Thrombosis

By thrombosis is meant a vascular occlusion by a blood clot. Why this can be dangerous, read here!

Thrombosis

The thrombosis is a vascular occlusion by a blood clot. Most commonly, thrombosis occurs in the veins in the leg. Important signs of thrombosis include swelling, pain and a red or bluish discoloration of the skin. Even fever is possible. Thrombosis is dangerous because the clot can dissolve and flush into other organs. Read all important information about thrombosis symptoms, treatment and prevention!

ICD codes for this disease: ICD codes are internationally valid medical diagnosis codes. They are found e.g. in doctor's letters or on incapacity certificates. I82I80I74

Product Overview

thrombosis

  • symptoms

  • treatment

  • Causes and risk factors

  • Diagnosis and examination

  • Disease course and prognosis

  • Prevent thrombosis

Thrombosis: short overview

  • Most common locations: Legs (especially lower leg), pelvic region, arms, upper or lower vena cava
  • Typical symptoms: Swelling, redness, overheating, pain and distension, fever, accelerated pulse
  • Treatment: Compression bandage or compression stockings, elevated storage, anticoagulant drugs, thrombectomy (OP)
  • Important investigations: Ultrasound imaging, venography ("vein X-ray"), CT, blood test (D-dimers, coagulation factors)
  • Hazards: Pulmonary embolism (pulmonary artery occlusion), vascular and tissue damage (postthrombotic syndrome)
  • Special form: Anal thrombosis (anal venous thrombosis)

Read also

  • Analthrombose

Thrombosis symptoms

There are a number of very typical signs of thrombosis. Depending on where the clot has formed, the symptoms are partially different.

Symptoms of thrombosis in the leg

Thrombosis is particularly common in the large veins of the lower leg. Because there, the blood flows against the force of gravity especially slowly back to the heart. The most common signs of thrombosis are then:

  • Swelling of the calf, often the ankle region and the foot
  • Severity and tension in the lower leg
  • Pain in the lower leg, sometimes in the foot, thigh or groin, which may resemble sore muscles
  • tense (shiny) and bluish discolored skin
  • Overheating of the lower leg
  • more visible skin veins (so-called warning veins)
  • light fever
  • accelerated pulse

Thrombosis in the arms usually cause more discomfort than vascular occlusions in the legs. In addition, they make themselves felt through an increased vein pattern, because the blood seeks its way to the heart via detours.

DangerEven if some of these symptoms are missing, a thrombosis in the leg is still not excluded. Neither are the said thrombosis signs proof that there really is a leg vein thrombosis.

Development of a thrombosis During a thrombosis, a blood clot forms in a blood vessel and blocks it. Mostly a vein in the leg is affected.

Symptoms of thrombosis in the arm

The veins in the arm can be closed by blood clots. This is much less common than in the leg. Typical symptoms of thrombosis in the arm are:

  • Swelling and overheating of the affected arm
  • Swelling of the hand
  • bluish skin veins
  • partially reddish-purple discoloration of the arm
  • Pain with pressure on the arm and when moving

Basically, thrombosis can occur in all blood vessels of the body. Unlike thrombosis in the extremities, the symptoms are often ambiguous. There may be severe pain or dysfunction of organs. To clarify such unspecific symptoms of thrombosis more and more medical examinations are required.

Symptoms of anal thrombosis (anal venous thrombosis)

An anal thrombosis is noticeable by a painful swelling in the anal area. The anal thrombosis is often difficult to distinguish from the so-called hemorrhoids. But it has another cause: in the case of anal thrombosis, the blood clot is formed in a small vein of the lower anal canal. The painful hemorrhoid, on the other hand, is an enlarged blood vessel of an arteriovenous vascular pad that penetrates outward from the inner anal canal.

Anal venous thrombosis is very painful, especially because it lies directly in the area of ​​the opening. The anal thrombosis, however, can usually be treated well. Here you can learn more about the symptoms, causes and therapy of anal thrombosis!

