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They are not ordinary blood drainage tubes. Veins are subtle organs that make up a complex and well-functioning system. Sometimes, however, it takes little to disturb his work, and then the veins begin to fall ill. It also happens that their failure threatens our lives.
A broken clot from a vein is life-threatening
Venous diseases should be taken seriously. This is not a cosmetic flaw, which can be masked with powder or thicker tights “- writes in his book” Varicose veins and other diseases of the veins “a well-known vascular surgeon, long-term head of the Department of Surgery at the Medical University in Warsaw, prof. dr hab. Wojciech Noszczyk, MD, PhD. This reading is aimed not only at those who struggle with diseases of the veins of the lower extremities, but also those who want to avoid cardiovascular ailments.
Discussing venous diseases, however, Professor Noszczyk begins with deep vein thrombosis, i.e. a thromboembolism. Why? “It’s a less known and more insidious disease than chronic venous insufficiency of the lower extremities. More dangerous than varicose veins, and usually asymptomatic. (…) Sometimes in patients with thrombosis, the clot of the vein breaks off and moves the veins along the bloodstream towards the heart and lungs, clogging the artery in the lungs. If it is large, it can cause death, the smaller ones, the size of a pinhead, block small arterioles of the lungs, making breathing difficult “- warns the professor, and we immediately think of the tragic story of Kamila Skolimowska, a Polish athlete and Olympic champion in the hammer throw.
Death came suddenly
She was 26 years old, fit and had regular medical examinations. And yet, during the training camp in Portugal, she suddenly felt bad. – Kamila came to our gym on Wednesday. She sat down on the bench and fainted, a physiotherapist Andrzej Krawczyk ran up to her and woke her up. We called an ambulance. She came to her on her own. She reportedly fainted again in her and they took her unconscious to the infirmary in Vila Real de Santo Antonio. A specialized unit came there to help with resuscitation. Unfortunately, it didn’t work. Kamila died an hour later – said Szymon Ziółkowski, Olympic champion and witness of the events.
The media was in turmoil. Everyone demanded an explanation: family, colleagues, friends, fans. – The worst part is that nobody expected it. After all, athletes are thoroughly tested throughout their lives. For several years there have been no signals that something is wrong – commented her family friend, Jacek Wszoła.
At that time, it was still suspected that the cause of death was a heart attack. Only later it turned out that the pulmonary embolism was to blame, and other facts came to light. Colleagues from the group admitted that she had previously felt unwell, had breathing problems, suffered from pain in her calf, and that she had passed out a few months earlier. Doctors then found a hematoma in her lung, but tests confirmed that it had been absorbed. To end all speculation, Kamila’s father, Robert Skolimowski (a well-known weightlifter), issued a public statement revealing the autopsy results: “The cause of Kamila’s death was a pulmonary embolism. After talking and consulting with doctors specializing in this topic, we know that it could have been caused by genetic conditions, dehydration, blood thickening, taking contraceptives or exercise, “he explained to the media.
Let’s meet the enemy
It is tricky, dangerous, and more common than it seems. Professor Noszczyk writes about deep vein thrombosis: “Medical statistics are alarming. They show that in Western countries, it affects 1-4 people per thousand inhabitants annually. It is estimated that in Poland, between 50 and 70 people suffer from this disease. people a year. (…) Thrombosis is, unfortunately, a disease of the future, and the risk of its occurrence increases with civilization diseases ”. How to avoid it? First of all, we should get to know the “enemy”.
Usually it all starts with damage to the walls of the veins. They are lined with a thin, delicate and smooth endothelium, which promotes the sticking of blood cells to it and the formation of blood clots. However, when we hit ourselves, cut ourselves or injure the tissues surrounding the vein, the sensitive vein wall breaks. The ranks are then filled with accumulating platelets and blood cells. If the injury is additionally accompanied by a decrease in activity (e.g. the patient must lie down) or dehydration of the body, and thus slower blood flow and its thickening, blood cells continue to accumulate and a thrombus is formed as a result. Over time, it closes the vein’s lumen like a cork and grows towards the heart. “This most often occurs in the deep veins of the lower leg. The thrombus spreads all the way to the popliteal and femoral veins, filling all the valves tightly. Usually, its initial section fits tightly to the vein wall, while the final section rises inside the vessel. And it is this terminal part of the thrombus that can suddenly break off and flow through the heart into the lungs with the flow of blood, ‘the professor warns. If it is large, death can occur in seconds. Small clots clog arterioles and make breathing difficult.
Leaves a trace
What happens when the clot breaks off? The right ventricle is overloaded with pressure, and not enough blood returns to the left ventricle from the lungs to maintain the blood pressure and supply the organs with blood. It causes shock, loss of consciousness, and then death. Fortunately, it doesn’t always end so tragically. More often the clot is absorbed and the vein is cleared by itself, or the blood flows through the collateral vessels, avoiding the obstructed vein. However, the disease leaves a mark in the form of secondary varicose veins or deformation of the inner vein wall. From smooth, it becomes rough and uneven, which promotes the formation of new clots. After a few months or years, a new one may form at the site of the clot.
