Chronic Venous Insufficiency & Deep Vein Thrombosis - Essay Sample

Introduction

Chronic Venous Insufficiency (CVI) and Deep Vein Thrombosis (DVT) are common cardiovascular diseases affecting many people across the globe. Their prevalence is informed by patient factors such as age, ethnicity, gender, as well as behavior. These two cardiovascular disorders follow specific pathophysiological mechanisms that spell their differences and similarities. Below is a comparison of the two cardiovascular diseases based on their pathophysiological processes. It encapsulates the pathophysiological differences and similarities, as well as risk factors and how they implicate individuals. The latter revolves around the roles played by specific risk factors in the onset and prevalence of the disease among a particular segment of a population.

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CVI and DVT

While CVI regards insufficient venous return, due to vulvar incompetence and varicose veins, DVT is the formation of thrombus in the veins due to low blood pressure in the threads than in arteries (McCance & Heuther, 2018). When the vulvar malfunctions, especially on superficial veins or malfunction and varicose veins, progresses, especially among obese individuals, CVI becomes imminent. Also, while CVI affects the superficial veins, its clinical presentation is quite visible and can be easily diagnosed through physical examination, DVT remains asymptomatic because the clots are found deep in the veins. It makes the physical examination an uphill task in the latter. DVT, on the other hand, occurs based on the blood pressure differences between the arteries and veins. When the latter's blood pressure is lower than the former, blood clots form in the arteries and the factors causing CVI and DVT spell their differences.

The most fundamental similarities between CVI and DVT regard the fact that the lower extremities are affected, as well as the specificity of the veins. Both DVT and CVI distress the veins in the lower margins (McCance & Heuther, 2018). The modified threads result in inflammation and swelling of the regions within which they are located. For instance, CVI's circulatory stasis, venous hypertension, as well as hypoxia results in inflammatory reaction cascades within blood vessels and tissues. The region of the extremity affected, as such, swells. The same applies to DVT because the clots constrict blood vessels. The constructed parts block efficient drainage, and this triggers the high blood pressure that, in turn, amounts to swelling of the extremity affected.

Another fundamental pathophysiological similarity regards the pathogenesis of the two cardiovascular disorders. CVI's pathogenesis is categorized as either venous obstruction or reflux in blood flow or a combination thereof (Santler & George, 2017). The point on venous obstruction is also paramount in DVT because the blood clots cause vessel obstruction. However, there arises a fundamental difference. While CVI's pathogenesis informs the reflux of blood, DVT's pathogenesis does not include the reflux of blood due to the absence of valves. Instead, increased blood pressure is witnessed.

While the formation of blood clots characterizes DVT, CVI is a function of fat deposition or sclerosis along the veins. The difference, as such, results from the agent generating venous obstruction. The formation of blood clots along the arteries in DVT may result from physiological complications in the cascades responsible for the maintenance of blood in its natural state. Also, it might be associated with other factors such as age or health complications that aggravate thrombosis. In CVI, however, sclerosis is at the core of venous obstruction in which the accumulation and deposition of fats along the veins remain a significant factor (McCance & Heuther, 2018).

Age as Patient Factor

The Implication of Age on the Pathophysiology

Several risk factors predispose individuals to cardiovascular diseases like CVI and DVT. In the case of CVI and DVT, age is a significant element. Naturally, CVI and DVT's onset and prevalence substantially increase with age. In DVT, to begin with, increasing age renders the venous valves incompetent such that the backflow of blood increases. For instance, DVT's incidence among people below 40 years is 1 per 1, 000. However, the opposite is witnessed among people aged above 75 years in which 1 out of 100 people is affected (van Langevelde, Sramek & Rosendaal, 2010). The explanations brought forth to validate and support age as a risk factor to DVT include decreased mobility in old age, the high prevalence of diseases characterized by elevated thrombotic risks such as fatalities, a reduction in venous compliance especially around the calf, and lastly, vulvar damages (van Langevelde, Sramek & Rosendaal, 2010). The case is also similar in CVI because age is associated with an increased incidence of injuries in valves, especially among females than males (Mattar, 2011). As such, CVI is most likely to be registered among the aged than young individuals. It is suggested that the valves fade away and lose their ability to perform as one grows old optimally. In the process, the incidences of blood flowing back through the valves increase.

