DOCSLIB.ORG

UNDERSTANDING CHRONIC VENOUS HYPERTENSION Chronic Venous Hypertension Accounts for About 70% of Ulcers on the Lower Limb

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
UNDERSTANDING CHRONIC VENOUS HYPERTENSION Chronic Venous Hypertension Accounts for About 70% of Ulcers on the Lower Limb Review UNDERSTANDING CHRONIC VENOUS HYPERTENSION Chronic venous hypertension accounts for about 70% of ulcers on the lower limb. It is important to understand the underlying pathophysiology of the condition in order to rationalise assessment and treatment approaches. Irene Anderson is Senior Lecturer in Tissue Viability, University of Hertfordshire Figure 1. A venous leg ulcer. Venous disease is the underlying this article is to highlight key substances can pass through cause of venous ulceration (Figure areas in order to help healthcare them to nourish the tissues. 1). Although patients may cite professionals understand and trauma as the cause of their ulcer explain to patients the complex Veins are thinner than arteries it is in fact a wound complicated processes involved in venous and have three layers: the tunica by a disease process in the hypertension and leg ulcer lower leg (Rainey, 2002). It is development. Tunica adventitia important for the practitioner to Connective tissue understand the pathophysiology Veins in the lower leg of venous disease as this will Veins carry blood back to the enable them to make rational heart and the blood flows at a treatment decisions and explain relatively low pressure compared the importance of self care to arterial blood flow (which and compression therapy to carries the blood away from Tunica the patient. This article aims to the heart under high pressure) intima explain the pathophysiology of (Tortora and Grabowski, 2000). Endothelium chronic venous hypertension Internal elastic The arteries branch into smaller lamina and link this to clinical signs and smaller vessels, until the External elastic lamina and the symptoms experienced blood flows into capillaries. Smooth muscle cells by the patient. The mechanical The walls of capillaries are only Tunica media and cellular processes are very one cell thick (Tamir, 2002) so complex and the objective of that oxygen, glucose and other Figure 2. Structure of the vein. 20 Wound Essentials • Volume 3 • 2008 p20-32CVT.indd 2 17/6/08 16:07:25 Review (previously called long and short veins [Waugh and Grant, 2001; Meissner et al, 2007]). Deep veins are held within the muscle fascia of the leg while superficial veins are less supported and are nearer the surface of the leg (Waugh and Grant, 2001). These are the veins which are visible, e.g. on the foot. The perforator veins are named as such because they ‘perforate’ the fascia layer surrounding the muscles of the legs, linking the superficial and deep veins. Perforator veins allow venous blood to flow from the superficial veins into the deep veins with the highest number of these joining veins being near the calf muscle (Meissner et al, 2007). All veins in the leg have valves to Figure 4. Chronic venous hypertension: ensure that venous blood travels backflow of venous blood increases the Figure 3. Venous blood flows up the back to the heart or from the blood volume in the leg veins forcing the leg and blackflow is prevented by one-way valves apart. one-way valves. superficial veins back to the deep veins via the perforators.These adventitia on the outside, tunica valves are particularly important in meets less resistance than media (middle layer) and the the lower leg as the blood needs when standing tunica intima, an inner layer of to flow upwards a considerable 8Breathing: On breathing in endothelial cells lining the vessel distance to the heart especially there is a negative pressure (Figure 2) (Waugh and Grant, if standing upright. If the valves created in the chest cavity. The 2001). The waste materials of do not work in the perforator abdominal pressure increases metabolism, such as carbon veins, blood is pushed out into as the diaphragm lowers and dioxide and lactic acid, filter in superficial veins, increasing the both mechanisms encourage the opposite direction into the pressure in these vessels. venous return capillaries which then join to form 8The calf-muscle pump: slightly larger vessels (venules, Venous flow in the lower leg this will now be discussed or tiny veins) which in turn join Venous blood returns to the heart in more detail. up to veins. mainly via the deep veins, which are bigger and stronger than the The calf-muscle pump The venous system is made superficial veins, and there are When blood is pumped into the up of a deep system and a three key mechanisms by which arteries by the heart, it is pushed superficial system, which are this blood flow is encouraged: forward under high pressure. joined by perforator (joining) veins 8Gravity: blood from the lower Only a little of this pressure is left ( Figure 3). The deep veins of the leg has to travel a long way once it has passed through the leg are the femoral, popliteal, against gravity to return to capillaries into the veins so the anterior and posterior tibial veins, the heart; therefore when the