Thrombosis Treatment

A thrombosis can be treated by medication, by compression therapy or surgically. Which method is used depends, among other things, on the place where the clot has formed. Often, however, the different treatment approaches have to be combined.

The most important goal of thrombosis treatment is to prevent the clot from detaching itself from the vein wall and migrating with the bloodstream to vital organs. Because then there is the danger of a so-called embolism (for example, a pulmonary embolism), ie the clogging of an artery through the clot with potentially life-threatening consequences. In addition, long-term, irreparable damage to the affected blood vessels, extremities or organs (post-thrombotic syndrome) should be avoided.

Elevation and compression

Important immediate measures for a recent thrombosis in the extremities are to uplift the affected leg or arm and apply a compression bandage. This can prevent the blood from damaging even more and the extremity from swelling up.

The compression bandage must extend well beyond the site of the thrombosis - in the case of a lower leg thrombosis, ie below the knee. He must be taut to squeeze the veins so that the blood flows better inside them. He must not constrict the extremity at any point.

A good way to achieve a sufficiently strong and even degree of compression is compression class II thrombosis stockings. Compression treatment should be continued in the long term if veins have been damaged by the thrombosis.

Thrombosis treatment with drugs

The drug thrombosis treatment is intended to prevent the blood clot from growing and possibly being flushed into the pulmonary arteries. In the best case, the drug can cause the body's own substances (enzymes) to reduce the thrombus again or even completely dissolve. Anticoagulant drugs can also prevent the reoccurrence of thrombosis.

Acute treatment of thrombosis

One begins the treatment of thrombosis with a so-called initial anticoagulation, which should begin immediately if the diagnosis thrombosis was made or if thrombosis is very likely the cause of discomfort.

For this purpose, the drug is usually heparin, which inhibits blood clotting. Heparin must be given in high doses as a syringe under the skin (subcutaneous injection) or as an infusion. Because the drug would disintegrate in the gastrointestinal tract and then not get into the bloodstream.

The active ingredient fondaparinux is injected under the skin. It is mainly used when patients have previously reacted to a heparin dose with a life-threatening decrease in the number of blood coagulation platelets = platelets). Further active ingredients of the acute thrombosis treatment are the so-called DOACs (direct oral anticoagulants) rivaroxaban and apixaban.

Long-term treatment after a thrombosis

Afterwards, usually after about five to ten days, the patients receive an anticoagulant drug in tablet form to prevent a new clot from forming. This so-called maintenance therapy will continue for three to six months. For this purpose, so-called vitamin K antagonists are used. These are antagonists of important for blood clotting vitamin K. Especially the active ingredients phenprocoumone and warfarin are used in Germany.

Important: The correct dosage of these drugs must be regularly checked by blood tests of the so-called coagulation values!

Operative thrombosis treatment

Especially in young patients experiencing thrombosis in a large vein in the leg and pelvic region for the first time, surgical intervention may be the best treatment option. An attempt is made to grasp the blood plug (thrombus) with the help of a catheter and to pull it out of the vein. Doctors also speak of "recanalization", because with the procedure a blocked blood vessel is made through again. The doctors also check if there is a flow obstruction in the vein that can be cleared.

Often, a thrombus-dissolving drug is given over the catheter. This localized form of thrombosis treatment has better success rates and lower risks than the systemic treatment that used to be common in the past, where the drug had to be distributed throughout the body in high doses.

Recanalization therapy should be performed as early as possible to reduce the risk of postthrombotic syndrome. Possible complications of this type of thrombosis therapy are bleeding, but also accidental detachment of clots. These could then continue in the vein path towards the heart and the pulmonary circulation.

In some cases, patients with leg vein thrombosis are implanted with a sort of "sieve" into the vena cava filter, either permanently or temporarily. It is designed to prevent detached blood clots from being flushed into the lungs. This procedure is suitable for patients who repeatedly suffer from pulmonary embolism despite anticoagulant drugs.

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    Thromboses - life-threatening hikers

    The ability of the blood to clot is vital - otherwise, the human would bleed even in minor injuries. But if a blood clot forms in the veins, danger is in arrears.Because when such a lump goes on a wander, it can clog vessels - and thus cause a stroke, a heart attack or a pulmonary embolism. Read here if you are particularly at risk for thrombosis and how you can protect yourself.

