Swelling, redness, movement limitations, pain, heaviness, pale and cold limbs, numbness, twinge, fainting, sudden chest pain, shortness of breath. These are some of the signs of thrombosis, a disease that increased after the arrival of the new coronavirus, according to vascular surgeon Bruno Freitas, from the State General Hospital (HGE).
The specialist emphasizes that the number of patients with thrombosis has increased in the largest emergency in Alagoas, as has been happening worldwide. “Around 16% of cases of thrombosis in hospitals are related to Covid-19, which is a systemic inflammatory disease with microvascular and vascular involvement, which manifests itself in various organs and systems, particularly in the respiratory one”, explained Bruno Freitas.
These cases of thrombosis do not only refer to patients with the virus manifested, but also to those who have already recovered. “We have cases of patients who recovered from the respiratory syndrome two months ago and are still at risk of developing a thromboembolic phenomenon. It’s as if the new coronavirus planted the seed, which only develops later,” said the vascular surgeon at HGE.
The specialist also explained that thrombosis is defined by the formation of a clot in the blood, which prevents or hinders circulation. “Symptoms may vary according to the location affected and the extent of the condition. It can be deep vein thrombosis – most cases – or arterial thrombosis. Deep vein thrombosis decreases blood flow back to the heart. Over time, the area becomes swollen, stiff and painful, with a feeling of heaviness. In the case of arterial thrombosis, blood flow is reduced from the heart to a certain region of the body. There is the possibility of a lack of tissue oxygenation, which may lead to tissue death, due to the loss of blood supply, causing gangrene of the limb”, he explained.
The most serious complication of deep vein thrombosis, as reported by the vascular surgeon, is pulmonary embolism, or pulmonary thromboembolism. “This occurs when the clot detaches itself from the vein of origin, passes through the heart and then reaches the lungs, interrupting circulation. The problem can trigger shortness of breath, cough, pain and lead to death. In arterial thrombosis, on the other hand, there is a danger of amputation of the affected limbs. The patient can also suffer a cerebrovascular accident (CVA) or a heart attack”, he informed.
The diagnosis of thrombosis is made by a specialist, through physical examination and tests such as vascular ultrasound with color Doppler, which confirms or rejects the diagnosis in more than 98% of cases, according to the vascular surgeon. “If there is a suspicion of a blockage of vessels in the head or chest, CT or MRI is also used. The thrombus can be dissolved or removed with medication and surgery. Treatment will depend on the type of thrombosis and the severity of each case. If it is the venous, for example, anticoagulant medications, elastic stockings to compress the legs and medications that facilitate the return of blood to the heart can be used”, specified the doctor.
Finding – Luiz Rodrigues, aged 50, arrived at the HGE with a venous thrombosis in his left leg, in the iliac-femoral region. In his case, the treatment was medicated. “I started to feel a lot of pain in my whole leg, which became stiff and I could barely walk. But, thank God I’m fine”, reported the patient.
Risk – Thrombosis is more common after the age of 60 and has a great genetic influence, but it can happen in young people and for other reasons. The main modifiable risk factors for men are smoking, alcohol consumption and sedentary lifestyle. In women, unbalanced habits also matter. However, pregnancy and the use of contraceptive pills, especially without medical supervision, are the main threats.
“To reduce the likelihood of suffering from thrombosis, it is necessary to exercise, maintain an adequate diet, not smoke, reduce alcohol consumption and control weight and chronic diseases such as diabetes and hypertension. The sooner the patient with thrombosis arrives at the hospital, the less aggressive the treatment will be. This join results in a better prognosis. The best prevention is to seek care as quickly as possible”, warned the doctor.