action of the muscles provides while the superficial veins are body is laying flat or when a pumping action that helps the great and small saphenous the legs are elevated the flow to push the blood up through 22 Wound Essentials • Volume 3 • 2008 p20-32CVT.indd 4 17/6/08 16:07:26 Review the veins. This muscle pump is particularly important in the legs, Normal venous return because on standing, blood has to travel a long way, against The veins gravity, to return to the heart. Damage to valves • Trauma/surgery to lower leg As the calf muscle contracts, • Vein thrombosis the valves in the deep veins • Increased vein capacity are squeezed and they open • Occupation • Obesity to allow the blood to travel • Pregnancy upwards. As the calf muscle relaxes the valve closes and creates a negative pressure as the section between valves empties. This negative pressure Abnormal venous return draws blood from the superficial The signs veins, through the perforators to refill the chamber ready for • Incompetent valves • Inflammatory cells activated the next contraction of the calf • Backflow (reflux) • Tissue damage/destruction muscle (Meissner et al, 2007). • Capillary leakage • Reduced growth factor activity • Oedema • Impaired tissue repair • Haemosiderin staining In the lower limb the normal • Skin changes venous pressure may range from • Ankle flare about 100mmHg when standing • Varicose veins still, falling to about 22mmHg when walking (Meissner et al, 2007). These pressure changes also occur on ankle flexion and How it affects the patient during exercises where the heel is raised and the person stands The patient on tiptoe. These changes in • Pain pressure on activity illustrate • Discomfort the key role of exercise in • Feeling of heaviness in the legs the management of venous • Risk of trauma hypertension. Even moderate • Potential ulceration and ulcer recurrence exercise in patients with reduced mobility can still be undertaken. Chronic venous hypertension The valves of the leg can become damaged by trauma, surgery to the lower leg that has involved Figure 5. Pathophysiology of chronic venous hypertension. cutting into veins, pregnancy, obesity, increased vein capacity on the vein wall and will affect increase. As the valves are unable and thrombosis. If the valves other parts of the venous system to prevent backflow of blood, are incompetent they will allow namely the perforators and the chronic venous hypertension backflow (reflux) of venous blood superficial system. As these results (Figures 4 and 5). Chronic in the deep vein and the volume veins stretch their valves here venous hypertension is the main of blood in the lower leg will will not close properly and the underlying cause of venous leg increase. This increased load volume of blood — and therefore ulceration (Morison and Moffatt, will cause a rise in the pressure the venous pressure — will 2004). 24 Wound Essentials • Volume 3 • 2008 p20-32CVT.indd 6 17/6/08 16:07:27 Review Review Table 2 Signs of chronic venous hypertension Signs Pathophysiology Common related signs and symptoms Ankle flare Chronic venous hypertension causes the capillaries to swell. Visible capillaries through the skin, most often on the medial (inner) malleolus (ankle). The area may also become itchy. Varicose veins Veins which are continually stretched lose elasticity and Prominent veins, varicosity may be palpable before becoming visible. Itch, pain the tunica media layer of the vein wall becomes fibrosed. especially after standing for long periods. Heavy bleeding if the vein is punctured. Increased volumes of blood cause the stretching and the valves can no longer close properly which increases the blood volume further because of backflow. the great and small saphenous and anterior tibial veins are most affected (Waugh and Grant, 2001). Oedema Swollen capillaries allow fluid to leak into the tissue. Pain, discomfort, difficulty walking and finding suitable footwear, skin trauma, fluid Normally excess tissue fluid would be reabsorbed back into leakage through skin, blistering. Risk of infection such as cellulitis. the capillaries but this may not be possible as the capillary is already congested due to backflow of blood in the veins (Waugh and Grant, 2001) Varicose eczema Inflammation, poor tissue nutrition and hydration. Link with Dry flaky skin, weeping skin, caused by sensitisers. Itch, skin trauma, skin venous hypertension is not fully understood. sensitivities. The skin initially is red and itchy, perhaps with scales and weeping blisters. As the condition becomes more chronic the skin can become much dryer and flaky, even with thick layers of dry scale known as hyperkeratosis (Cameron, 2007). Lipodermatosclerosis Prolonged inflammation, tissue fibrosis. Dry, hard, woody skin. Changes in lower leg shape known as the ‘inverted champagne bottle’. Haemosiderin staining Leakage of red cells from stretched capillaries stain the tissue Dark staining particularly in the area of the medial malleolus. a brown or rusty colour (Dealey, 2005). It is not just valve incompetence as it becomes tangled in the veins prevents excess tissue that leads to venous fibrosis (Meissner et al, 2007).
