The Pathophysiology of Chronic Venous Insufficiency
Chronic venous insufficiency (CVI) is a condition affecting the venous system in the lower part of the body when the valves in the legs are not working effectively. The pathophysiology of CVI is composed of the peripheral venous system which is dependent on various valves and muscle pumps (Gresele et al.,2017). Proper functioning of the system demands that blood entering the lower extremity venous system circulate against gravity for effective circulation in an individual. When venous pressure increase, the flow of blood is impaired causing dysfunction in the lower extremity.
The Pathophysiology of Deep Venous Thrombosis .
Deep venous thrombosis refers to clotting of blood which occurs in the deep veins of the body extremities. The conditions emerge as a result of impairment which cause venous return leading to swelling in an extremity, pain and pulmonary embolism. The condition affects clotting of blood in the body causing the formation of thrombus or blood clots in the deep parts of the body (Watson et al., 2016). The blood clots in the veins have adverse effects on the body as their dislodge can block blood flow.
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Differences
Venous thrombosis
Thrombosis is the formation of thrombus or clots which is attributed to morbidity and mortality in many clinical cases. Venous thrombosis refers to blood clot which occur within the veins. An example and a common type of venous thrombosis is the deep veins thrombosis DVT which occurs as a result of blood clot deep in the veins of the leg (Wolberg et al.,2015). The mechanism o occurrence of venous thrombosis is not clearly defined but is thought to be caused through a tissue when prothrombin is converted into thrombin.an arterial thrombosis on the other hand occurs when the wall of a blood vessel is damaged (Gresele et al.,2017). It refers to the process through which platelet rich thrombus are formed due to ruptured atherosclerotic plagues. An arterial thrombosis is associated with disability and death due to its severe complications. The condition occurrence due to the component of the plague results in rapture promoting subsequent thrombosis (Wolberg et al.,2015). The main difference between venous thrombosis and arterial thrombosis lies in the activation of coagulation. In the arterial system, activation of coagulations is prevented by the high flow.
Behavior factor in pathophysiology of CVI
CVI occurs when the valve which keep blood from flowing backward fail to function effectively and cause blood to collect in the main. The occurrences are caused by behaviors o individuals such as failure to exercise, long hours of sitting or standing which raises the pressure in the vein weakening the valve. The condition is also common to individuals who are obese or smokers where personal behavior contributes to CVI. On the other hand, behavior also have its place in the pathophysiology of DVT (Gresele et al.,2017) . In deep vein thrombosis, blood clots are caused by substances which prevent normal blood circulation and blood clot. Such events include injury to veins, surgery, medications and limitations in movement.
Human behavior is also a risk factor of DVT. Such behaviors include having a prolonged bed rest which forces the legs to remain still. As a result, the calf muscles fail to contract and hence hinder blood circulation increasing the risk of blood clot formation. Other behaviors include uncontrolled consumption of food leading to obesity which increases the pressure in the veins in the lower extremity (Gujja, & Wiley, 2017). Behaviors such as smoking affects blood circulation and interfere with the clotting process. Sitting still for longer periods when driving or flying also contributes to DVT.
Diagnosis and prescription of treatment for CVI
The diagnosis includes evaluation of medical history which provides insights into the diagnosis. Using a vascular or duplex ultrasound, the blood flow in the legs is tested. Other tests include the use of sound waves by placing a device on the patient skin over the vein to determine the direction and speed of flow. Further test includes the use of x-rays and scans for further analysis and determination of other causes of swelling in the leg. The treatment of CVI is most effective in the early stages (Gujja, & Wiley, 2017). The treatment involved different combinations of treatments with the goal of reducing pooling of blood and prevention of leg ulcers. The main treatments include regular exercise, weight loss, practice of good hygiene as well as avoidance of long period of standing or sitting.
Deep Venous Thrombosis (DVI)
The diagnosis of DVI is done using ultrasonography and d-dimer testing. History and physical examinations are conducted to determine the probability of the condition before administration of tests. Further analysis determines the need for additional tests if deep venous thrombosis is suspected. DVI is treated through the process of anticoagulation effected through injectable heparin and an oral anticoagulant (Watson et al., 2016). The treatment prevents PE and also reliefs the symptoms, prevents reoccurrence and associated conditions such as the chronic venous insufficiency, and postphlebitic syndrome. The main goal of the treatment is prevention of severe complications, however in rare cases treatment can involve surgery.
References
Gresele, P., Kleiman, N. S., Lopez, J. A., & Page, C. P. (Eds.). (2017). Platelets in Thrombotic and Non-Thrombotic Disorders: Pathophysiology, Pharmacology and Therapeutics: an Update . Springer.
Gujja, K., Sanina, C., & Wiley, J. M. (2017). Chronic venous insufficiency. Interventional Cardiology: Principles and Practice , 759-767.
Watson, L., Broderick, C., & Armon, M. P. (2016). Thrombolysis for acute deep vein thrombosis. Cochrane Database of Systematic Reviews , (11).
Wolberg, A. S., Rosendaal, F. R., Weitz, J. I., Jaffer, I. H., Agnelli, G., Baglin, T., & Mackman, N. (2015). Venous thrombosis. Nature Reviews Disease Primers , 1 , 15006.
