venous thrombo

It implies thrombus formation in the systemic or right side of the heart. It can embolise to lung resulting in pulm embolism n infarction.

Common sites
-deep venous system of lower limbs(95% emboli arise from here)
-pelvic veins
-right atrium
-right ventricle.

Pathogenesis
-stasis of blood
-abnormalities of vessel wall
-hypercoagulable state.

Risk factors
-low cardiac output
-obesity.advancing age
-prolonged bed rest
-post partum period
-dehydration.polycythemia
-long surgical procedure
-Left and right ventricular failure

C/f
-low grade fever
-pain tenderness warmth and swelling of calf muscles
-there may be cyanosis,edema n gangrene

Investigations
-D dimer is elevated >500ng/ml
-doppler ultrasonography
-ascending cöntrast venography
-impedance plethysmography
-radiofibrinogen method.

Treatment
-bed rest
-physiotherapy to limbs
-start treat with warfarin for 3-6 mths.
-low molecular weight heparin
-thrombolysis wid streptokinase
-thrombectomy