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Thrombophlebitis


Blood clots can form in arteries or veins. When inflammation due to a blood clot occurs in a vein, it is called thrombophlebitis. Thrombophlebitis usually occurs in the veins of the legs. Rarely, it can occur in the veins of the arms or neck. Superficial (near the surface) thrombophlebitis occurs in the veins that are visible just under the skin. The area of inflammation is usually reddened, tender, and warm to the touch and can be painful. The leg or arm may swell and fever may occur. Deep venous thrombosis (DVT) is more dangerous than superficial thrombophlebitis. Deep venous thrombosis often cannot be seen or felt by the individual. Swelling of the leg or arm or fever may alert a person to the presence of a DVT, especially if risk factors for DVT exist. Pulmonary embolism, a condition that can be fatal, results from a DVT that becomes loose in the venous system and travels to the lungs. There, the blood clot blocks proper blood flow to the lungs and decreases oxygen levels in the body. The October 8, 2008, issue of JAMA includes an article about diagnostic testing for DVT. RISK FACTORS Inactivity due to recent injury, surgery, or prolonged sitting Pregnancy or recent childbirth Oral contraceptive use or estrogen therapy Cancer Stroke or other diseases that limit movement Family history of clotting disorders Central venous catheters (used for injection of medications or for dialysis) SYMPTOMS In addition to a medical history and physical examination, the doctor may order tests to evaluate superficial thrombophlebitis or to look for presence of a DVT. These tests may include ultrasound (using sound waves to look for a blood clot in the vein), computed tomography (CT) or magnetic resonance imaging (MRI) to visualize blood vessels, blood tests, or venography (using injection of a dye to trace the course of a vein). PREVENTION Move your legs, especially during prolonged sitting or bed rest Use compression (strong support) stockings Discuss your personal and family history with your doctor before considering hormone therapy TREATMENT Treatment for superficial thrombophlebitis usually includes elevating the leg, warm compresses to the area, and medication to decrease pain and inflammation. Support stockings may be worn to reduce swelling. Treatment for DVT or pulmonary embolism usually involves anticoagulation (blood thinning) treatment with heparin (by injection) or warfarin (by mouth for longer-term treatment). Pregnant women should not use warfarin because it can harm the developing fetus. FOR MORE INFORMATION National Heart, Lung, and Blood Institute http://www.nhlbi.nih.gov American Heart Association http://www.americanheart.org Source: JAMA. 2008;300(14):1718.