Load more

Recommended publications
  • Lower Extremity Deep Venous Thrombosis
    SECTION 5 Vascular System CHAPTER 34 Lower Extremity Deep Venous Thrombosis Ariel L. Shiloh KEY POINTS • Providers can accurately detect lower extremity deep venous thrombosis with point-of- care ultrasound after limited training. • Compression ultrasound exams are as accurate as traditional duplex and triplex vascular ultrasound exams. • Compression ultrasound exam at only two sites, the common femoral vein and popliteal vein, permits rapid and accurate assessment of deep venous thrombosis. Background care providers can perform lower extremity compression ultrasonography exams rapidly Venous thromboembolic disease (VTE) is a and with high diagnostic accuracy to detect common cause of morbidity and mortality in DVT. 7–13 A meta-analysis of 16 studies showed hospitalized patients and is especially preva- that point-of-care ultrasound can accurately lent in critically ill patients.1–3 Approximately diagnose lower extremity DVTs with a pooled 70% to 90% of patients with an identified source sensitivity of 96% and specificity of 97%.14 of pulmonary embolism (PE) have a proxi- Traditional vascular studies, the duplex mal lower extremity deep venous thrombosis and triplex exams, use a combination of (DVT). Conversely, 40% to 50% of patients two-dimensional (2D) imaging with compres- with a proximal DVT have a concurrent pul- sion along with the use of color and/or spectral monary embolism at presentation, and simi- Doppler ultrasound. More recent studies have larly, in only 50% of patients presenting with a demonstrated that 2D compression ultrasound PE can a DVT be found.4–6 exams alone yield similar accuracy as tradi- Point-of-care ultrasound is readily available tional duplex or triplex vascular studies.9,11,15–17 as a diagnostic tool for VTE.
    [Show full text]
  • Difference Between Vein and Venule Key Difference - Vein Vs Venule
    Difference Between Vein and Venule www.differencebetween.com Key Difference - Vein vs Venule The veins are the blood vessels that carry blood towards the heart. It always has a low blood pressure. Except the pulmonary and the umbilical veins, all the remaining veins carry the deoxygenated blood. On the contrary, the arteries carry blood away from the heart. The veins have valves in them to prevent the black flow of blood and to maintain unidirectional blood flow. They are less muscular, larger and are located closer to the skin. Venules are very smaller veins. They are the ones that collect blood from the capillaries. The collected blood will be directed to the larger and medium veins where the blood is transported towards the heart again. Many venules unite to form larger veins. The key difference between Vein and Venule is, the vein is a larger blood vessel that carries blood towards the heart while, the venule is a smaller minute blood vessel that drains blood from capillaries to the veins. What is a Vein? The veins are larger blood vessels present in throughout the body. The main function of veins is to carry oxygen-poor blood back into the heart. Veins are classified into some categories such as, superficial veins, pulmonary veins, deep veins, perforator veins, communicating veins and systematic veins. The wall of the vein is thinner and less elastic than the wall of an artery. The walls of the veins consist three layers of tissues which are named as tunica externa, tunica media, and tunica intima. Veins also have larger and irregular lumen.
