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Thrombophlebitis
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Thrombophlebitis

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HEART & BLOOD

Cardiovascular System

Thrombo means "clot." Phlebitis is inflammation of a vein. Thrombophlebitis occurs mostly in the legs. It is a circulatory problem that develops when a blood clot slows the circulation in a vein, either right under the skin or deeper in the leg. On rare occasions, thrombophlebitis can affect veins in your arms.

The affected vein may be near the surface of your skin (superficial thrombophlebitis) or deep within a muscle (deep vein thrombosis).

The cause often is prolonged inactivity, such as sitting during a long period of travel in an airplane or automobile or lengthy bed rest after surgery. The inactivity decreases blood flow through your veins and may cause a clot to form. Paralysis, certain types of cancer and use of the hormone estrogen also may lead to thrombophlebitis. An inherited tendency for blood clots places you at higher risk of thrombophlebitis.

Signs and symptoms

Signs and symptoms of thrombophlebitis include:

  • Warmth, tenderness and pain in the affected area

  • Redness and swelling

When a deep vein is affected, your leg may become tender, painful and swollen. You may also have a fever. When a superficial vein is affected, a red, hard and tender cord may be present just under the surface of your skin.

Risk factors

Thrombophlebitis is caused by a blood clot. Blood clots can result from many different things — namely anything that causes your blood not to circulate properly. Your risk of thrombophlebitis increases if you:

  • Are inactive for a long period of time, such as sitting in a car or an airplane.

  • Are confined to bed for a prolonged time, such as after surgery, a heart attack or a leg fracture.

  • Have certain types of cancer, such as pancreatic cancer, which may result in an increase in your blood of procoagulants, substances necessary for blood clotting (coagulation).

  • Have had a stroke resulting in paralysis of your arms or legs.

  • Have a pacemaker or have a thin, flexible tube (catheter) in a central vein, for treatment of a medical condition. This may irritate the blood vessel wall and decrease blood flow.

  • Are pregnant or have just given birth, which may mean you have increased pressure in the veins of your pelvis and legs.

  • Use oral contraceptives or hormone replacement therapy, which may increase the clotting factors in your blood.

  • Have a family history of a tendency of blood clots.

  • Have varicose veins. Clots may develop in dilated superficial veins (varicose veins), causing superficial thrombophlebitis.

  • Have had an injury (trauma) to a vein, although this is an uncommon risk factor for thrombophlebitis.

  • Have had an infection in a vein, although this an uncommon risk factor for thrombophlebitis.

When to seek medical advice

See your doctor if you have a red, swollen or tender vein — especially if you have one or more risk factors for thrombophlebitis. In case the reason for the vein inflammation is a clot, you want to seek medical attention urgently, before the clot completely obstructs your vein or dislodges and causes other serious health problems.

Screening and diagnosis

Your doctor may be able to diagnose superficial thrombophlebitis based on the discomfort you've experienced and by examining the affected vein near the surface of your skin. To diagnose deep vein thrombosis, your doctor may choose one of these methods:

  • Ultrasound. A wand-like device (transducer) placed over your leg sends sound waves into your leg. As the sound waves travel through your leg tissue and reflect back, a computer transforms the waves into a moving image on a video screen. A clot may be visible in the image.

  • Venography. A dye (contrast agent) is injected into a large vein in your foot or ankle. An X-ray procedure creates an image of the veins in your legs and feet, to look for clots.

  • Blood test. Almost all people who develop acute thrombosis have an elevated level in their blood of a clot-dissolving substance called D dimer. However, D dimer is elevated in other conditions, too. Thus, although a test for D dimer is very sensitive, it's not very conclusive.

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Last Modified : 03/15/08 12:26 AM