Symptoms presented by VT patients depend on the site and degree of thrombotic vessel occlusion. Individuals suffering from deep vein thrombosis, an entity typically compromising the veins of the lower limbs, may present with edema and erythema of the affected region. Tissues damaged by venous stasis may be tender or painful, and patients typically claim their discomfort to intensify after prolonged standing or walking. Homans' sign may be present. In severe cases, phlegmasia cerulea dolens or gangrene may be observed [6].

The occlusion of pulmonary arteries by thrombi that formed in the venous system causes acute-onset chest pain, dyspnea, tachycardia, and cyanosis. Affected individuals may also claim dizziness, sweating, and cough. A low-grade fever may be detected. A considerable subset of patients suffering from pulmonary embolism has a medical history of deep vein thrombosis.

• Pain

  We present the case of an adolescent patient who presented to a pediatric emergency department with progressive pain, discoloration, and swelling of the shoulder of his nondominant hand. [ncbi.nlm.nih.gov]

  Signs and symptoms include pain or stiffness, swelling and redness in the affected leg. The discomfort may start anywhere from the upper thigh to the ankle. [ucsfhealth.org]

  The skin over the vein becomes red, swollen, and painful. Doctors examine the area, but tests are not usually needed. People may need to take analgesics to relieve pain until the disorder resolves. [msdmanuals.com]

  Classic symptoms include: Pain Swelling Warmth Redness Leg cramps, often starting in the calf Leg pain that worsens when bending the foot Bluish or whitish skin discoloration You may or may not have all of these symptoms, or your may have none. [medicinenet.com]

  Tissues damaged by venous stasis may be tender or painful, and patients typically claim their discomfort to intensify after prolonged standing or walking. Homans' sign may be present. [symptoma.com]

• Surgical Procedure

  Thrombosis can happen for no apparent reason, but it is often associated with an inherited predisposition to blood clots, surgical procedures, immobility, oral contraceptive use or underlying medical conditions. [ucsfhealth.org]

  Surgery Pulmonary thromboendarterectomy is a surgical procedure and the only effective treatment for patients with Chronic Pulmonary Thromboembolism (blood clot in the lungs). [my.clevelandclinic.org]

  For this procedure, the patient will be asked to wear a medical gown and to lie down on an examination table. [docdoc.com.sg]

  Having a recent major surgical procedure, especially hip and knee orthopedic surgeries or one that requires prolonged bed rest, predispose the blood to clotting. [vascularcures.org]

• Gangrene

  Although surgery may be required when venous gangrene of the intestine occurs, early diagnosis may allow successful conservative management with anticoagulation. [casesjournal.biomedcentral.com]

  In severe cases, phlegmasia cerulea dolens or gangrene may be observed. The occlusion of pulmonary arteries by thrombi that formed in the venous system causes acute-onset chest pain, dyspnea, tachycardia, and cyanosis. [symptoma.com]

  Venous gangrene may result. Infection rarely develops in venous clots. [merckmanuals.com]

  In advanced cases of arteriosclerosis, a thrombus may fill up whatever channel remains through a vessel, completely blocking off circulation and causing gangrene. [medical-dictionary.thefreedictionary.com]

  This case series describes 55 instances of Fournier gangrene in diabetic adults being treated with sodium–glucose cotransporter-2 inhibitors. [annals.org]

• Heart Disease

  Heart Health What to Do If You Have a Family History of Heart Disease December 27, 2019 If you have a family history of heart disease, you likely know that your risk for heart disease is higher. But how much higher? The answer ... [webmd.com]

  Complications include ischemic heart disease, stroke, and thrombosis The prevalence of Behçet's disease has been rising in the 21st century in the U.K., and has been associated with high rates of cardiovascular complications, a retrospective matched cohort [medpagetoday.com]

  What Is Vascular Disease? Most Americans are familiar with heart disease and with the consequences of blockages in the vessels that carry blood to and from the heart. [vascularweb.org]

  Family history and heart disease Signs and Symptoms of VTE Last Reviewed: Mar 1, 2017 [heart.org]

  Increased estrogen levels, often due to medications (birth control, hormone treatments) or pregnancy A family history of DVT and PE Increased age Obesity Other chronic medical illnesses (heart disease, lung disease, etc.) [myavls.org]

• Cyanosis

  The occlusion of pulmonary arteries by thrombi that formed in the venous system causes acute-onset chest pain, dyspnea, tachycardia, and cyanosis. Affected individuals may also claim dizziness, sweating, and cough. A low-grade fever may be detected. [symptoma.com]