    [Show full text]
  • Peripheral Vascular Disease (PVD) Fact Sheet
    FACT SHEET FOR PATIENTS AND FAMILIES Peripheral Vascular Disease (PVD) What is peripheral vascular disease? Vascular disease is disease of the blood vessels (arteries and veins). Peripheral vascular disease (PVD) affects The heart receives blood, the areas that are “peripheral,” or outside your heart. sends it to The most common types of PVD are: the lungs to get oxygen, • Carotid artery disease affects the arteries and pumps that carry blood to your brain. It occurs when it back out. one or more arteries are narrowed or blocked by plaque, a fatty substance that builds up inside artery walls. Carotid artery disease can increase Veins carry Arteries carry your risk of stroke. It can also cause transient blood to your oxygen-rich [TRANZ-ee-ent] ischemic [iss-KEE-mik] attacks (TIAs). heart to pick blood from up oxygen. your heart TIAs are temporary changes in brain function to the rest of that are sometimes called “mini-strokes.” your body. • Peripheral arterial disease (PAD) often affects the arteries to your legs and feet. It is also caused by Healthy blood vessels provide oxygen plaque buildup, and can for every part of your body. cause pain that feels like a dull cramp or heavy tiredness in your hips or legs when • Venous insufficiency affects the veins, usually you exercise or climb stairs. in your legs or feet. Your veins have valves that This pain is sometimes Damaged Healthy keepvalve blood fromvalve flowing backward as it moves called claudication. If PAD toward your heart. If the valves stop working, blood worsens, it can cause cold Plaque can build backs up in your body, usually in your legs.
    [Show full text]
  • Anatomy of the Large Blood Vessels-Veins
    Anatomy of the large blood vessels-Veins Cardiovascular Block - Lecture 4 Color index: !"#$%&'(& !( "')*+, ,)-.*, $()/ Don’t forget to check the Editing File !( 0*"')*+, ,)-.*, $()/ 1$ ($&*, 23&%' -(0$%"'&-$(4 *3#)'('&-$( Objectives: ● Define veins, and understand the general principles of venous system. ● Describe the superior & inferior Vena Cava and their tributaries. ● List major veins and their tributaries in the body. ● Describe the Portal Vein. ● Describe the Portocaval Anastomosis Veins ◇ Veins are blood vessels that bring blood back to the heart. ◇ All veins carry deoxygenated blood. with the exception of the pulmonary veins(to the left atrium) and umbilical vein(umbilical vein during fetal development). Vein can be classified in two ways based on Location Circulation ◇ Superficial veins: close to the surface of the body ◇ Veins of the systemic circulation: NO corresponding arteries Superior and Inferior vena cava with their tributaries ◇ Deep veins: found deeper in the body ◇ Veins of the portal circulation: With corresponding arteries Portal vein Superior Vena Cava ◇Formed by the union of the right and left Brachiocephalic veins. ◇Brachiocephalic veins are formed by the union of internal jugular and subclavian veins. Drains venous blood from : ◇ Head & neck ◇ Thoracic wall ◇ Upper limbs It Passes downward and enter the right atrium. Receives azygos vein on its posterior aspect just before it enters the heart. Veins of Head & Neck Superficial veins Deep vein External jugular vein Anterior Jugular Vein Internal Jugular Vein Begins just behind the angle of mandible It begins in the upper part of the neck by - It descends in the neck along with the by union of posterior auricular vein the union of the submental veins.
