Deep vein thrombosis

" first part

RISK FACTORS OF THROMBOSIS

Over 40 years of age
Pregnancy, puerperium
Previous or current malignant tumor
Blood disorders that tend to favor coagulation processes
Hereditary or acquired diseases of the coagulation system
Heart failure
Diabetes mellitus
Previous myocardial infarction
Previous episode of venous thrombosis
Family history of deep vein thrombosis
Major surgery or recent injuries, especially of the lower limbs or abdomen
Estrogen hormone therapy, including oral contraception
Injury to the lower limbs
Subjects who have recently undergone major surgery
Prolonged immobilization (long periods of bed rest, long journeys)
Dehydration (increases blood viscosity)
Additional risks in obese people or people with varicose veins and in smokers.

Diagnosis

To understand if a vein is simply "tired" and the circulation is slowed down, or if you are actually in the presence of a thrombosis problem, a preliminary visit to your doctor is essential, who will decide, if necessary, to send the patient for a specialist examination called venous ultrasound of the lower limbs. It is a non-invasive technique, very important because, due to the extreme variability of the symptoms associated with this condition, the clinical diagnosis is poorly reliable. D-Dimer test.

Blood tests useful in case of venous thrombosis

antithrombin
prothrombin time INR
thromboplastin time
activated protein C
D-Dimer test.

Therapy

For further information: Drugs for the treatment of Deep Vein Thrombosis

Therapy of patients with deep vein thrombosis includes three approaches: pharmacological (anticoagulants and fibrinolytics), surgical (thrombectomy, an operation that has now fallen into disuse) and mechanical (intermittent pneumatic compression in the postoperative period, elastic stockings or bandages, early mobilization) .

In patients in whom the risk of thrombosis is considerable, for example due to a previous history of relapses, and ineffective drug therapy, so-called caval filters can be used (real sieves that prevent the migration of thrombotic fragments into the lungs, preventing the " embolism).

Anticoagulant therapy is often undertaken for prophylactic and therapeutic purposes in subjects who have already experienced an episode of deep vein thrombosis. It is necessary, for example, before and after a demanding surgery that forces one to bed rest for a certain period. These drugs are used to decrease the ability of blood to clot, thus making it more "fluid". "heparin, which is used intravenously or subcutaneously for a few days, and oral anticoagulants, given by mouth for at least a few months. Sometimes thrombolytic drugs are also used, especially in hospitals, which are used to dissolve the thrombus more quickly.

TIPS FOR PREVENTING THROMBOSIS

Wear comfortable clothes and shoes
During the day, perform frequent physical exercises of the lower limbs
Carve out a daily appointment with regular physical activity (a forty-minute walk at a brisk pace is enough)
Stop smoking
Follow a sober and balanced diet, consuming plenty of fluids and minimizing alcohol intake
Do not expose your legs to the sun during the hottest hours of the day, or to direct heat sources (for example a stove).
In the presence of the important risk factors seen in the article, it is essential to strictly follow the doctor's instructions on the use of graduated compression stockings and anticoagulant drugs.

Prevention

Venous thromboses are "team diseases", in the sense that they are determined by multiple risk factors, some of which can be modified. If through proper prevention we remove important pawns from the group (smoking, overweight, physical inactivity), we weaken the adverse factors and reduce the risk. On other fronts, however, it is necessary to intervene with specific drugs (see anticoagulants).

Diet and thrombosis

Let's start by saying that there are no "magic" foods, that is, capable of preventing thrombosis, but there are certainly foods that help more than others to have a more fluid blood, because they help to lower the level of cholesterol and triglycerides in the blood . Omega-three, for example, are very important because they lower the blood levels of these lipids and have an "anti-inflammatory action. A diet rich in fish therefore prevents breakage but also the formation of thrombus, especially in the arterial level. E" however. it is essential that it is accompanied by an adequate consumption of foods rich in fiber, for example by alternating a meal with whole grains to one with classic refined ones. In this way, for example, the absorption of fats in the intestine is reduced, one feels fuller and avoids introducing too many "junk" between meals. Furthermore, fibers reduce the absorption of toxins and improve intestinal function. The foods that contain them are also rich in vitamins and some of these, such as folic acid, help to mitigate the negative effects of a diet that is too high in fat. and animal proteins.

Hyperhomocysteinemia, a condition predisposing the formation of arteriovenous thrombi, is for example common in the elderly and vitamin deficiencies represent one of the most common causes. Consequently, vitamins are also its best treatment, which makes use of supplements based on folic acid, vitamin B6 and cobalamin or vitamin B12.

The effects of the diet on the thrombotic risk are therefore indirect, in the sense that they do not directly act on the main risk factor, represented by the excessive, improper or inappropriate activation of the coagulation system.

Smoking, on the other hand, directly increases some clotting factors, which make the blood "thicker" and more likely to form blood clots. The same can be said, but in the opposite sense, for physical activity, the benefits of which are positively reflected in both the prevention and therapy of deep vein thrombosis.