Few do not know that a person's blood flows through the veins and arteries. Both of them are dispersed throughout the volume of the body, some at the very surface of the skin, others deep under it. It is not easy to detect problems with deep vessels, since the external signs of the disease are weak. Multiple symptoms come to the aid of physicians - Homans and Moses, Lowenberg and Louvel, Opitz and Ramines. Each of them is a signal that something is wrong with the blood vessels. To clarify the diagnosis, there is a complex but accurate diagnosis, however, the reason for going to the doctor, as a rule, is the very first, initial symptoms. What are they, how do they manifest themselves and how serious are they? Let's figure it out.
What are dangerous blood clots
Before we tell you what the Moses symptom and other symptoms are, let's clarify the situation with blood clots. In fact, these are blood clots that appear in the blood vessels due to disturbances in the hemostasis system. They can move through the vessel or attach themselvesto his wall. At first, clots are usually small, but they are able to grow because thrombotic masses build up over time.
There comes a moment when the grown thrombus completely clogs the vessel, which without urgent action can lead to death. But the closure of the vessel by 70-75% is fraught with big troubles, namely, a decrease in the flow of oxygen to the tissues to critical levels and the accumulation of metabolic products, which leads to intoxication. When blood clots form in a living person in the blood vessels, the diagnosis is thrombosis. This disease is familiar to 1/5 of the world's population, and in men it occurs much more often than in women. Thrombosis can happen in any veins and arteries - in the arms, in the internal organs, in the brain, but is more often observed in the lower extremities. If you do not pay due attention to the disease, it gives complications that take thousands of lives every year.
Causes of blood clots in the veins of the lower extremities
Why do some people get blood clots and others don't? There are many risk factors here, and they are all divided into three groups - congenital, acquired and mixed. Moses' symptom is equally relevant in any risk group. Congenital factors for the onset of the disease are one or another violation of hemostasis and mutations at the genetic level.
Among those purchased are the following:
- advanced age;
- pregnancy;
- leg injuries (e.g. fractures);
- obesity;
- leg surgery;
- use of certain contraceptives;
- physical inactivity;
- hormonal disorders;
- benign blood tumor (polycythemia);
- malignant tumor of the pancreas;
- some medicines;
- plaster overlay;
- the presence of a catheter in the central vein;
- infections.
Thrombophlebitis
Moses' symptom is a sign of not only thrombosis, but also thrombophlebitis - an ailment that combines the formation of a blood clot and inflammation of a vein. The reasons for its occurrence are:
- thrombophilia (tendency to form blood clots);
- a number of infectious diseases;
- vein injuries;
- violation of blood flow;
- allergy;
- change in blood composition;
- overweight;
- hypertension.
Thrombophlebitis can be acute and chronic. It causes the greatest danger when a fragment of a blood clot breaks off, enters the heart or pulmonary artery with blood flow. The outcome depends on the size of the fragment and the speed of action.
Signs of clogged veins
To suspect that deep veins of the legs have started thrombosis, not only the symptom of Moses helps. The disease also has the following symptoms:
- limb swelling;
- sensations of discomfort, fullness, pain in the limb;
- high temperature (does not always appear).
If blood clots clog vessels close to the surface of the skin, the beginning of the problemunmistakably determined visually by swollen veins, a characteristic mesh in a problem area, a change in its texture and color. If blood clots clog deep vessels, external signs are not so distinct, plus they may indicate a number of other diseases, for example, swelling of the extremities occurs with heart failure, pain is felt with injuries. Therefore, doctors, when performing clinical diagnostics, take into account the specific signs of deep vein thrombosis in the calves and lower legs.
If thrombosis occurs in the veins of the upper third of the thigh, the patient may feel pain in the lower back, sacrum, in the inguinal zone. One of the signs of pathology may be an increase in temperature. At the same time, the Moses symptom and other clinical symptoms considered in this article are absent. Sometimes blood clots in the veins of the thigh cause no symptoms at all, and the disease becomes known too late, when a pulmonary embolism has already occurred.
Homans and Moses symptom
Diagnosis according to Homans is considered the most characteristic and is as follows. The patient lies on the couch on his back. The head is at the same level with the body (without a pillow). The patient's legs should be slightly bent at the knees. The doctor bends the foot of his foot in the ankle joint from the back. Moreover, if there is thrombosis in the veins of the legs up to the knee, the patient has a sharp pain in the muscles of the calves.
Moses' symptom is another method of clinical diagnosis of deep vein thrombosis and thrombophlebitis. It consists in the following. The doctor squeezes the patient's lower leg in front and behind, and then from two sides. If in the first case there is a sharp pain, and in the second it is absent, there is a high probability of a blood clot in the veins.
Other symptoms of clinical diagnosis
For greater confidence in the correctness of the preliminary diagnosis, doctors use a test not only for the Moses symptom. The photo shows the preparatory process before the Lowenberg test. The doctor first palpates the problematic area of the limb in the patient, then puts on a sphygmomanometer cuff in the central lower leg (middle third) and inflates air to a pressure of about 150 mm Hg. Pain in the calf indicates the presence of a blood clot.
You can put the cuff on the thigh (lower third), and not on the lower leg, and also blow air into it. If at the same time pain appears in the calf, this will already be a symptom of Opitz-Raminetz.
Sometimes, patients have calf pain when coughing or even sneezing. This is also a sign of thrombosis, called Louvel's symptom, but of all it is the least characteristic.
Accurate diagnosis
If a patient is suspected of having deep vein thrombosis or thrombophlebitis, but the symptoms of Homans and Moses are negative, the patient is advised to undergo additional diagnostics. Her methods:
- Ultrasound (dopplerography, sonoelastography);
- MRI;
- blood tests (hemostasis tests).
If the patient has swelling andsoreness of the lower limb, but there are no above symptoms, this may be a signal of another disease, for example, the consequences of an injury, heart failure, arthrosis and others. Accurate diagnosis and is carried out to find out the reliable cause of foot problems.
Treatment
It is very important to detect deep vein thrombosis in the early stages of the disease, which, of course, is helped by the simplest methods of clinical diagnosis, such as Homans' symptom and Moses' symptom. Treatment is prescribed by a doctor, guided by clinical diagnosis, as well as the results of accurate diagnosis. If the process is not running, therapy may be limited to conservative methods:
- application of ointments to the problem area ("Hepanol", "Heparin", "Nise" or "Indovazin"), which relieve pain, relieve inflammation, prevent the formation of blood clots;
- ingestion of anticoagulants that dissolve blood clots and cleanse the bed of veins;
- physiotherapeutic procedures (UHF and magnetotherapy to relieve swelling, electrophoresis with medications to dissolve blood clots as soon as possible);
- hirudotherapy (leeches inject a substance into the blood that prevents it from clotting and thereby improves blood flow);
- elastic compression (wearing special stockings and tights).
An essential condition of treatment is bed rest.
According to indications, micro-operations (incision of a vein under local anesthesia) are performed on the lower extremities to remove blood clots.
If a threat of thromboembolism is detected(blockage) of the pulmonary artery, the patient is immediately operated on.
Prevention
Common truth - any disease is easier to prevent than to get rid of it. To prevent acquired risk factors for thrombosis and the symptom of Moses, Homans and others from appearing, you need to strengthen your veins. There are many ways to do this and they are effective only in combination. This is:
- diet;
- hardening (contrast baths, walking barefoot, swimming);
- reasonable physical activity;
- foot hygiene;
- wearing compression stockings (especially when flying);
- avoiding hypothermia of the legs and their hyperfatigue;
- traditional medicine that helps relieve inflammation and strengthen the walls of blood vessels.
