Pathophysiology of Deep Venous Thrombosis and Chronic Venous Insufficiency

Blood veins have thin walls that are distensible, with valves to prevent pooling of blood. Sometimes, owing to numerous factors, the blood in veins can form clots of thrombus leading to a condition called DVT. The Deep venous thrombosis (DVT) occurs due to the formation of blood clot (thrombus) in the lower proximity of the venous vessel walls. According to (Huether & McCance, 2012, p. 586), DVT can be attributed mainly to three factors. These factors are the damage on the venous endothelial walls, hypercoagulable states and venous statis. The DVT is asymptotic mainly due to the deep location of the veins, making clinical detection difficult.

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            The chronic venous insufficiency (CVI) is a consequence of the deep venous thrombosis (DVT) (Grossman & Porth, 2014, P. 762). The CVI develop owing to chronic valvular incompetence and varicose veins (Huether & McCance, 2012, p. 586). According to the authors, varicose veins occur due to the pooling of blood as a result of valve failures, trauma and gradual venous distention.  The prolonged pooling of blood causes inadequate venous flow over a long period of time, which leads to CVI.

Differences between Venous and Arterial Thrombosis

            The venous and arterial thromboses are both vascular disorders that occur in the blood vessels. The venous thrombosis occurs due to the development of thrombus in the veins, owing to the activation of the clotting process. According to (Huether & McCance, 2012) the venous thrombosis occurs when the accumulation of platelets and clotting factors lead to the formation of thrombus around the venous valve. The thrombus can propagate and grow further proximally due to inflammation. A significant growth of the thrombus can obstruct venous blood flow, creating significant blood pressure behind the thrombus in the vein, which manifests itself as edema. The venous thrombosis can be caused by a combination of genetic, venous statis, damage to the endothelium and hypercoagulable states.

 In contrast, the arterial thrombosis is caused by a clot that occurs in the arteries, which carry blood at high pressure from heart to other body organs. The main of arterial thrombosis is arteriosclerosis and atrial fibriallation.

How Age Impacts the Pathophysiology of Chronic Venous Insufficiency and Deep Venous Thrombosis

            There is increase in the risk of venous and arterial thrombosis with increased age (Huether & McCance, 2012). The possible mechanisms of the increase include decreased exercise, increased immobility, which results in venous statis and increased activation of blood coagulation. With an increase in age, the plasma concentrations of some coagulation factors increase progressively. Moreover, increased age is often followed with reduced mobility and tissue degradation. The reduced mobility age and trauma coupled with old age are huge risk factors that impact on the pathopysiology of CVI and DVT. Conversely, increased mobility and exercise reduces the likelihood of CVI and DVT.

How to Diagnose and Prescribe Treatment of the Disorders for a Patient Based On Age

The CVI is easy to diagnose owing to the presence of symptoms (Huether & McCance, 2012). The CVI can be diagnosed by observing the hyperpigmentation of the areas around ankles, any presence of venous statis ulcers and edema at lower extremities. The diagnosis of DVT can be confirmed through a combination of Doppler ultrasonography and serum D-dimer measurement. The treatment of CVI and DVT based on age can be achieved by examining patient mobility history and recommending appropriate exercise. The patient would be advised to always elevate legs, increase mobility and perform physical exercises.

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