In correlation to Samantha’s Jordans case she had prior knee surgery three days prior to her experiencing swelling of the leg and her vitals showed that her blood pressure is slightly elevated as well as having a fever of 100 degrees Fahrenheit and high pulse. During her recovery 3 days later after surgery she is diagnosed with a DVT. Samantha couldn’t believe that the DVT had turned into a pulmonary embolism because she believed she lives a active healthy lifestyle, but the nurse told her it’s common that this happens after surgery. The patient was put on a heparin drip to avoid further health complications because she did begin to have shortness of breath and symptoms of cough.
Deep vein thrombosis is a big issue among patients undergoing surgery, post op, patient’s that tend to be immobile, and other specific chronic illnesses. DVT can lead to a common complication known as pulmonary embolism which can be life threatening. The signs and symptoms of DVT include the following: asymmetrical ogoma, calf swelling, and localized pain which can eventually turn into a pulmonary embolism if left untreated. A patient’s leg that has been diagnosed with a DVT may experience a swollen leg, edema, and a warm leg. The veins inside of the legs carry blood back to the heart. In a normal leg the blood flow functions at a normal rate allowing the blood to circulate through the heart which assist the hemodynamic flow by preventing backflow. A leg with DVT contain thrombus forming units occurring within the veins of the leg usually in the lower portion of the leg. Clotting is present in a leg with DVT made up of a cluster of platelets, fibrin, mesh, and red blood cells that become clumped together during coagulation and forms what is commonly known as a thrombus.
Once a thrombus has occurred it has a few phases and begins with propagation which is growing along the vessel, organization which is organizing itself within the layer of the vessel, recanalization which forms holes within the thrombus, embolism which means dislodgment of the thrombus allowing the thrombus to travel throughout the body via the lungs, and resolution when a thrombus becomes broken down by plasmin. When a thrombus dislodges itself and becomes an embolist it can then travel up to the heart via the inferior vena cava. The heart then pumps the embolist to the the pulmonary unit causing a pulmonary embolism. This is a major complication of deep vein thrombosis. Risk factors for developing DVT include pregnancy, increased age, malignancy, obesity, major surgery, being hospitalized and being immobile for long periods of time. 25-50% of surgical patients have a higher risk of developing a DVT. Certain medications may play a role in developing DVT and genetic information as well which some people that have certain deficines may be more prone to developing a DVT. Management of DVT include heparin which is given through IV (low molecular weight heparin) or(subcutaneous unfractionated heparin) which are anticoagulants. Warfarin is given orally and both heparin and warfarin target the common pathway. I’d like to add all the possible treatment options to treat DVT may include: Apixaban (Eliquis), Betrixaban (Bevyxxa), Dabigatran (Pradaxa), Edoxaban (Savaysa), Fondaparinux (Arixtra), and Rivaroxaban (Xarelto) which are the most common treatment for DVT.
References
Krupski WC;Bass A;Dilley RB;Bernstein EF;Otis SM; (n.d.). Propagation of deep venous thrombosis identified by duplex ultrasonography. Journal of vascular surgery. Retrieved June 22, 2022, from https://pubmed.ncbi.nlm.nih.gov/2214041/ (Links to an external site.)
Deep vein thrombosis (DVT). Cleveland Clinic. (n.d.). Retrieved June 22, 2022, from https://my.clevelandclinic.org/health/diseases/16911-deep-vein-thrombosis-dvt (Links to an external site.)
Banasik, J. L., Banasik, B. N., & Miller, B. J. (2022). Pathophysiology. Elsevier.