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    Carrier blood flow

    Ingestion of blood is a risk factor: thromboses occur mainly in the veins, because here the blood flows more slowly than in the arteries. Most commonly, this happens in the legs, where the blood must be pumped to the heart against gravity. A great help for the venous pumps is movement - it prevents thrombosis.

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    Whoever rested, rusts

    Inactivity, however, is poison for the vessels: Long sitting (especially crowded!), For example, when traveling, increases the risk of Batthrombosen. Therefore, "tourist class syndrome" is called this phenomenon. But even those who have to lie in bed for a long time have a higher risk of thrombosis. Therefore, bedridden patients or those who have undergone surgery receive blood thinners.

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    Thick blood

    There is another risk of thrombosis if the blood is too thick. This is the case, for example, if you sweat too much or drink too little. But even hormonal changes can increase the risk of thrombosis - for example, during pregnancy or by taking the pill. Anyone who smokes then is particularly at risk: certain substances in cigarettes also alter the blood clotting and damage the vessel walls.

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    Risky calcification

    Whether due to cigarettes, diabetes, injuries or other factors: Vascular damage causes thrombosis in the soil. In particular, atherosclerosis is risky: it has formed on the inner site of the arteries plaques of calcium and fats. If these are torn, the body tries to mend the tear by clotting the blood. This can also form a clot.

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    Graft in the heart

    But clots can also develop directly in the heart, such as heart failure, when the blood is no longer effectively pumped out of the heart. Also in cardiac arrhythmias, in which the blood is swirled in the heart chambers. From there, the clots reach the brain very quickly, where they can cause a stroke.

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    Warning sign for thrombosis

    Some thromboses do not cause any symptoms at all. Others are noticeable: they trigger pain - especially under pressure. The affected part of the body is swollen, reddish and feels warmer. Then seek medical attention immediately to avoid dangerous clot migration!

Thrombosis: causes and risk factors

Thromboses are blood clots that form in the blood vessels - almost always in veins. You can basically have three different causes that may exist alone or in combination:

  • Flow obstacles in the blood vessel: Damage / diseases or deposits on the vessel wall or constrictions of the blood vessels due to mechanical pressure from outside (for example scarring, tumors)
  • slow flow rate: In abnormally dilated veins (varicose veins), by the effect of gravity or / and by a too low muscle tension (in immobility, paralysis or after operations), lack of fluid (blood becomes thicker)
  • increased coagulation tendency of the blood: Disorders of the blood coagulation system, severe systemic diseases (cancer, autoimmune diseases), drug side effects (such as the "pill"), smoking

Traveling thrombosis and thrombosis after surgery

Blood backflow to the heart must work in the deep veins of the leg against gravity. This is supported in healthy, physically active people by two mechanisms:

  1. Venous valves: They act like valves and allow the blood to flow only in one direction, namely to the heart.
  2. Muscle pump (muscle-vein pump): Through the work of the (calf) musculature, the veins in the leg are compressed again and again. In cooperation with the venous valves, the blood is thus pressed towards the heart.

If one or both mechanisms fail to function, blood flow can slow down greatly and the risk of thrombosis increases. This is the case, for example, when sitting in the car, the train or the plane for a long time. Therefore, one often speaks of a "traveling thrombosis". But even sitting for hours on the computer can increase the risk of thrombosis.

Similarly, after injury or surgery, after which the leg is sedated or generally strict bed rest must be met, the natural effect of the muscle pump. Because every trauma - and surgery in the broader sense of the word - significantly increases the blood's ability to coagulate, the risk of thrombosis after surgery is greatly increased.

Thrombosis: Pill even riskier than imagined

Taking the pill is dangerous, because the hormones contained increase the risk of thrombosis. From

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Thrombosis in varicose veins

Varicose veins are highly dilated blood vessels. They are particularly common in the area of ​​the legs, especially the lower leg.In varicose veins the blood flows more slowly and in addition, the natural valves in the veins, the venous valves, no longer function properly. This also increases the risk of thrombosis.

