Deep Venous Thrombosis and Chronic Venous Insufficiency
It is imperative for advanced practice nurses to be able to correctly identify human anatomy imbalances and hence differentiate different types of symptoms and relate them to their respective diseases. The venous system which encompasses the body’s circulatory system can be affected by several conditions. Some of these conditions include pathophysiology issues such as deep venous thrombosis (DVT) and chronic venous insufficiency (CVI). As such, it is prudent for nurses to review all symptoms so as to rule out other disorders so as not to prescribe medication for the wrong conditions. As such, this paper expostulates on the pathophysiology of deep vein thrombosis and chronic venous insufficiency and explores gender influences on the two conditions.
Pathophysiology of Deep Vein Thrombosis
Deep venous thrombosis (DVT) refers to a phenomenon whereby blood clots in an extremity’s deep vein such as a thigh, calf or the pelvis. It is the main cause of pulmonary embolism and is caused by conditions which impair venous return hence leading to endothelial injury or hypercoagulability (Bates & Ginsberg, 2004). Deep vein thrombosis (DVT) is a manifestation of a pathological entity which is referred to as venous thromboembolism (VTE). According to the Centers for Disease Control and Prevention (CDC) (2017), 900,000 Americans are affected by pulmonary embolism (PE) or deep vein thrombosis (DVT), while approximately 100,000 individuals die annually due to complications related to DVT. However, a DVT should not be confused with a blood clot in the artery or an arterial thrombus which results from plaques in atherosclerosis, whereby the artery’s blockage can lead to a stroke or a myocardial infraction (Bates & Ginsberg, 2004). In essence, accurate diagnosis of DVT encompasses an ultra sound which creates pictures of blood flowing through their vessels and hence shows any anomaly. Additionally, a D-dimer test or venography (ve-NOG-rah-fee) can be used to diagnose the condition accurately to prevent any type of misdiagnosis.
Pathophysiology of Chronic Venous Insufficiency
The pathogenesis of chronic venous disease, on the other hand, encompasses venous obstruction, reflux or a combination the two. In this case, health issues such as venous valve inflammatory changes of the vessel wall, incompetence, hemodynamic factors, and venous hypertension play key roles in the occurrence of CVI (Rathbun & Kirkpatrick, 2007). Patients suffering from CVI often complain of ‘heavy legs’ and experiencing of evening edema in addition to having pruritus and nocturnal leg cramps. In order to ascertain the presence of the condition, lipodermatosclerosis is a warning sign of oncoming ulceration (Rathbun & Kirkpatrick, 2007). However, the CEAP classification is the standard classification of chronic venous disease which is recognized internationally. Also, color-flow duplex ultrasound can also be used in the accurate diagnosis of the condition. Moreover, the condition is among the most prevalent medical issues in the adult population.
Lastly, there are similarities and differences between DVT and CVI. The similarities encompass the fact that both conditions are ‘chronic’ and rarely of abrupt onset. As such, for both conditions, patients will have longstanding symptoms such as aching and intense pain. On the other hand, the differences between the two conditions include the fact that DVT takes place in deeply placed veins while CVI takes place in shallowly placed veins. Also, DVT majorly encompasses blood clots in an extremity’s deep veins whereas CVI entails venous valve inflammatory changes of the vessel walls.
Patient Factor: Gender
Both DVT and CVI have a greater prevalence among females. These higher prevalence rates are due to gynecologic or obstetric conditions in women which act as risk factors in both DVT and CVI. Also, women’s use of hormone replacement therapies and oral contraceptives increase their hypercoagulability, as well as their risk for DVT (Rathbun & Kirkpatrick, 2007). Additionally, lifestyle issues such as wearing of constricting dresses or crossing of legs at the knees among women have also been ascertained as factors which contribute to high risks of conducting DVT and CVI. As such, the issue of taking certain contraceptives such as oral contraceptives as well as the addressed lifestyle issues influence blood flow in the legs and hence act as a catalyst for the occurrence of DVT and CVI in women. In this case, one major way of checking for the conditions in women is to check the health of their legs as well as checking for any pain in their legs after which diagnosis should be done immediately and treatment prescribed by a doctor (Goldhaber, Tapson & Committee, 2004).
The above discussion explores on two major medical issues; DVT and CVI. These are conditions with a high prevalence in developed countries and especially in the U.S among aged individuals. As such, a nurse is likely to come across a person suffering from either or both of the two conditions. It is thus imperative for a nurse to be able to correctly identify the two consitions. Having information on how to deal with the conditions can help in avoiding miss diagnosis in addition to ensuring that conditions are addressed early in advance.
Bates, S. M., & Ginsberg, J. S. (2004). Treatment of deep-vein thrombosis. New England Journal of Medicine, 351(3), 268-277.
Centers for Disease Control and Prevention. (2017). Venous thromboembolism (blood clots). Retrieved from https://www.cdc.gov/ncbddd/dvt/index.html
Goldhaber, S. Z., Tapson, V. F., & Committee, D. F. S. (2004). A prospective registry of 5,451 patients with ultrasound-confirmed deep vein thrombosis. The American journal of cardiology, 93(2), 259-262. http://www.sciencedirect.com/science/article/pii/S000291490301422X
Rathbun, S. W., & Kirkpatrick, A. C. (2007). Treatment of chronic venous insufficiency. Current treatment options in cardiovascular medicine, 9(2), 115-126.