Compare The Pathophysiology Of Chronic Venous Insufficiency And Deep Venous Thrombosis. Describe How Venous Thrombosis Is Different From Arterial Thrombosis.
There are various similarities and differences between the pathophysiology of chronic venous insufficiency and deep venous thrombosis. In order to appreciate the pathophysiology of chronic venous insufficiency, it’s important to understand the peripheral venous systems which act as a reservoir and conduit system for storing blood and returning it to the heart. For this system to function properly, it needs a series of valves and muscular pumps that convey blood from the lower-extremity levels of the venous system, against gravity and fluctuating thoracoabdominal pressure, to the central circulation system. CVI affects this venous system of the lower venous structures and is associated with impaired venous systems, with venous hypertension causing various conditions such as edema, skin alterations, ulcerations, and discomfort. The causative factors of chronic venous insufficiency include disorders which lead to hypertension mainly through venous injury or incompetence that involves the venous valves, which can often lead to extreme cases of deep venous thrombosis. The condition is primarily due to the dysfunctional valves that are contained deep within the blood vessels or perforated blood vessels that are responsible for the reflux of blood due to progressive dilation and tortuosity which is caused by increased venous pressure (Gulati, 2013). Deep venous thrombosis is a manifestation of venous thromboembolism and may include conditions such as edema, leg pain due to varicose veins, tenderness, erythema of the skin near the thrombosis area, and pulmonary embolism. Almost 50% of the patients lack specific symptoms of DVT and have to rely on physical findings such as calf pain on foot dorsiflexion, blanched leg appearance due to edema, different discoloration of lower extremities, and cordlike and tender subcutaneous venous segment. In lower extremity DVT, most small thrombi resolve spontaneously after surgery. However, approximately 15% of these cases may extend into the proximal femoral venous system and pulmonary emboli. Upper extremity DVT is composed of effort-induced and secondary thrombosis. Effort-induced thrombosis is also known as Paget-von Schrotter syndrome and accounts for about 25% of chronic venous compressive abnormalities caused by muscular structures in the costoclavicular space at the thoracic inlet and outlet. The remaining 75% of the patients suffer from secondary thrombosis which involves hypercoagulability and indwelling of the central venous catheters (Patel, 2016)
Arterial thrombosis is different from venous thrombosis because it usually takes place when blood flow from the heart other parts of the body occurs. This leads to tissue death, gangrene, or heart attacks. Venous thrombosis, on the other hand, occurs within veins that return blood to the heart. This can be treated with anticoagulants. A common cause of arterial thrombosis is arteriosclerosis, while for venous thrombosis is DVT (Koch, Chideckel, King, & Hungs, 2016).
Explain How The Patient Factor You Selected Might Impact The Pathophysiology Of CVI And DVT. Describe How You Would Diagnose And Prescribe Treatment Of These Disorders For A Patient Based On The Factor You Selected.
Chronic venous insufficiency describes some different and advanced forms of long standing venous conditions including those that affect the limbs, edema, various venous ulcerations, and skin changes. Varicose veins affect more than a population of 25% of women and 15% of men in the country while chronic venous insufficiency is considered to take place among an estimated 4-5% of the population in European countries. This prevalence is compared to that of diabetes.
The deep venous thrombosis condition is estimated to affect about 1-6% (per 1000 persons each year), and post-thrombotic syndrome developed some time after deep venous thrombosis in 17% of the limbs within a one year gap (McPhee and Hammer, 2010). Various confirmed management options for DVT include anticoagulants such as heparins, warfarin, factor Xa inhibitors, endovascular and surgical interventions, physical measures (ambulation and elastic compression stockings), and endovascular therapies that are performed in the reduction of the severity and duration of lower extremity symptoms. Heparin products used in treating DVT include unfractionated heparin and low molecular weight heparin; factor XA inhibitors include Fondaparinux and Rivaroxaban; while endovascular treatments include angioplasty, mechanical thrombectomy, venous obstructions stenting, and thrombus removal. The American Heart Association recommends recurrent thromboembolism and acute proximal DVT for inferior vena cava filters (Patel, 2016). Diagnosis of CVI mainly involves clinical testing and ultrasonography to exclude DVT. Some methods used include leg elevation techniques, compression bandages, stockings, pneumatic devices, and surgery when the disorder becomes severe. Various experts include weight loss programs, regular exercise, and reduction of dietary sodium (Huether, S. E., & McCance, K. L., 2012).
Construct Two Mind Maps—One for Chronic Venous Insufficiency and One for Deep Venous Thrombosis. Include The Epidemiology, Pathophysiology, And Clinical Presentation, As Well As The Diagnosis And Treatment You Explained In Your Paper.
References
Ali, K. (2016). Mind maps (2015). Slideshare.net. Retrieved 27 June 2016, from http://www.slideshare.net/drkhaloodqays/mind-maps-2015doc-toonpage
Gulati, O. (2013). Pycnogenol® in Chronic Venous Insufficiency and Related Venous Disorders. Phytother. Res., 28(3), 348-362. http://dx.doi.org/10.1002/ptr.5019
Hanson, H. (2015). Chronic Venous Insufficiency. Prezi.com. Retrieved 27 June 2016, from https://prezi.com/h2jd777fgoep/chronic-venous-insufficiency/
Huether, S. E., & McCance, K. L. (2012). Understanding pathophysiology (Laureate custom Ed.). St. Louis, MO: Mosby.
Koch, D., Chideckel, D., King, D., & Hungs, D. (2016). What's the difference between arterial and venous thrombosis? - Answered by top doctors on HealthTap. HealthTap. Retrieved 27 June 2016, from https://www.healthtap.com/user_questions/22479-what-s-the-difference-between-arterial-and-venous-thrombosis
McPhee, S. J., & Hammer, G. D. (2010). Pathophysiology of disease: An introduction to clinical medicine (Laureate Education, Inc., custom Ed.). New York, NY: McGraw-Hill Medical.
Patel, K. (2016). Deep Venous Thrombosis: Practice Essentials, Background, Anatomy.Emedicine.medscape.com. Retrieved 27 June 2016, from http://emedicine.medscape.com/article/1911303-overview#a4