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    Veins - 10 tips on how to keep your legs fit

    Varicose veins, spider veins, thromboses - sick veins are not just an aesthetic problem. Keep your veins fit!

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    Make your legs restless!

    There's a simple rule to keep your legs in shape, the 3L-3S rule: walking and lying rather than sitting and standing. Keep your leg muscles moving, for example, through cycling, hiking, running, swimming or leg-gymnastics. The focus should be on the training of endurance.

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    Flat instead of high

    It is best not to wear high heels, even if they look so beautiful. Better is comfortable, flat footwear.

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    Circle toes

    It is not always possible to avoid sitting or standing for a long time, for example, people with an office job or those who have to sit in long conferences. The following applies: Activate your venous pump. For example, move your toes regularly up and down or claw them - stimulating blood circulation and muscle tone. Also, do not sit cross-legged.

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    Legs on the table!

    Store your legs more often. This works both while sitting and lying down - this may also be suitable for your desk. The blood does not accumulate and can flow back into the body.

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    Kneipp helps

    Shower your legs regularly cool (cold fountains, alternating showers). Start with your feet and bring the cold stream of water up to your thigh. The cool water promotes circulation and strengthens the elasticity of the veins.

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    Get out of the hot tub

    Avoid too much heat and tropical heat. Avoid using hours of sunbathing, hot water bottles and hot tub baths. The vessels dilate, the blood "sags" in the legs and is more difficult to transport back to the heart.

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    Shoes away!

    Throw your (maybe too tight) footwear into the corner and walk barefoot as often as you can. So the feet have more freedom and are better supplied with blood.

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    Bacon gone

    Reduce your overweight, if you are too fat - preferably through a high-fiber diet. Because every kilo more is an additional burden on the legs. The return of the venous blood to the heart becomes more and more laborious with increasing body weight and increased fat accumulation in the abdomen - venous diseases are favored.

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    Drink a lot

    Do you drink much! Recommended are about two liters of fluid a day - in heat or athletic effort more. Good thirst quenchers are water, fruit juice spritzers or unsweetened tea.

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    Fly and run

    A trip to Asia takes several hours - bad for the legs, which are usually trapped in the front seat. The blood builds up in the legs, in the worst case, it can lead to a life-threatening thrombosis. Here, foot exercises, lots of drinking and special travel socks reduce the risk of thrombosis.

Thrombosis: diagnosis and examination

In a venous thrombosis in one leg, this is overheated and swollen. Certain pressure points and movements trigger pain, which the doctor (usually a specialist in internal medicine) can determine with a physical examination. Typical examples are:

  • Calf pain when the toe is raised (Homans sign)
  • Pain when pressing the calf (Meyer sign)
  • Pressure pain on the inside of the foot (Payr sign)

In addition, an ultrasound examination can depict venous occlusion. In general: A superficial thrombosis is characterized by greater discomfort and is therefore often easier to diagnose than a vascular occlusion in deeper veins (phlebothrombosis). The latter, however, often has serious consequences.

With a phlebography (also: phlebography), the blood vessels in the body can be displayed on an x-ray. The procedure is therefore well suited for the diagnosis of deep vein thrombosis. For this purpose, a contrast agent is injected into a superficial vein on the back of the foot. To ensure that the contrast medium finds its way into the deep veins of the leg, the veins near the skin surface are first tied off with a moderately tight bandage. Where there is a thrombosis, the flow of contrast agent is interrupted or "constricted".

A much used examination procedure in vascular medicine is computed tomography (CT). In this method, the patient's body is virtually sliced ​​by X-rays. Due to the high density of images can also be represented vessels and organs. This method is used for example in thrombosis in the abdomen or in a cavernous sinus thrombosis in the head.

