Why Do I Have Calf Pain? It Could Be Deep Vein Thrombosis
A young woman presented her podiatrist's office with pain and swelling in her calf. He was seen two weeks before and had a fractured bone in his leg. To treat this condition, he was given a CAM boot (running cast) to stabilize the fracture. The medications he is taking include contraceptives (birth control pills). What causes the pain?
Definition of Inner Vein Thrombosis (DVT)
Freezing blood plays an important role in healing. When injuries cause bleeding, platelets and fibrin clumps together form a long-lasting barricade of blood flow. It prevents blood loss from the body and facilitates the healing process. However, this process can occur at unnecessary times, causing unwanted blood flow to the blood vessels. The most common site for missing blood clots is deep vein veins.
Deep vein thrombosis, or DVT, occurs when blood clots form in the calf. You may have heard of episodes of DVT caused by sitting or lying down for long periods of time, such as in airplanes or in hospitals. Long periods of immobility slow down blood flow through the veins, which is a major risk factor for clot formation. DVT can also occur after surgery due to venous wall damage.
Blood instability is another reason why DVT can develop. Hypercoagulability is a condition of excessive blood clotting, and may be the reason why the patients in the above example provide clinics today. Extra estrogen from contraceptive use can increase blood efficiency. Note also that the patient arrives at the CAM walker, which makes it inactive for a long time and risks developing DVT.
Other risk factors include pregnancy, smoking, or genetic conditions such as thrombophilia.
Clinical Delivery
Patients with DVT may present with pain in one leg which improves as the feet progress. Redness, swelling and tenderness are other symptoms to consider. However, it should be noted that patients with DVT may not experience any symptoms at all.
Potential complications
The major concern for the development of DVT is the potential for the frozen portion to rupture, forming the embolus. The embolus flows through the blood and can position itself downstream. Pulmonary embolism is a dangerous complication that occurs when some of the arteries rupture and are trapped in the artery in the lungs. Symptoms of pulmonary embolism include shortness of breath and sudden cough. Patients with these symptoms should visit the emergency department immediately. This can be life-threatening!
Physical examination
When a podiatrist suspects DVT, there is a simple physical test that can be performed as a screening tool. Some patients may show pain when their feet are extended to the ankle, showing Homan's positive signs. Bancroft's positive signs are observed when patients are in pain when doctors squeeze their calves from front to back. This test cannot confirm whether DVT is present, but it certainly can aid diagnosis when combined with patient history and further diagnostic tests.
Diagnostic tests
The use of duplex ultrasound is a surefire way to confirm the diagnosis of DVT. This procedure does not measure the blood vessels in the patient's calf due to flow irregularities. Thrombus is present when flow obstruction is observed.
The d-dimer test can also be used. The D-dimer is a piece of fibrin, one of the molecules involved in building a strong clot in the bloodstream. Blood was taken from the patient and the d-dimer level was measured. If the measured level is high, indicates a positive test, then further tests can be performed to confirm the DVT. This test is usually used when there is a low probability that the patient has DVT because of a negative test ruling.
Treatment
The importance of treating DVT, although not asymptomatic, is to prevent more deadly complications such as pulmonary embolism. Anticoagulants may be prescribed for the purpose of achieving this goal by dissolving the tumor or preventing it from growing. These drugs include Low Hole Molecular Heparins (LMWH) or Coumadin injection.
Prophylactic measures can also be taken in patients at risk for developing DVT. Compression stockings can be used on patients who are stuck for a long time. Anticoagulants can also be used prophylactically. It is important to advise patients who have previous episodes or are at risk of not staying too long while traveling long distances as this may lead to the development of DVT.
If you read this because you think that this might be what causes your calf pain & hellip; .call 911 or hurry to the nearest emergency room!
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