Thrombophlebitisis inflammation of the veins (veins) that triggers the formation of blood clots in one or more veins. Generally, thrombophlebitis occurs in the veins in the legs, but it is possible this condition can also occur in the veins in the arms.
Thrombophlebitis can occur in veins close to the skin (Fig.superficial thrombophlebitis) or in deeper veins (deep vein thrombosis). However, this article will limit the discussion to superficial thrombophlebitis, or simply called thrombophlebitis.
Causes of Thrombophlebitis
Thrombophlebitis is caused by the formation of blood clots. This can occur due to several things, such as:
- Blood clotting disorders inherited from parents, eg protein C . deficiency
- Injury to the vein due to insertion of a vascular catheter or pacemaker
- Not moving for a long time, for example sitting in a car or plane on a long trip, or lying down for too long because of an illness (such as a stroke)
Thrombophlebitis Risk Factors
The risk of thrombophlebitis in a person can increase if there are some of the following factors:
- Aged 60 years and over
- Are pregnant or have just given birth
- Have you had thrombophlebitis before?
- Using a pacemaker or a catheter attached to a central vein
- Experiencing hormonal changes, for example from taking hormone replacement therapy or taking birth control pills
- Being dehydrated (lack of fluids), so that the blood vessels become narrowed and the blood thickens
- Have a history of blood clotting disorders, both in yourself and in your family
- Have excess weight
- Smoke
- Have you ever had a stroke?
- Suffering from cancer
Symptoms of Thrombophlebitis
Symptoms and signs of thrombophlebitis appear in areas of the body where the veins become inflamed. Signs and symptoms include:
- Swelling
- Protrusion of veins on the surface of the skin
- Reddened skin that feels warm to the touch
- Pain that gets worse when pressed
When to go to the doctor
Immediately consult a doctor if the above symptoms appear, especially if you have risk factors for thrombophlebitis. Treatment should be given immediately if the pain and swelling in the veins is severe enough.
Thrombophlebitis can cause pulmonary embolism. Immediately go to the nearest hospital emergency room if you experience the following symptoms:
- Chest pain
- Hard to breathe
- Bleeding cough
Diagnosis of Thrombophlebitis
The doctor will first ask about the symptoms, past medical history, and the patient's family medical history. After that, the doctor will perform a physical examination to see which blood vessels are affected by thrombophlebitis.
Next, the doctor will suggest a series of more detailed examinations, such as:
- Blood test, to measure levels of D-dimer, which is a protein that is formed when a blood clot breaks down
- Ultrasound, to ensure that the patient's complaints are caused by thrombophlebitis, not deep vein thrombosis
- Venography (X-rays with the help of contrast fluid), to determine the condition of blood flow in the veins
- CT scan, if the doctor suspects symptoms of pulmonary embolism
- MR angiography (MRI with the help of contrast fluid), to see the condition of the blood vessels
Thrombophlebitis Treatment
Thrombophlebitis that occurs below the surface of the skin (superficial) can be treated independently at home. The trick is to do the following simple steps:
- Taking nonsteroidal anti-inflammatory drugs (NSAIDs)
- Compress the sore area with warm water 2-3 times a day
- Placing the affected leg in a higher position while sleeping or sitting
- Use compression stockings to improve leg blood flow and reduce swelling
However, if within 1 week the condition does not improve or gets worse, the doctor may suggest the following treatment methods:
- Giving blood thinning drugs (anticoagulants), such as heparin or warfarin, to prevent blood clots from getting bigger
- Administration of clot-busting or thrombolytic drugs, such as alteplase
- Installation of a filter or a filter in the large vein (vena cava) in the abdomen, to prevent pulmonary embolism
- Surgery to remove varicose veins, to relieve pain and prevent recurrence of thrombophlebitis
Complications of Thrombophlebitis
Although rare, thrombophlebitis can cause the following complications:
- Pulmonary embolism, which is a blood clot that blocks an artery in the lungs and causes a life-threatening condition
- Post thromotic ssyndrome (PTS), which is a condition that appears several months or years after the patient has thrombophlebitis, characterized by severe pain accompanied by swelling and heaviness in the affected leg.
Prevention of Thrombophlebitis
There are a number of ways that can be done to prevent thrombophlebitis, namely:
- Actively moving
- Walk at least once an hour if you have a job that requires sitting for a long time
- Avoid wearing tight clothes
- Drink enough water to avoid dehydration