In rare forms of vascular occlusions, such as thrombosis in the eye, a specialist ophthalmologist can take a picture of the retina and thus detect a stasis.

blood test

In addition to imaging, a blood test is important. This is looking for breakdown products of blood clots, the so-called D-dimers. It should be noted that the D-Dimer Thrombosis Test should only be used to exclude a blood clot if there is a high likelihood of vascular occlusion. A broad screening is not feasible with this blood test.

Thrombosis & pregnancy

If thrombosis occurs during pregnancy or after miscarriage, additional examinations should be performed to find the cause. As a result, a similar course in a later pregnancy may be avoided.

Other special cases

Also in thrombosis, which have no clear cause or occur in atypical vessels, the doctor will also try to find the cause of clot formation. For example, some people suffer from hereditary diseases that can interfere with blood clotting.

Read more about the therapies

  • compression bandage
  • Lyse

Thrombosis: disease course and prognosis

Thrombosis is a very serious disease and can cause dangerous complications. These arise,

  • when a blood clot dissolves and migrates to the heart, from where it can enter the lungs, for example (pulmonary embolism)
  • if a vein can be blocked by a thrombus and permanently damaged (consequence: postthrombotic syndrome)

Pulmonary embolism is a particularly common and life-threatening complication of thrombosis. The thrombus (or parts of it) is flushed with the blood stream through the venous system to the right ventricle and from there into the pulmonary arteries. If he places a large artery there, a large part of the lungs will no longer be supplied with blood.

He can then no longer participate in the gas exchange, whereby a life-threatening oxygen deficiency can arise. In addition, the right ventricle can be excessively stressed by a high flow resistance; Right heart failure is also possible due to a pulmonary embolism. An embolism is therefore always a medical emergency!

Pulmonary embolism due to thrombosisA pulmonary embolism develops when part of a blood clot dissolves and enters the lungs via the heart.

Postthrombotic syndrome

Although the majority of thromboses heal without consequences, a third of patients suffer from a so-called post-thrombotic syndrome. This causes varicose veins due to a blood drainage disorder, which persists even after reopening of the affected vessels. This drainage obstruction can lead to further tissue damage or to new blood clots.

Prevent thrombosis

The best thrombosis prophylaxis (= prevention) is to avoid or reduce these thrombosis risk factors. For example, you should pay attention to sufficient exercise, especially on long flights, but also on long office work days. In addition, a sufficient fluid intake (drinking, liquid food) is important to keep the blood fluid and thus to avoid the formation of a clot.

Thrombosis syringes

After an injury or surgery or other illness-related immobilization, one can prevent clots with drugs: daily thrombosis injections with heparin can prevent the formation of a blood clot in most cases.

Anti-thrombosis stockings

So-called anti-thrombosis stockings are special, elastic stockings made of a skin-friendly, thin fabric that either reach down to the knee, or even over the knee, the thigh miterfassen. The light pressure that they exert on the veins causes the blood to flow back to the heart a little faster and more evenly.

In particular, if thrombosis risk factors such as a tendency to varicose veins exist, before and after surgery or for long journeys, it is recommended to wear anti-thrombosis stockings. Often they can help one thrombosis to prevent.

Additional information

Book recommendations:

  • Guide to varicose veins, leg swelling and thrombosis (Erika Medoza, 2016, Springer-Verlag)

guidelines:

  • S3 guideline "Prophylaxis of Venous Thromboembolism (VTE)" of the Association of Scientific Medical Societies (as of 2015)
  • S2k guideline "Diagnosis and Therapy of Venous Thrombosis and Pulmonary Embolism" of the German Society for Angiology - Society for Vascular Medicine (as of 2015)

Support Groups:

German Society for Angiology - Society for Vascular Medicine e.V.House of the Federal Press Conference
Shipbuilder dam 40
10117 Berlin

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Action alliance thrombosis:

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German Vascular League e.V.Mühlenstr. 21-25
50321 Bruehl

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Thrombosis

FAQ - 💬

❓ What are the warning signs of thrombosis?

