVTs can damage valves in the leg veins and can result in pain, swelling, discoloration, and/or leg sores. The primary risk of a DVT is that it will develop into a pulmonary embolism. If left untreated, approximately 25 percent of DVTs escalate into a life-threatening pulmonary embolism.

Pulmonary Embolism - Pulmonary emolism, or PE, is a blood clot that breaks loose and travels to the lungs. A PE can occur if fragments of a DVT (or the entire clot itself) loosen from the vein of the leg and travel (or "embolize") to the lungs, where they lodge in one or more of the major veins that carry blood from the lungs to the heart. A pulmonary embolism can be life-threatening, depending on the size of the blood clot and how quickly it is treated.

If a person has had a DVT, they are at higher risk for having another DVT in the future. Many research studies have studied why some people have another venous thrombosis and why others do not.

The latest research suggests that men are three times more likely than women (20 percent versus 6 percent) to have an additional blood clot. It remains unclear exactly what triggers a recurrence, but additional risk factors (such as genes and lifestyle) certainly play a role.

Causes of venous thrombosis

Blood is more prone to clot if one or more of the following three factors occur:

Changes in the blood vessel wall
Changes in blood flow
Changes in blood constituents

Sings and Symptoms of venous thrombosis

Common sign and symptoms of venous thrombosis is :

Leg pain in one leg only
Leg tenderness in one leg only
Swelling (edema) of only one leg
Increased warmth of one leg
Changes in skin color of one leg, redness
Venography of the legs
Doppler ultrasound exam of an extremity
Plethysmography of the legs
D-dimer blood test

Diagnosis of venous thrombosis

Ultrasound scan
A venogram is currently the 'gold standard' for routine diagnosis of DVT
In a CT angiogram , dye is injected into the bloodstream. The chest is imaged using Computerised Tomography (CT). If a pulmonary embolism is present, this will show up as an area where there is no dye.
Magnetic Resonance Direct Thrombus Imaging (MRDTI), provides a very accurate picture of the clot.

Treatment of venous thrombosis

The standard treatment has been an anticoagulant medication called heparin, which was given through the vein.
Patients with altered mental status or hemiplegia should be given nothing by mouth to prevent aspiration. Intravenous fluids should not be hypotonic solutions.
Warfarin usually takes several days to become fully effective, so heparin is continued until the warfarin has been fully effective for at least 24 hours.
Seizures should be treated with appropriate anticonvulsants. Fosphenytoin is recommended for treatment of seizures in those patients who require a parenteral formulation.
Warfarin causes an increase in the time it takes blood to clot (known as the PT). The PT is monitored to determine if the blood is sufficiently anticoagulated.

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