    [Show full text]
  • Incidence of Deep Venous Thrombosis and Stratification of Risk Groups in A
    ORIGINAL ARTICLE Incidence of deep venous thrombosis and stratification of risk groups in a university hospital vascular surgery unit Incidência de trombose venosa profunda e estratificação dos grupos de risco em serviço de cirurgia vascular de hospital universitário 1 1 1 2 Alberto Okuhara *, Túlio Pinho Navarro , Ricardo Jayme Procópio , José Oyama Moura de Leite Abstract Background: There is a knowledge gap with relation to the true incidence of deep vein thrombosis among patients undergoing vascular surgery procedures in Brazil. This study is designed to support the implementation of a surveillance system to control the quality of venous thromboembolism prophylaxis in our country. Investigations in specific institutions have determined the true incidence of deep vein thrombosis and identified risk groups, to enable measures to be taken to ensure adequate prophylaxis and treatment to prevent the condition. Objective: To study the incidence of deep venous thrombosis in patients admitted to hospital for non-venous vascular surgery procedures and stratify them into risk groups. Method: This was a cross-sectional observational study that evaluated 202 patients from a university hospital vascular surgery clinic between March 2011 and July 2012. The incidence of deep venous thrombosis was determined using vascular ultrasound examinations and the Caprini scale. Results: The mean incidence of deep venous thrombosis in vascular surgery patients was 8.5%. The frequency distribution of patients by venous thromboembolism risk groups was as follows: 8.4% were considered low risk, 17.3% moderate risk, 29.7% high risk and 44.6% were classified as very high risk. Conclusion: The incidence of deep venous thrombosis in vascular surgery patients was 8.5%, which is similar to figures reported in the international literature.
    [Show full text]
  • Vein Disease: Your Personal Prevention Programme While Your
    Vein disease: Your personal prevention programme While your arteries transport blood containing oxygen and nutrients to the body cells, the veins are responsible for taking ‘used’ blood via the heart back to the lungs, where it can be enriched with fresh oxygen. In order for blood to be returned to the heart against the force of gravity, the vein valves must close tightly and the tissue which surrounds the veins must be strong. Otherwise the veins expand and become varicose. There’s a danger of thromboses, emboli and so-called ‘open leg’ ulcers. Self-diagnosis Spider-bursts (left) and reticular veins (right) are changes in the blood vessels which can be early signs of vein disease. Varicose veins (left and right) should be treated, if necessary surgically, as soon as possible. Deep vein thrombosis (left) is highly dangerous: You must seek treatment immediately! If you have vasculitis (inflammation of the vein wall - right) you should also visit a doctor or specialist clinic without delay. The classic symptoms of vein disease are swollen legs, pins and needles and feelings of tension in the calves, foot and calf cramps, legs which feel heavy or tired in the evening. Standing the whole day or frequent flying put a special burden on the vein system of the legs. © heigel.com www.heigel.com These things are good for your veins: Take frequent long walks as this exercises the leg and foot musculature. Sports involving sustained activity, such as hiking, swimming, jogging, skiing, dancing, cycling and gymnastics, are especially recommended. Whenever you are involved in an activity which involves sitting or standing, take every opportunity which presents itself to walk around.
    [Show full text]
  • What Is Dvt? Deep Vein Thrombosis (DVT) Occurs When an Abnormal Blood Clot Forms in a Large Vein
    What is DVt? Deep vein thrombosis (DVT) occurs when an abnormal blood clot forms in a large vein. These clots usually develop in the lower leg, thigh, or pelvis, but can also occur in other large veins in the body. If you develop DVT and it is diagnosed correctly and quickly, it can be treated. However, many people do not know if they are at risk, don’t know the symptoms, and delay seeing a healthcare professional if they do have symptoms. CAn DVt hAppen to me? Anyone may be at risk for DVT but the more risk factors you have, the greater your chances are of developing DVT. Knowing your risk factors can help you prevent DVt: n Hospitalization for a medical illness n Recent major surgery or injury n Personal history of a clotting disorder or previous DVT n Increasing age this is serious n Cancer and cancer treatments n Pregnancy and the first 6 weeks after delivery n Hormone replacement therapy or birth control products n Family history of DVT n Extended bed rest n Obesity n Smoking n Prolonged sitting when traveling (longer than 6 to 8 hours) DVt symptoms AnD signs: the following are the most common and usually occur in the affected limb: n Recent swelling of the limb n Unexplained pain or tenderness n Skin that may be warm to the touch n Redness of the skin Since the symptoms of DVT can be similar to other conditions, like a pulled muscle, this often leads to a delay in diagnosis. Some people with DVT may have no symptoms at all.