  […] breath, palpitation, or coughing up blood; dizziness or lightheadedness may occur with a massive PE.5 Symptoms may be confused with those of myocardial infarction or pneumonia.5 The patient may present with tachypnea, tachycardia, and diaphoresis.5 Cyanosis [uspharmacist.com]

  Syncope Hypotension, cyanosis Decreased left ventricular filling, causing forward heart failure. Diagnosis of DVT JAMA. 2006 Jan 11;295(2):199-207. [pathophys.org]

  […] thinner or aspirin combined with intermittent pneumatic compression.[7] Signs and symptoms[edit] Signs and symptoms of DVT, while highly variable, include pain or tenderness, swelling, warmth, dilation of surface veins, redness or discoloration, and cyanosis [en.wikipedia.org]

• Osteoporosis

  KEYWORDS: Rivaroxaban; deep venous thrombosis; femoral neck fracture; nadroparin; osteoporosis; total hip arthroplasty [ncbi.nlm.nih.gov]

  LMWH also causes less osteoporosis than UFH (E2). UFH requires an initial loading dose followed by continuous intravenous infusion. [mja.com.au]

  Kates, Venous thromboembolic prophylaxis for hip fractures, Osteoporosis International, 10.1007/s00198-010-1403-2, 21, S4, (593-604), (2010). [dx.doi.org]

Thrombi interfering with venous blood flow may be depicted employing duplex sonography, magnetic resonance imaging or computed tomography [7]. The former is preferred if the affected vein can be visualized by means of sonography, e.g., in patients suffering from thrombosed varicose veins or deep vein thrombosis of the extremities. Certain sites may not be accessible, so, for example, magnetic resonance flow imaging or contrast-enhanced computed tomography scans have to be carried out to depict cerebral vein thrombosis [8]. Of note, imaging techniques as described before have largely replaced contrast venography, an invasive approach to diagnosing VT. Still, venograms may provide useful information in case of subacute or chronic VT [8] [9].

Anamnestic data may reveal a predisposition for VT. For instance, thrombosis of isolated veins may be related to catheter insertion, surgery or trauma. In contrast, patients suffering from thrombophilia or other systemic conditions facilitating thrombus formation generally present with multiple VT. The underlying disease may be associated with additional disorders that should be considered when planning diagnostic measures:

• Laboratory analyses of blood samples may reveal thrombophilia, enhanced levels of D-dimer [10], or altered concentrations of coagulation factors.
• Coagulation studies should be conducted to test for a systemic prothrombotic condition.
• Diagnostic imaging is helpful to assess the condition of lungs and heart.
• Genetic screenings may be indicated to diagnose hereditary diseases.

Diagnosis and treatment of a DVT is meant to prevent pulmonary embolism. [medicinenet.com]

Our results emphasize that corticosteroids are essential for the treatment of BD-associated CVT, and that anticoagulant therapy may be safely stopped during follow-up in the presence of optimal BD treatment (steroids alone or with immunosuppressive drugs [ncbi.nlm.nih.gov]

[…] thus cost-effective approach to treatment of acute SVT. [ashpublications.org]

[39] Traditionally this was heparin, but several of the DOACs are licensed for treatment without initial heparin use.[38] If heparin is used for initial treatment of VTE, fixed doses with low molecular weight heparin may be more effective than adjusted [en.wikipedia.org]

[…] for monitoring LDVT prognosis and risk. [ncbi.nlm.nih.gov]

Table 4: Predictors influencing the prognosis of pregnancy-related CVT patients. [nature.com]

Complications include seizures, hydrocephalus, intracranial hypertension and neurological deterioration. [ 10 ] Prognosis Long-term follow-up suggests a generally good prognosis but there may be residual pyramidal symptoms, epilepsy, visual field defects [patient.info]

Treatment and prognosis In approximately 50% of cases, cerebral venous thrombosis progresses to venous infarction 1. [radiopaedia.org]

LESSONS: This case report demonstrates the importance of considering jugular vein lesions as an etiology of CVT. [ncbi.nlm.nih.gov]

Smith, A Genome‐Wide Association Study for Venous Thromboembolism: The Extended Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Consortium, Genetic Epidemiology, 37, 5, (512-521), (2013). [dx.doi.org]

This section focuses on deep-vein thrombosis and discusses its risk factors, epidemiology and associated complications In this section: Venous thrombi Venous thromboembolism Risk factors Incidence and prevalence Associated complications Venous Thrombosis [thrombosisadviser.com]