The risk increases with age
Thromboembolism is not easy to diagnose, so it is important to understand the factors that increase its risk. Apart from the aforementioned thrombosis, they include age and low life activity. The XNUMXth year of life is the limit of security. Then the risk increases with each decade, because then we are more likely to suffer from cardiovascular disease and move less and less. In both cases, blood circulates slower and its stagnation in the lower extremities is dangerous. What do we feel after many hours of driving a car, flying a plane or standing still for a long time? Our legs are like lead, our knees hurt, we have a harder time walking. It’s all because the blood in the lower limbs flows slower in the sitting and standing position, the muscle pump works worse, and the valves in the veins are closed. In order for them to open and blood from the legs to flow towards the heart, muscles need to be moved. Therefore, immobilization is another risk factor. It grows in people after operations, fractures or severe limb injuries, and even in those who lead a sedentary lifestyle. Hence, patients are so quickly rehabilitated after the procedures, telling them to get up and walk, raise their legs. As it turns out, this is of great importance.
Professor Noszczyk also includes taking oral contraceptives, hormonal imbalances, pregnancy, obesity, smoking, cancer and some blood diseases among the risk factors for thrombosis. “If a patient has several risk factors, and when measuring the circumference of the lower legs, the doctor detects swelling, he usually performs additional tests” – explains the professor. However, so that the doctor does not miss anything, let him know about possible swelling, the feeling of heavy legs that usually occurs in the evening, and difficulties in breathing. It’s red light. “Alarm!” – the veins scream. Let’s examine them even if we do not have varicose veins. After all, ultrasound does not hurt, and phlebography, that is, injecting a contrast agent into a vein and taking X-rays, will survive even the greatest coward.
Through the filter
Deep vein thrombosis is treated in several ways. The simplest one involves the administration of anticoagulants. When a doctor notices a clot during venography or ultrasound, he orders an injection of heparin (it thins the blood, prevents the formation of clots). Usually, it is injected under the skin, in the area of the navel, and the patient is placed in the upside-down position. Treatment (by mouth) is usually continued to prevent the risk of a pulmonary clot and the formation of new clots. Attention! We always provide each doctor with the name of the drug that we take. It must not be forgotten even at the dentist!
The so-called fibrinolytic treatment (consisting in dissolving clots), as there is a relatively high risk of complications and bleeding. Even more rarely, clots are removed surgically. However, when the patient cannot take medication, and the dissolution of the clots does not work, doctors implant a special filter in the vena cava to catch and stop clots flowing to the lungs.
Let’s be good to the veins
It is obvious that the prophylaxis of venous diseases is of great importance. It is unlikely that any effective remedies for damaged venous valves will be found in the foreseeable future. However, you can and must develop vein-friendly habits that will help prevent thrombosis and stop the developing venous insufficiency. (…) The mere observation of our organism is not enough. We have to act – encourages professor Noszczyk and indicates some basic solutions.
First: the right kind of sport (as it turns out, sports with weights, such as weightlifting, crutch pushing, and horseback riding or skiing are not good for the veins; swimming, walking, dancing, cycling is good). Second: relieving the legs. Third: a proper diet. The basic therapeutic principle is: “Keep the legs in motion.” So let us move our toes, even when we are sitting on a chair or walking in place, let us stand on our heels, let us sway our body. During the evening session in front of the TV set your feet on a footstool or table, preferably higher than the heart. Inelegant? It’s healthy for that! Let’s start the morning with a few squats, leg shakes or bicycles. Avoid hot baths (they impair blood circulation) and treat your legs to alternate showers as often as possible. Pay attention to comfortable shoes (the heel should be 2 centimeters) and loose clothing. Let’s introduce bran, vegetables and fruit to our diet for good, limit sugar and salt. It is known that obesity and constipation promote venous diseases. Therefore, we should ensure that our meals are rich in fiber, and we should not forget about the right amount of fluids (8-10 glasses a day) – preferably mineral water, herbal or fruit teas. If we lose weight additionally, we will gain double, because we will remove the risk of thrombosis.
Women’s disease
Surface vein thrombosis
Women between the ages of 30 and 60 suffer from it most often, and doctors see the causes of the disease in varicose veins, injuries and various types of infections. It differs from deep vein thrombosis in that the thrombus firmly adheres to the vein wall, and the symptoms of the disease are visible. There is a painful and soft cord on the leg around which the skin is noticeably warmer and may be red. Sometimes it is accompanied by pain in the whole leg, fever, the vein becomes visible, and you can feel it clearly even after two weeks. The doctor recommends taking anti-inflammatory drugs, and limiting sitting and standing. The patient should frequently rely on his feet.
The text is based on the book by prof. dr. hab. Wojciech Noszczyk Żylaka and other diseases of the veins; PZWL Medical Publishing.
Text: Anna Niewiadomska
Source: Let’s live longer