Phlebitis means inflammation of a vein. When inflammation is associated with a blood clot, the condition is called thrombophlebitis. It may affect veins close to the skin or deeper veins, and the level of urgency depends on which veins are involved and whether a clot is present.
What is superficial thrombophlebitis?
Superficial thrombophlebitis affects a vein near the skin. The area may become tender, warm, red or firm along the course of the vein. It can occur in a varicose vein or after irritation from an intravenous line, injury or another local trigger. Although many superficial cases are limited, symptoms should still be assessed because treatment depends on the extent and location of the clot.
How is deep vein thrombosis different?
Deep vein thrombosis (DVT) is a blood clot in a deep vein, most often in the leg. It is not simply another name for phlebitis. DVT matters because part of a clot can travel to the lungs and cause a pulmonary embolism. New one-sided leg swelling, significant pain, unexplained breathlessness, chest pain, fainting or coughing up blood requires urgent medical evaluation.
Who may be at higher risk?
Risk varies from person to person. Factors can include a previous clot, prolonged immobility, recent surgery or hospitalization, certain cancers, pregnancy and the postpartum period, estrogen-containing medicines, inherited clotting conditions, obesity, smoking and increasing age. Having one risk factor does not mean a clot will occur, and people without obvious risk factors can also develop one.
How are phlebitis and DVT evaluated?
A clinician usually starts with the history and examination. If a clot is suspected, duplex ultrasound is commonly used to assess blood flow and look for thrombosis. A D-dimer blood test may be useful in selected situations, but it cannot by itself confirm DVT and is interpreted together with clinical risk. Additional testing is chosen according to the patient’s symptoms and medical history.
What does treatment involve?
Treatment is based on whether the problem is superficial inflammation, a superficial clot with features that increase risk, or a DVT. Management can include symptom control, mobility advice, compression in selected patients, and anticoagulant treatment when clinically indicated. Medicines such as anti-inflammatory drugs or anticoagulants are not appropriate for everyone, so they should be used only after a clinician reviews bleeding risk, other medicines and the location of the clot.
People with visible or symptomatic varicose veins may also benefit from an assessment of the underlying venous problem rather than treating repeated inflammation in isolation.
When should you seek medical help?
Arrange medical assessment for a new painful, red or swollen vein, especially if symptoms are worsening or you have risk factors for thrombosis. Seek urgent care for sudden breathlessness, chest pain, fainting, coughing up blood, or marked one-sided leg swelling.
If you would like to discuss vein-related symptoms or whether an in-person assessment is appropriate, use the VJ Clinics contact page to confirm the relevant service and appointment location.