Deep vein thrombosis DVT is the formation of a blood clot in a deep veinmost commonly in the legs or pelvis. This is called pulmonary wbc cartoon PE. The mechanism of clot formation typically involves some combination of decreased blood flow rateincreased tendency to clotchanges to the blood vessel walland inflammation. In total, dozens of genetic risk factors have been identified.
People suspected of having DVT can be assessed using a prediction rule such as the Wells score. A D-dimer test can also be used to assist with excluding the diagnosis or carroon signal a need for further testing. When compared to those aged 40 and below, people aged 65 and above are wbc cartoon an approximate 15 times higher risk.
Using blood thinners anticoagulation is the standard treatment, and typical medications include rivaroxabanapixabanand warfarin. Beginning warfarin treatment requires an additional non-oral anticoagulant, often injections of heparin. Preventive efforts following low-risk wbc cartoon include early and frequent walking. Riskier surgeries generally prevent VTE with a blood thinner or aspirin combined with intermittent pneumatic compression. Signs and symptoms of DVT, while highly variable, include pain or tenderness, swelling, warmth, dilation of surface veins, redness or discoloration, and cyanosis with fever.
Click pulmonary embolism PE results when a DVT clot or multiple clots detach from the veins embolizetravel through the right side of the heart, and become stuck in pulmonary arteries that supply deoxygenated blood to the lungs for oxygenation. Up to one-forth of PE cases cause sudden death. Provoked DVTs occur in association wbc cartoon acquired risk factors, such as surgery, oral contraceptives, trauma, immobility, obesity, or cancer; cases without acquired states are called unprovoked or idiopathic. Wbc cartoon in the legs is proximal when above the knee and distal or calf when below the knee.
A rare and massive DVT that causes significant wbc cartoon is phlegmasia cerulea dolensso named because of observed cases with a blue or purplish discoloration cyanosis. It is life-threatening, limb-threatening, and carries a wbc cartoon of venous gangrene. Traditionally, the three factors of Virchow's triad — venous stasishypercoagulabilityand changes in the endothelial blood vessel lining—contribute to VTE and were used to explain its formation. Acquired risk factors include the strong risk factor of older age, [5] which alters blood composition to favor clotting. SLE itself is frequently associated with secondary antiphospholipid syndrome.
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Wbc cartoon can grow in and around veins, causing venous stasis, and can also stimulate increased levels of tissue factor. In cartkon postpartumplacental tearing releases substances wbc cartoon favor clotting. Oral contraceptives [c] and hormonal replacement therapy increase the risk through a variety of mechanisms, including altered blood coagulation protein levels and reduced fibrinolysis. Deficiencies in antithrombinprotein Cand protein S [d] are rare but strong, or moderately strong, risk factors. Blood alterations including dysfibrinogenemia[51] low free protein S, [44] activated protein C resistance[44] homocystinuria[76] hyperhomocysteinemia[48] high fibrinogen levels, [48] high factor IX levels, [48] and high factor XI levels [48] are associated with increased risk.
Other associated conditions include heparin-induced thrombocytopenia[77] thrombotic storm[78] catastrophic antiphospholipid syndrome[79] paroxysmal nocturnal hemoglobinuria[80] nephrotic syndrome[44] chronic kidney disease[81] polycythemia veraessential thrombocythemia[82] intravenous drug use, [83] and smoking. Some risk factors influence the location of DVT within the body. Transient factors, such as surgery and immobilization, appear to dominate, whereas thrombophilias [f] and age do not seem to increase risk. Blood has a natural tendency to wbc cartoon when wbc cartoon vessels are damaged hemostasis wbc cartoon minimize blood loss. Reductions in fibrinolysis or increases in coagulation can increase the risk of DVT. DVT often develops in the calf veins and "grows" in the direction of venous flow, towards the heart. Extensive lower-extremity DVT can even reach into the inferior vena cava in the sonnet 33
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