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Blood clots can form in arteries or veins. When inflammation due to a blood clot occurs in a vein, it is called thrombophlebitis. Thrombophlebitis usually occurs in the veins of the legs. Rarely, it can occur in the veins of the arms or neck. Superficial (on the surface) thrombophlebitis occurs in the visible veins just under the skin. The area of inflammation is usually reddened, tender, and warm to the touch and can be painful. The extremity may swell and fever may occur. Deep vein thrombosis (DVT) is more dangerous than superficial thrombophlebitis. Deep vein thrombosis often cannot be seen or felt by the individual. Swelling of the leg or fever may alert a person to the presence of a DVT, especially if risk factors for DVT exist. Pulmonary embolism, a condition that can be fatal, results from a DVT that becomes loose in the veins and travels to the lungs. There, it blocks proper blood flow to the lungs and decreases oxygen levels in the body. The April 6, 2011, issue of JAMA includes an article about thromboembolism (clots being carried by the bloodstream). This Patient Page is based on one previously published in the July 26, 2006, issue of JAMA.
Inactivity due to recent injury, surgery, or prolonged sitting
Pregnancy or recent childbirth
Oral contraceptive use or estrogen therapy
Stroke or other diseases that limit movement
Family history of clotting disorders
Central venous catheters (used for injection of medications or for dialysis)
In addition to a medical history and physical examination, the doctor may order tests to evaluate superficial thrombophlebitis or to look for presence of a DVT. These tests may include D-dimer (a blood test), ultrasound (using sound waves to look for a blood clot in the vein), magnetic resonance imaging (MRI) to visualize blood vessels, or venography (using injection of a dye to trace the course of a vein). If pulmonary embolism is suspected, computed tomography (CT) may be done.
Move your legs, especially during prolonged sitting (such as air travel) or bed rest
Use compression (strong support) stockings
Discuss your personal and family history with your doctor before considering hormone therapy
Treatment for superficial thrombophlebitis usually includes elevating the leg, warm compresses to the area, and medication to decrease pain and inflammation. Support stockings may be worn to reduce swelling. Treatment for DVT or pulmonary embolism usually involves anticoagulation (blood thinning) treatment with heparin (by injection) or warfarin (by mouth for longer-term treatment). Pregnant women should not use warfarin because it can harm the developing fetus.
National Heart, Lung, and Blood Institutehttp://www.nhlbi.nih.gov
American Heart Associationhttp://www.americanheart.org
To find this and previous JAMA Patient Pages, go to the Patient Page Index on JAMA's Web site at http://www.jama.com. Many are available in English and Spanish.
Sources: National Heart, Lung, and Blood Institute; American Heart Association
The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 312/464-0776.
TOPIC: VASCULAR DISEASE
Torpy JM, Burke AE, Golub RM. Thrombophlebitis. JAMA. 2011;305(13):1372. doi:10.1001/jama.305.13.1372
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