Case Study No. 7: Deep Vein Thrombosis - Desklib

This case study discusses the medical history and lifestyle of Leona, a 52-year-old female who developed deep vein thrombosis (DVT) after a lengthy flight to Australia. The article explains the causes, symptoms, and treatment of DVT, along with the impact of atherosclerosis and obesity on platelet function. It also suggests preventive measures to avoid DVT. The document type is a case study, and the assignment type is not mentioned. The subject is not specified, and the course code and college/university are not mentioned.

Running head: CASE STUDY NO. 7: DEEP VEIN THROMBOSIS
CASE STUDY NO. 7: DEEP VEIN THROMBOSIS
Name of the Student
Name of the University
Author’s Note

1CASE STUDY NO. 7: DEEP VEIN THROMBOSIS
Table of Contents
Case Study No. 7:.......................................................................................................................2
Answer to question 1:.................................................................................................................2
Answer 2....................................................................................................................................2
Answer to 3................................................................................................................................3
Answer to question 4..................................................................................................................4
References..................................................................................................................................6

2CASE STUDY NO. 7: DEEP VEIN THROMBOSIS
Case Study No. 7:
The following case study highlights Leona who is a fifty two years old female
affected with deep vein thrombosis (DVT) three days after a lengthy flight to Australia.
Leona’s condition will be comprehensively deliberated along with her medical history and
lifestyle. Leona is an overweight smoker with atherosclerosis. Given a vacation of two weeks
from her work, she had planned a trip from Minnesota to Sydney via flight however, three
days after the long flight, she developed inflammation in her left calf and was hospitalized
and was diagnosed with deep vein thrombosis.
Answer 1:
DVT is the blood clot which forms within deep veins generally in veins of the leg
(Cieslik, Mrozinska, Broniatowska and Undas 2018). The blood clot that develops in the
larger vein around the muscles of calf and thigh with smokers, obese, and diabetic individuals
being more prone in developing DVT. People who are immobilized for a long period of time
are at risk of thrombosis development. Leona is an overweight smoker, who had to travel to
Sydney, Australia from Minneseta (approximately 18-hour flight time). The long duration of
travel and sitting time would have placed her at a high risk of thrombosis due to absence of
mobility andhistory of obesity, atherosclerosis and smoking. Proteins namely protein C,
protein S and antithrombin III all function together in the coagulation system such as to avoid
venous thrombosis from occurring and hypercoagulability may occur when the pattern
becomes disturbed (Watson, Broderick and Armon 2016).

3CASE STUDY NO. 7: DEEP VEIN THROMBOSIS
Answer 2
Hypercoagulability creates excessive coagulation and may result in the creation of
clots (Watson, Broderick and Armon 2016). Hypercoagulability is dependent on predisposing
factors including anti-phospholipid antibodies, pregnancy, contraceptives, malignancies,
heart failure, and stasis. Hemostasis is one of those predisposing variables appropriate to the
situation of Leona.
Atherosclerosis encourages the attachment of the platelet to the walls of the vessel
and thus causes blood flow disturbance. Her past medical history predisposes her to harm to
the vessels, ultimately leading to thrombosis, which in turn occurred after a lengthy period of
inactivity. When platelets stick to the vessel wall, atherosclerosis occurs and growth factors
are released that cause the muscle to develop thrombosis. Since Leona has no prior DVT
history and no family history of DVTs, her current diagnosis would be regarded as a
condition that has been obtained due to her atherosclerosis and lifestyle issues of smoking
and obesity.
As stated above, atherosclerosis impacts the function of the platelet by interrupting
the blood flow through the veins and causing endothelial harm, thus promoting adherence of
the platelets. This has improved her likelihood of developing atherosclerosis because Leona
smokes, which in turn led to the development of DVT. The impact of enhanced platelet
activity on the growth of atherosclerosis occurs through the participation of regulatory
molecules in inflammatory reactions and this mediates atherosclerosis progression. This
implies that the capacity of platelets to work properly is limited by atherosclerosis (Budnik
and Brill 2018).