    [Show full text]
  • Hypertension: Putting the Pressure on the Silent Killer
    HYPERTENSION: PUTTING THE PRESSURE ON THE SILENT KILLER MAY 2016 TABLEHypertension: putting OF the CONTENTS pressure on the silent killer Table of contents UNDERSTANDING HYPERTENSION AND THE LINK TO CARDIOVASCULAR DISEASE 2 Understanding hypertension and the link to cardiovascular disease THEThe social SOCIAL and economic AND impact ECONOMIC of hypertension IMPACT OF HYPERTENSION 3 Diagnosing and treating hypertension – what is out there? DIAGNOSINGChallenges to tackling hypertension AND TREATING HYPERTENSION – WHAT IS OUT THERE? 6 Opportunities and focus areas for policymakers CHALLENGES TO TACKLING HYPERTENSION 9 OPPORTUNITIES AND FOCUS AREAS FOR POLICYMAKERS 15 HYPERTENSION: PUTTING THE PRESSURE ON THE SILENT KILLER UNDERSTANDING HYPERTENSION AND THE LINK TO CARDIOVASCULAR DISEASE Cardiovascular disease (CVD), or heart disease, is the number one cause of death in the world. 80% of deaths due to CVD occur in countries and poor communities where health systems are weak, and CVD accounts for nearly half of the estimated US$500 billion annual lost economic output associated with noncommunicable diseases (NCDs) in low-income and middle-income countries. In 2012, CVD killed 17.5 million people – the equivalent of every 3 in 10 deaths.1 Of these 17 million deaths a year, over half – 9.4 million - are caused by complications in hypertension, also commonly referred to as raised or high blood pressure2. Hypertension is a risk factor for coronary heart disease and the single most important risk factor for stroke - it is responsible for at least 45% of deaths due to heart disease, and at least 51% of deaths due to stroke. High blood pressure is defined as a systolic blood pressure at or above 140 mmHg and/or a diastolic blood pressure at or above 90 mmHg.
    [Show full text]
  • Hypertension and Coronary Heart Disease
    Journal of Human Hypertension (2002) 16 (Suppl 1), S61–S63 2002 Nature Publishing Group All rights reserved 0950-9240/02 $25.00 www.nature.com/jhh Hypertension and coronary heart disease E Escobar University of Chile, Santiago, Chile The association of hypertension and coronary heart atherosclerosis, damage of arterial territories other than disease is a frequent one. There are several patho- the coronary one, and of the extension and severity of physiologic mechanisms which link both diseases. coronary artery involvement. It is important to empha- Hypertension induces endothelial dysfunction, exacer- sise that complications and mortality of patients suffer- bates the atherosclerotic process and it contributes to ing a myocardial infarction are greater in hypertensive make the atherosclerotic plaque more unstable. Left patients. Treatment should be aimed to achieve optimal ventricular hypertrophy, which is the usual complication values of blood pressure, and all the strategies to treat of hypertension, promotes a decrease of ‘coronary coronary heart disease should be considered on an indi- reserve’ and increases myocardial oxygen demand, vidual basis. both mechanisms contributing to myocardial ischaemia. Journal of Human Hypertension (2002) 16 (Suppl 1), S61– From a clinical point of view hypertensive patients S63. DOI: 10.1038/sj/jhh/1001345 should have a complete evaluation of risk factors for Keywords: hypertension; hypertrophy; coronary heart disease There is a strong and frequent association between arterial hypertension.8 Hypertension is frequently arterial hypertension and coronary heart disease associated to metabolic disorders, such as insulin (CHD). In the PROCAM study, in men between 40 resistance with hyperinsulinaemia and dyslipidae- and 66 years of age, the prevalence of hypertension mia, which are additional risk factors of atheroscler- in patients who had a myocardial infarction was osis.9 14/1000 men in a follow-up of 4 years.