Reflection

Diagnosis of DVT and Treatment

DVT is naturally asymptomatic, and as such, clinical detection is problematic. The determination of this disorder is informed by whether or not thrombosis occurs. As such, the technique used in the diagnosis might be contextualized. For instance, in a case where the thrombus is formed, I will combine Doppler ultrasonography with the D-dimer measurement. The Doppler ultrasonography and D-dimer measurement are the paramount diagnostic mechanisms of determining the presence of the disorder, and the rationale of their preference is informed by DVT's asymptomatic nature (McCance & Huether, 2018). However, in rare cases where the disorder presents clinical symptoms, physical diagnosis is an excellent starting point. It is also fundamental to not that DVT is largely asymptomatic because clot formation remains deep within the veins. As such, the diagnostic processes should focus on Doppler ultrasonography and D-dimer measurement because physical presentations are rarely seen.

DVT's pathophysiology informs that the blood clots in the veins are the primary issue. As such, the treatment and management of the disease will revolve around the administration of anticoagulants such as warfarin and heparin. In the latter's case, the low molecular weight preparations are an idea for the disorder (McCance &Heuther, 2018). The newer versions of oral anticoagulants, such as the direct thrombin inhibitors and inhibitors of factor Xa, have somewhat become first-line treatment medications because their use is associated with favorable and viable risk-to-benefit ratios among patients. Thrombin inhibitors are strategically administered to interfere with the formation of clots along the veins. Even so, the installation of filters along the inferior vena cava, alongside thrombolytic therapy, is indicated for particular patients. The thrombolytic treatment is meant to break down the blood clots along the vessels to enable a hassle-free flow of blood.

Diagnosis of CVI and Treatment

The diagnosis of CVI aims at establishing the extent and magnitude of the presenting symptoms. For instance, the presence of edema in the affected lower edges and skin hyperpigmentation of the membrane around the ankles and feet is crucial (McCance & Heuther, 2018). The presence of these physical symptoms will be a positive test for CVI, and the converse is true. I will perform a physical examination to determine the presence of swellings, changes in the skin, the appearance of ulcers on the leg, as well as varicose veins. As a complement, I will examine whether or not there are infection and the presence of any biochemical that could probably trigger the activities of the immune cells around the affected areas. The essence of establishing the existence of disease is based on the fact that CVI comes along with characteristic infections that cause ulcers around the effected lower extremities.

The treatment of varicose veins is a multidimensional aspect as it entails various approaches. Even so, it condenses to pharmacological and non-pharmacological approaches through which the invasive and non-invasive treatment strategies arise. While the pharmacological treatment frameworks used pharmacodynamics agents manufactured to correct the disorders, the non-pharmacological treatment does not exploit the xenobiotic. The non-invasive treatment approach should conservative, and this implies that excellent healing of the wound should be prioritized. It should be followed by spread of the limbs, physical workout, as well as the use of stockings of high density (McCance & Heuther, 2018). While wound care aims at arresting the physical manifestation on the skin, the physical exercise aims at preventing further clotting that exacerbates the condition. Would care products such as antiseptics and antibiotics are essential for the infections that hinder healing. The invasive frameworks of management, on the other hand, encapsulates surgical ligation or sclerotherapy, endovenous ablation, vein stripping, and lastly, conservative resection of veins.

CVI Mind Map

• Varies between 1% to 40% in females, and 1% to 17% in males
• Occupation; common among people experience long hours of standing
• Highly prevalent among the old age; 65 years and above
• Common in multiparity, pregnancy, and low social class
• Epidemiology
• Chronic Venous Insufficiency
• Varicose veins
• Leg inflammation
• Clinical Presentation
• Ulceration and skin changes
• Discomfort

Fig 1: The composition of CVI Mind Map

DVT Mind Map

• Affects 1/1, 000 of individuals below 40 years, and 1/100 of persons aged 75 years and above
• Highly prevalent among immobile individuals, people suffering from disorders aggravating thrombus formation and those practicing sedentary lifestyle
• Accounts for most Venous Thromboembolism
• Commonly affects the calf.
• Epidemiology
• Deep Vein Thrombosis
• Redness and tenderness
• Visibility of the veins
• Clinical Presentation
• Swelling of the calf
• Bluish decoloration

Fig2: The features of DVT Mind Map

Conclusion

Deep vein thrombosis and chronic venous deficiency are specific cardiovascular disorders with differing pathophysiological pathways. Wh...