Therefore, this case provides the opportunity to review the pathophysiology of MVT, APS and their medical management including current trends in anticoagulation. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. [ncbi.nlm.nih.gov]

Although the end result is vessel occlusion and tissue ischemia, the pathophysiologic processes governing these pathologies have similarities as well as distinct differences. [accessmedicine.mhmedical.com]

The consequence of protein Z or ZPI congenital deficiency, or of acquired autoantibodies to protein Z, in the pathophysiology of thrombosis, fetal loss, and cancer (ovarian or gastric) is not completely clear; however, a defect of either protein Z or [msdmanuals.com]

This can prevent blood from flowing properly through the lung and decreasing the amount of oxygen absorbed and distributed back to the body. Diagnosis and treatment of a DVT is meant to prevent pulmonary embolism. [medicinenet.com]

We conducted this meta-analysis to evaluate its benefits for the prevention of deep venous thrombosis (DVT) after lower extremity orthopedic surgery. [ncbi.nlm.nih.gov]

The goal of anticoagulation therapy is to find a middle ground where you continue to clot when your body needs to clot, yet at the same time prevents your thrombosis or embolism from getting worse. [ucsfhealth.org]

"Aspirin for the prevention of recurrent venous thromboembolism: the INSPIRE collaboration". Circulation. 130 (13): 1062–71. doi:10.1161/circulationaha.114.008828. [en.wikipedia.org]

Venous thrombosis (VT) refers to the formation of a blood clot in any vein. In general, VT may be triggered by endothelial lesions or may be the result of a systemic prothrombotic state. The latter may be observed in patients suffering from certain hereditary disorders (e.g., protein C deficiency, protein S deficiency, hereditary deficiency of antithrombin III) or acquired conditions associated with venous stasis (e.g., forced immobilization, pregnancy, neoplasms, cardiac disease) [1] [2]. In this context, VT may be considered as a manifestation of an underlying disorder. It is of utmost importance to identify this pathology if causative treatment is to be provided.

On the other hand, VT may lead to serious complications. The formation of small thrombi within venous vessels does not necessarily cause venous stasis, but it does provoke alterations of local fluid mechanics. At such sites, erythrocytes are likely to form so-called red thrombi. These are secondary thrombi that increase the volume of the initial blood clot. Eventually, dependent tissues may be compromised and patients may develop symptoms consistent with chronic venous insufficiency [3], postphlebitic syndrome, or Budd-Chiari syndrome [4], among others. Venous thrombi may also be dragged away, reach the right heart and pulmonary circulation. As the blood clot advances through the pulmonary circulation, the diameter of arteries is constantly declining. This increases the likelihood of the thrombus becoming lodged in these vessels, thus causing a potentially fatal pulmonary embolism, pulmonary infarction or chronic thromboembolic pulmonary hypertension [5].

1. Khan S, Dickerman JD. Hereditary thrombophilia. Thromb J. 2006;4:15.
2. Trenor CC, 3rd, Chung RJ, Michelson AD, et al. Hormonal contraception and thrombotic risk: a multidisciplinary approach. Pediatrics. 2011;127(2):347-357.
3. Yamaki T, Nozaki M. Patterns of venous insufficiency after an acute deep vein thrombosis. J Am Coll Surg. 2005;201(2):231-238.
4. Shin N, Kim YH, Xu H, et al. Redefining Budd-Chiari syndrome: A systematic review. World J Hepatol. 2016;8(16):691-702.
5. Goldhaber SZ. Venous thromboembolism: epidemiology and magnitude of the problem. Best Pract Res Clin Haematol. 2012;25(3):235-242.
6. Bhatt S, Wehbe C, Dogra VS. Phlegmasia cerulea dolens. J Clin Ultrasound. 2007;35(7):401-404.
7. Steven A, Raghavan P, Altmeyer W, Gandhi D. Venous Thrombosis: Causes and Imaging Appearance. Hematol Oncol Clin North Am. 2016;30(4):867-885.
8. Saposnik G, Barinagarrementeria F, Brown RD, Jr., et al. Diagnosis and management of cerebral venous thrombosis: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2011;42(4):1158-1192.
9. Mendichovszky IA, Priest AN, Bowden DJ, et al. Combined MR direct thrombus imaging and non-contrast magnetic resonance venography reveal the evolution of deep vein thrombosis: a feasibility study. Eur Radiol. 2016.
10. Riley RS, Gilbert AR, Dalton JB, Pai S, McPherson RA. Widely Used Types and Clinical Applications of D-Dimer Assay. Lab Med. 2016;47(2):90-102.