👉 Deep vein thrombosis (DVT) symptoms can include: Leg swelling....Pulmonary embolism

  • Sudden shortness of breath.
  • Chest pain or discomfort that worsens when you take a deep breath or when you cough.
  • Feeling lightheaded or dizzy.
  • Fainting.
  • Rapid pulse.
  • Rapid breathing.
  • Coughing up blood.
11 Jun 2022

❓ What is the cure for thrombosis?

👉 The most common and effective treatments for thrombosis are medications called anticoagulants. These help prevent the formation of new blood clots. Usually, a person receives injectable anticoagulants, such as heparin or low-molecular-weight heparin. These medications begin working within hours.

❓ What is the most common thrombosis?

👉 Venous thromboembolism (VTE) is the most common vascular disease after acute myocardial infarction and stroke. It is represented by two main clinical events: deep venous thrombosis (DVT) and pulmonary embolism (PE), which often constitute an unique clinical picture in which PE follows DVT.

❓ Does a thrombosis go away?

👉 It takes about 3 to 6 months for a blood clot to go away. During this time, there are things you can do to relieve symptoms. Elevate your leg to reduce swelling. Talk to your doctor about using compression stockings.

❓ What causes thrombosis?

👉 Injury to a vein, such as from surgery, a broken bone, or other trauma. Lack of movement, such as after surgery or on a long trip. Inherited blood clotting disorders. A central venous catheter.

❓ What does an early blood clot feel like?

👉 The feeling can range from a dull ache to intense pain. You may notice the pain throbs in your leg, belly, or even your arm. Warm skin. The skin around painful areas or in the arm or leg with the DVT may feel warmer than other skin.

❓ What triggers thrombosis?

👉 Injury to a vein, such as from surgery, a broken bone, or other trauma. Lack of movement, such as after surgery or on a long trip. Inherited blood clotting disorders. A central venous catheter.

❓ What are 5 causes of a thrombus?

👉 What Causes a Thrombus?

  • Injury to the leg veins.
  • Illness that affects the veins.
  • Immobility.
  • Broken bone.
  • Certain medications.
  • Obesity.
  • Inherited (genetic) disorders.
  • Autoimmune disorders that increase the risk of blood clots.

❓ Is walking good for blood clots?

👉 Conclusions: Early walking exercise is safe in patients with acute DVT and may help to reduce acute symptoms. Exercise training does not increase leg symptoms acutely in patients with a previous DVT and may help to prevent or improve the postthrombotic syndrome.

❓ What can cause thrombosis?

👉 What causes thrombosis?

  • Disease or injury to the leg veins.
  • Not being able to move around (immobility) for any reason.
  • A broken bone (fracture)
  • Certain medicines.
  • Obesity.
  • Inherited disorders, or a greater likelihood of having a certain disorder based on your genes.

❓ Is thrombosis life threatening?

👉 Thrombosis occurs when blood clots block veins or arteries. Symptoms include pain and swelling in one leg, chest pain, or numbness on one side of the body. Complications of thrombosis can be life-threatening, such as a stroke or heart attack.

❓ What is thrombosis?

👉 Thrombosis (from Ancient Greek θρόμβωσις thrómbōsis "clotting”) is the formation of a blood clot inside a blood vessel, obstructing the flow of blood through the circulatory system.

❓ What is thrombosis and who is at risk?

👉 Every year, thousands of people in the United Kingdom die because of thrombosis, but what is thrombosis and who is at risk? Thrombosis is when a blood clot forms within a blood vessel and prevents the proper flow of blood around the circulatory system. This can have serious medical consequences, including death.

❓ What are the symptoms and treatment of thrombosis?

👉 Symptoms include pain and swelling in one leg, chest pain, or numbness on one side of the body. Complications of thrombosis can be life-threatening, such as a stroke or heart attack. Treatment includes medicines that thin the blood or prevent clots, and using stents or catheters to open blocked vessels.

❓ What is thrombosis and pulmonary embolism?

👉 Thrombosis: blood clots form in the deep veins of the human body. Pulmonary Embolism: a dangerous situation that occurs when a clot breaks up and travels through the body. Deep Vein Thrombosis (DVT): commonly occurs in the legs and is caused by blood clotting or sedentary lifestyles.


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