Thromboembolism - Symptoms, Treatment, Causes, Surgery
What is Thromboembolism?
Thromboembolism is a condition characterized by the combination of two separate conditions called Thrombosis and its main complication known as an embolism. It is a formation of blood clots in the blood vessel or in the heart where the embolus or the foreign substance breaks away and blocks another blood vessel via the bloodstream. The obstruction of the clot can involve the lungs, brain, kidney, gastrointestinal tract and the legs.
Thromboembolism has an impact in causing disease and mortality especially in adult patients all over the world. The incidence is prevalent in African American individuals and is more common in males than in females. Thromboembolism is common in adult patients and rarely occurs in children and with peak onset in individuals above the age of 40 years.
Thrombosis is a condition characterized by the development of thrombus or blood clot within the blood vessel leading to the obstruction of blood flow in the circulatory system. The blood clot is formed by the platelets and fibrin which occur when there is a presence of blood vessel injury to thwart blood loss. Thrombosis is composed of two forms classified according to the area of formation. Venous thrombosis is the formation of thrombus in the vein while arterial thrombosis is thrombus formation within the artery.
An embolism is a thrombus that breaks away as a result of too much blood clot formation subsequently obstructing the blood vessels of another organ of the body via the bloodstream causing organ damage. An embolism is also classified according to its point of entry where venous embolism entered through the vein while arterial embolism entered through the artery.
Thromboembolism includes two interrelated conditions called deep vein thrombosis and pulmonary embolism. The symptoms of the condition however depend on the organ affected by Thromboembolism or the site with deprived or insufficient blood supply.
Thromboembolism often involves the vein thus the deep vein thrombosis that usually occurs in the legs or in the pelvis. The onset of deep vein thrombosis results to the inflammation of the vein and the surrounding skin. The symptoms of thrombosis include the following:
- Redness and warmth over the affected site
The formation of thrombus in excess will result in its breaking off and travel to another organ of the body where it will lodge in the blood vessel and cause obstruction. The embolus can enter the circulatory system via the blood vessel and enter the heart where it will lodge in one of the branches of the pulmonary artery of the lungs and is called pulmonary embolism. This is the main complication of Thromboembolism where it manifests with signs and symptoms such as:
- Acute onset of dyspnea or the shortness of breath
- Pleuritic chest pain
- Onset of fever
- Depression and anxiety
- Tachypnea or rapid breathing with a rate of less than 18 breaths per minute.
- Tachycardia or rapid resting heart rate that exceeds the normal range.
- Bluish discoloration of the skin or the mucous membrane resulting from insufficiency in oxygen supply may also be experienced.
- Sudden loss of consciousness or syncope is noted in massive pulmonary embolism.
Thromboembolism occurs when the thrombus formed breaks off and travels through the bloodstream and lodge to the blood vessel of the other organ of the body. The small size of the blood vessel will make it impossible for the thrombus to pass therefore causing an obstruction and lack in the supply of blood flow subsequently damaging the other parts of the body.
Thromboembolism can result from various causes such as:
- Injury or trauma such as surgery, infarction, heart attack and infection that lead to damage in the blood vessels or in the heart
- Diseases and disorders such as congestive heart failure, malignancy, inflammatory bowel disease, myocardial infarction, fracture, spinal cord injury associated with paralysis, and nephrotic syndrome
- Surgical procedures related to the type of procedure and its duration. Hip surgery or hip replacement is among the surgical factor being considered to cause Thromboembolism which is implicated on the twisting of the femoral veins during the procedure.
Other factors considered to cause Thromboembolism include the following:
- Age of the patient where individuals over the age of 40 years are at high risk for developing Thromboembolism.
- Individuals who are obese or overweight
- Individuals suffering from varicose veins
- Estrogen medication such as oral contraceptives and hormone replacement therapy.
- Prolonged immobility of an individual such as prolonged sitting or standing.
The goal in the treatment of Thromboembolism is to prevent blood clot from growing and prevent it from breaking and travelling to the bloodstream where it can lodge in the blood vessel. Anticoagulant and thrombolytic therapy are the options for treating Thromboembolism.
Heparin and Warfarin both have anticoagulant properties that can thin blood, break up blood clots and prevent new blood clots from forming. The medication can be given through intravenous infusion or can be injected under the skin.
Surgical intervention through thrombectomy and venous interruption is indicated for patients are not responding well to blood thinning medication or for those who have previously undergone major surgical procedures. Surgery however is the rare option for treating Thromboembolism while surgery is usually accompanied with a filter to prevent blood clot from breaking off.