    [Show full text]
  • Association Between Hemorrhoids and Lower Extremity Chronic Venous Insufficiency
    Open Access Original Article DOI: 10.7759/cureus.4502 Association Between Hemorrhoids and Lower Extremity Chronic Venous Insufficiency Ugur Ekici 1 , Abdulcabbar Kartal 2 , Murat F. Ferhatoglu 2 1. General Surgery, Istanbul Gelişim University, Istanbul, TUR 2. General Surgery, Okan University Medical Faculty, Istanbul, TUR Corresponding author: Abdulcabbar Kartal, [email protected] Disclosures can be found in Additional Information at the end of the article Abstract Aim The aim of the present study was to evaluate the incidence of varicose veins among patients with hemorrhoidal disease and to compare its incidence reported in various community-based studies. Method The study group comprised of 100 patients who underwent surgery for symptomatic internal or external hemorrhoids; the control group consisted of 100 volunteers who received no prior therapy for hemorrhoidal disease and lacked any symptoms or findings suggestive of this condition. Subjects in both the groups were inquired with respect to their demographic data and risk factors. Both groups were asked to stand for two minutes before performing leg examinations while still in the standing position. The findings were recorded for both the groups. Varicose veins were classified according to the clinical appearance section of the Clinical, Etiologic, Anatomic, and Pathophysiologic (CEAP) classification that was developed by the 1994 American Venous Forum. Results There was no significant difference between the two groups with respect to age and body mass index (BMI). Significant relationships were identified between the groups with respect to the incidence of varicose veins and chronic constipation. The incidence of C1 and C2 varicose veins observed in the study group was higher than that observed in the control group.
    [Show full text]
  • What You Need to Know About Deep Vein Thrombosis (DVT)
    What You Need to Know About Deep Vein Thrombosis What is a Deep Vein Thrombosis? A deep vein thrombosis (DVT) is a blood clot that forms in the veins in the body (usually in the leg or pelvis). What causes a Deep Vein Thrombosis? Deep vein thrombosis (DVT) sometimes occurs for no apparent reason. However, certain factors can increase the chance of developing a DVT: • Inactivity • Hospital stays and surgery • Damage to your blood vessel from an injury or trauma • Medical and genetic conditions • Pregnancy • Taking estrogen-based medicine such as hormonal birth control or hormone replacement therapy • Overweight or obese • Family history of DVT • Older age What are the symptoms of DVT? Only about half of the people who have a DVT have signs and symptoms. These signs and symptoms of a deep vein clot include: • Pain or tenderness, often starting in the calf. • Swelling, including the ankle & foot. • Warmth and redness of the area or a noticeable discoloration Vascular Surgery -1- How is a DVT diagnosed? Your doctor will ask you questions about your symptoms and if your symptoms suggest that a blood clot is likely, you could have one or all of the following tests: • Blood test for a D-dimer: this test measures the level of a compound released when blood clots are dissolving. A high level may mean you have Deep Vein Thrombosis (DVT). • Imaging studies: o Ultrasound – This is the most common test for diagnosing deep vein blood clots. This test uses sound waves to create pictures of blood flowing through the arteries and veins in the affected leg.
    [Show full text]
  • Hypertension, Cholesterol, and Aspirin with Cost Info
    Diabetes & Your Health High Blood Pressure & Diabetes Aspirin & Did you know as many as two out of three adults with Heart Health diabetes have high blood pressure? High blood pressure Studies have shown is a serious problem. It can raise your chances of stroke, that taking a low- heart attack, eye problems, and kidney disease. dose aspirin every Many people do not know they have high blood pressure day can lower the because they do not have any symptoms. That is why it risk for heart attack is often called “the silent killer.” and stroke. The only way to know if you have high blood pressure is Aspirin can help to have it checked. If you have diabetes, you should those who are at high have your blood pressure checked every time you see risk of heart attack, the doctor. People with diabetes should try to keep their such as people who blood pressure lower than 130 over 80. have diabetes or high blood pressure. Cholesterol & Diabetes Aspirin can also help Keeping your cholesterol and other blood fats, called lipids, under control can people with diabetes help you prevent diabetes problems. Cholesterol and blood lipids that are too who have already high can lead to heart attack and stroke. Many people with diabetes have had a heart attack or problems with their cholesterol and other lipid levels. a stroke, or who have heart disease. You will not know that your cholesterol and blood lipids are at dangerous levels unless you have a blood test to have them checked. Everyone with diabetes Taking an aspirin a should have cholesterol and other lipid levels checked at least once per year.
    [Show full text]