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Disorders of the Veins and Arteries
Vein and artery disorders such as chronic venous insufficiency (CVI) and deep venous thrombosis (DVT) and frequently encountered by advanced practice nurses, making the need to understand the. epidemiology, pathophysiology, and clinical presentation of these conditions important. To this end, this paper reviews the relevant literature to provide a comparison of the pathophysiology of chronic venous insufficiency and deep venous thrombosis and a description concerning how venous thrombosis is different from arterial thrombosis. In addition, an explanation concerning how the patient factor might impact the pathophysiology of CVI and DVT is followed by a description of how a clinician would diagnose and prescribe treatment of these disorders for a patient based on the selected factor. Finally, a summary of the research and important findings concerning these foregoing issues are presented in the conclusion.
Review and Discussion
Chronic venous insufficiency
This condition typically involves an exacerbation of DVT even though nearly 50% of patients suffering from chronic venous insufficiency have not been diagnosed with DVT previously (Wilansky & Wilkerson, 2002). In addition, CVI can also be caused by the compression of a pelvic vein (typically by malignancy) as well as an arteriovenous fistula (Wilansky & Wilkerson, 2002). According to a study published by the American...
In addition, the study by Jaff and Weinberg (2014) notes that, "The most common clinical manifestations of PTS include swelling, skin changes and limb pain" (para. 5). An estimated 10% of DVT patients will experience severe PTS which is characterized by skin ulcerations (Jaff & Weinberg, 2014). Although these suboptimal clinical outcomes adversely affect quality of life and add significant costs to medical care for DVT sufferers, there remains a paucity of timely and relevant research concerning early diagnostic methods and evidence-based treatment protocols to date (Jaff & Weinberg, 2014). While additional research is needed, the National Institutes of Health (2016) report that what is known for certain at present is that the following represent risk factors for DVT:
Older age;
Family history of DVT;
Female gender (related to levels of the hormone progesterone);
History of deep vein thrombosis in the legs;
Obesity;
Pregnancy;
Sitting or standing for a long periods; and,
Tall height (Venous insufficiency, 2016, para.…
References
Jaff, M. R. & Weinberg, I. (2014, September 22). Postthrombotic syndrome: A scientific statement calling for more data. American Heart Association. Retrieved from http://www.heart.org/HEARTORG/.
Other names for deep vein thrombosis. (2016). National Heart, Lung, and Blood Institute. Retrieved from http://www.nhlbi.nih.gov/.
Venous insufficiency. (2016). National Institutes of Health. Retrieved from https://www. nlm.nih.gov/medlineplus/ency/article/000203.htm.
Weigand, T. (2002, October). Deep venous thrombosis and airline travel. Defense Counsel Journal, 69(4), 523-525.
Who is at risk for deep vein thrombosis? (2016). National Heart, Lung, and Blood Institute. Retrieved from http://www.nhlbi.nih.gov/.
Disorders of the Veins and Arteries Pathophysiology of Chronic Venous Insufficiency and Deep Venous Thrombosis Chronic venous insufficiency (CVI) pathophysiology is either the obstruction or reflux of venous blood flow (Gujja, Wiley, & Krishnan, 2014). The perforating veins valve normally functions by preventing the reflux of blood from the deep veins into the superficial veins. CVI occurs when there is venous hypertension that is caused by incompetent valves. Venous blood will escape
Pathophysiology What's Gone Wrong? CVI is generally an indication of blood stasis or venous reflux, most commonly valvular incompetence in the low-pressure superficial venous system. The inability of blood to return to the heart from the legs causes it to pool and clot. CVI generally occurs within the deep veins (Deep Vein Thrombosis), may also be related to varicose twisting, valve malformations or pelvic tumors. Risk Factors Obesity, inactivity, pregnancy, smoking and extended periods
Chronic Venous Insufficiency and Deep Vein Thrombosis There are a number of conditions that affect the circulatory system in different ways. Not all circulatory issues are connected with blood clotting or high cholesterol. In fact, chronic venous insufficiency (CVI) is more associated with some form of trauma that damages the tissues of veins and reduces their ability to circulate blood effectively. This is much different to Deep Vein Thrombosis, which is
2004: 45). Recommendations Many recommend use of minimally invasive techniques including SEPS to treat and address problems related to chronic venous insufficiency (Kalra & Glovisczki, 2002). Multiple studies confirm the safety and efficacy of SEPS when used early, especially resulting from its low complication rates compared with other procedures including the formerly popular Linton procedures (Kalra & Gloiscki, 2002; Lee, et al. 2003; Tenbrook, et al., 2004; Bianchi, et al. 2003). More
Comparison of pathophysiology of CVI and DVT The pathogenesis of CVI is not completely understood; however, it's based on both venous reflux and obstruction; or an amalgamation of the two. Though venous reflux is actually based on a number of mechanisms, the key elements are venous valve ineffectiveness, vessel wall swelling, hemodynamic elements and additionally venous hypertension. These systems could be further exasperated by dysfunctional pumping devices (vascular and/or muscle pump),
Mostly proteins and platelets combine to form blood clotting in order to heal wounds inside the arteries. However, the accumulation of fatty protein and platelet deposits on the artery walls can sometimes cause the arteries to become narrow and hardened. This makes the artery more prone to damage and if it ruptures, the blood clotting occurs and thus, the artery becomes infected by arterial thrombosis. Impact of patient age on