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Common Congenital Heart Lesions - page 119 / 126

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Venous Thrombosis

First, some general info…

Definition:

  • Venous thrombosis/thrombophlebitis: both these terms are used to describe the inflammatory

response of a vessel wall that is caused by thrombus inside a superficial or deep vein

Classification:

  • Thrombi in the legs are classified as either deep venous thrombi or superficial venous thrombi.

Composition of thrombus over time:

  • Early: venous thrombus composed of platelets and fibrin

  • Later: RBCs become interspersed in the fibrin and thrombus starts to propagate in the direction of

blood flow.

Vessel changes due to thrombosis:

  • Vessel structural changes can be minimal or can involve granulocyte infiltration, loss of endothelium, and/or edema.

  • Vessel flow may be diminished or obstructed by thrombi. Thrombi may dislodge, forming thromboemboli.

Now, onward to the disorders…

Venous Thrombosis – Deep Venous Thrombosis (DVT) Clinical Presentation:

  • May be asymptomatic.

  • Symptoms can include:

    • o

      Calf or thigh discomfort, esp when standing or walking

      • o

        Unilateral leg swelling

  • Complication of post phlebitic syndrome may present with:

        • Chronic leg swelling

        • Stasis pigmentation

        • Skin ulcerations

  • Complication of pulmonary embolism (PE) may present with:

    • Pleuritic chest pain

    • Tachypnea

    • Cough

    • dyspnea

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