4CASE STUDY NO. 7: DEEP VEIN THROMBOSIS
Answer to 3
When platelets count in the blood rises, it leads to spontaneous development of blood
clots, leading to an abnormality in blood clotting. This process then disrupts the flow to
essential organs like brain, heart, and liver and ultimately leads to chronic health issues.
Normal level of platelets permits proper clotting in order to prevent blood loss from the body
however, irregularity in its functioning due to atherosclerosis and obesity leads to improper
functioning of the platelets thereby causing adverse effects in the body (Watson, Broderick
and Armon 2016).
Atherosclerosis can grow in any artery, leading to many health issues.
Atherosclerosis, however, can be controlled through efficient modifications in diet and
lifestyle. If modifications in lifestyle and diet are not helpful, surgery is another alternative.
Atherosclerosis accelerates changes in blood clotting by damaging and disrupting the
vascular endothelium causing interruption in the flow of blood (Budnik and Brill 2018).
Immobility encourages blood coagulation modifications by enhancing the sensitivity
of the platelet to adhesively and aggregation (Vedantham et al. 2017). Sitting for an extended
period of time, it led to accumulation of blood in her legs, which later contribute topain,
discomfort, and inflammation that she felt leading to hospitalization. Providers understand
that pain, erythema, tenderness and inflammation of the impacted limb frequently present
DVTs, and Leona introduced this. When present as a DVT, it is important to immediately
treat the condition. If untreated, it may lead to clot breakoff, and the clot may travel, causing
embolism in the lungs (Di Nisio, van Es and Büller 2016). The strategy that Leonawould
have taken to avoid this includes to get up and walk on the island of the aircraft. She could
also have made simple moves and stretched her legs to maintain blood flow. Compression

5CASE STUDY NO. 7: DEEP VEIN THROMBOSIS
stockings also could have been used by her as it is recommended for elderly people with
prolonged flight plans (Clarke et al. 2016).
Answer 4
Since atherosclerosis includes the arrangement of lipids and lymphocytes, this leads to
the artery walls being constricted and thickened. The narrowing of the artery walls restrict the
blood flow containing platelets whose primary function is the formation of clots to the
weakened portion of the body (Streiff et al. 2016). Leona’s immovability along with history
of smoking and atherosclerosis increased the risk of coagulability leading to deep vein
thrombosis.
She got heparin therapy while Leona was hospitalized. The main rationale for this is
that it is first line of treatment since heparin has a brief half-life so it has an instant impact.
Heparin also needs to be controlled to observe the clotting cascade through the use of
activated partial thromboplastin time (APPT) laboratory testing with value ranging from 1.5
and 2.5 who would not be on heparin, hence the need for original hospitalization (Righini et
al. 2016).
The average therapy with heparin ranges from five to 10 days to an extra three to six
months with an oral agent. The objective is to prevent thrombin and fibrin clot generation
quickly during the heparin therapy stage. Some people who are at greater danger for future
risk may need to implement oral therapy after six months.

6CASE STUDY NO. 7: DEEP VEIN THROMBOSIS
References
Budnik, I., & Brill, A. (2018). Immune factors in deep vein thrombosis initiation. Trends in
immunology, 39(8), 610-623.
Cieslik, J., Mrozinska, S., Broniatowska, E., & Undas, A. (2018). Altered plasma clot
properties increase the risk of recurrent deep vein thrombosis: a cohort study. Blood, 131(7),
797-807.
Clarke, M. J., Broderick, C., Hopewell, S., Juszczak, E., & Eisinga, A. (2016). Compression
stockings for preventing deep vein thrombosis in airline passengers. Cochrane database of
systematic reviews, (9).
Di Nisio, M., van Es, N., & Büller, H. R. (2016). Deep vein thrombosis and pulmonary
embolism. The Lancet, 388(10063), 3060-3073.
Righini, M., Galanaud, J. P., Guenneguez, H., Brisot, D., Diard, A., Faisse, P., ... & Martin,
M. (2016). Anticoagulant therapy for symptomatic calf deep vein thrombosis (CACTUS): a
randomised, double-blind, placebo-controlled trial. The Lancet Haematology, 3(12), e556-
e562.
Streiff, M.B., Agnelli, G., Connors, J.M., Crowther, M., Eichinger, S., Lopes, R., McBane,
R.D., Moll, S. and Ansell, J., 2016. Guidance for the treatment of deep vein thrombosis and
pulmonary embolism. Journal of thrombosis and thrombolysis, 41(1), pp.32-67.
Vedantham, S., Goldhaber, S. Z., Julian, J. A., Kahn, S. R., Jaff, M. R., Cohen, D. J., ... &
Murphy, T. P. (2017). Pharmacomechanical catheter-directed thrombolysis for deep-vein
thrombosis. New England Journal of Medicine, 377(23), 2240-2252.

7CASE STUDY NO. 7: DEEP VEIN THROMBOSIS
Watson, L., Broderick, C., & Armon, M. P. (2016). Thrombolysis for acute deep vein
thrombosis. Cochrane Database of Systematic Reviews, (11).