Patients with thrombophlebitis typically present with the following symptoms:

• Inflammation and swelling of the affected region
• Erythema of the affected part
• Pain on the area of inflammation
• Tenderness over the affected vein
• Warmth of the superficial skin

• Pain

  They can include: Pain Tenderness Redness Warmth Swelling Hardening of the vein In most cases, superficial thrombophlebitis resolves on its own with no problems. Treatment is focused on relieving symptoms. [fairview.org]

  Pain is one of the major disadvantages of rocuronium, which is used during induction of anesthesia. Even at subparalyzing doses, 50-100% of patients complain of intense pain. [ncbi.nlm.nih.gov]

  […] to dissolve an existing clot You may be told to do the following: Keep pressure off the area to reduce pain and decrease the risk for further damage. [nlm.nih.gov]

  Covering the affected area with a warm flannel cloth and wearing compression stockings may ease the pain and discomfort and also reduce the swelling. Anti-inflammatory ointments and gels may also be effective in alleviating the pain. [vr.net.au]

• High Fever

  Low grade fever may accompany superficial and deep phlebitis. High fever or drainage of pus from the site of thrombophlebitis may suggest an infection of the thrombophlebitis (referred to as septic thrombophlebitis). [ipcphysicaltherapy.com]

  If vein swelling and pain are severe or are accompanied by a high fever or shortness of breath, go to an emergency room. [knowyourdisease.com]

  High fever with any symptoms in an arm or leg Lumps in a leg Severe pain and swelling in an arm or leg Chest pain and shortness of breath, which could be the symptoms of pulmonary embolism (blood clot in the lung). [emedicinehealth.com]

• Localized Edema

  Clinical Features and Natural History Top Signs of superficial thrombophlebitis include painful localized edema and erythema of the skin. [empendium.com]

  Superficial thrombophlebitis (ST) is a painful thrombotic condition that presents as a tender, erythematous, palpable cord with localized edema. [pub.hematology.org]

• Intermittent Claudication

  For example, studies suggest it may be modestly effective for circulation problems in the legs caused by a condition called intermittent claudication (vii). [naturesbest.co.uk]

• Dyspnea

  Monitor for the following side effects: dyspnea, palpitations, diaphoresis, chest pain, hypotension, and headache. [rnpedia.com]

  […] vapina, makuaistin muutokset, migreeni, ekstrapyramidaalioireet Näköhäiriöt, silmähäiriöt Korvien soiminen Sydämentykytys, keuhkojen edeema, sydäninfarkti1 Hypertensio, tromboflebiitti, vaskuliitti, suonikohjut, syvä tromboflebiitti, verisuonivaurio Dyspnea [mymemory.translated.net]

• Thrombosis

  /Specific Code Applicable To Nonpyogenic thrombosis of cerebral vein Nonpyogenic thrombosis of intracranial venous sinus Type 1 Excludes nonpyogenic thrombosis of intracranial venous system causing infarction ( I63.6 ) cerebral (sinus) (vein) G08 ICD- [icd10data.com]

  Swelling and pain in an upper extremity are suggestive of thrombosis. Pain associated with SVT is usually localized over the site of thrombosis. [emedicine.medscape.com]

  Muscular vein thrombosis is not a superficial thrombophlebitis but a sub-category of deep vein thrombosis, in which the thrombosis is located in the muscular veins of the calf region (plexus soleus or plexus gastrocnemius). [ebm-guidelines.com]

• Chest Pain

  Monitor for the following side effects: dyspnea, palpitations, diaphoresis, chest pain, hypotension, and headache. [rnpedia.com]

  […] in placebo-controlled, active-controlled, and open-label trials of Enbrel, serious adverse events reported included malignancies (see below), asthma, infections (see below), heart failure, myocardial infarction, myocardial ischaemia, chest pain, syncope [da.glosbe.com]

  […] dizziness, or fainting Extreme confusion Extreme drowsiness or trouble waking up New pain in the chest, arm, shoulder, neck, or upper back © 2000-2019 The StayWell Company, LLC. 800 Township Line Road, Yardley, PA 19067. [fairview.org]

  Chest pain or dyspnoea (? PE). Investigate? Thrombophlebitis occurs in a previously normal superficial vein and there is no obvious predisposing cause. Consider a thrombophilia screen (check with haematology team). [emed.ie]

  A PE will cause shortness of breath and chest pain, and can be life-threatening. All DVTs must be treated immediately to prevent this occurring. Unfortunately, in some cases a PE may be the first sign of a DVT. [empr.com]

• Erythema

  On physical exam, there is erythema on the posterior calf and tenderness along the course of a superficial vein. A duplex ultrasound demonstrates impaired blood flow and incompressibility of a superficial vein. [medbullets.com]

  In cases where periorbital swelling complicating sinusitis is diagnosed, clinical findings of swelling and erythema extending beyond the orbital region into the cheek should alert the physician about this unusual complication and the need for further [ncbi.nlm.nih.gov]

• Warm Skin

  Symptoms of superficial thrombophlebitis include: Redness Inflammation Warm skin Pain and tenderness Skin discoloration Vein hardening Treatment options for superficial thrombophlebitis DVT requires immediate medical attention, but superficial thrombophlebitis [yourveinexpert.com]

  When symptoms do occur, they may include: swelling in the leg red, discolored, or white skin a cord in a leg vein that can be felt rapid heart beat (tachycardia) slight fever warm skin more visible surface veins dull ache, tightness, tenderness or pain [surgery.med.miami.edu]

• Dermatitis

  A 29-year-old man presented with complaints of fever and pain and itching of his left neck with atopic dermatitis and abrasion. These symptoms had persisted for two days and dullness and fever developed, but the patient did not consult a physician. [ncbi.nlm.nih.gov]

  Inability to obtain appropriate clinical management Medical Conditions Which Are To Be Included In Entitlement / Assessment Superficial thrombophlebitis Stasis dermatitis Venous ulcers Common Medical Conditions Which May Result In Whole Or In Part From [veterans.gc.ca]

• Pruritus

  English Eye disorder includes adverse reactions of eye pruritus, ocular hyperaemia, eye irritation, eye disorder, and foreign body sensation in eyes. [mymemory.translated.net]

• Stroke

  Stroke of unknown origin in young patients is seen to be closely correlated with patent foramen ovale (PFO) than stroke in patients with established stroke mechanisms. [ncbi.nlm.nih.gov]

  However, it also can occur in people with medical conditions that lead to sluggish blood flow in the legs, especially pregnant women and people who are immobilized because of stroke or cancer. [health.harvard.edu]

  Thrombophlebitis can be a life-threatening for this can lead to free-moving blood clots or emboli that can result to pulmonary embolism, heart failure or stroke. [byebyedoctor.com]

• Agitation

  Hypoactive delirium 06 Feb 2019 Mrs Jones, cherished and well cared for by her equally elderly husband, couldn't possibly have delirium as she is not agitated. [gp-update.co.uk]

The diagnosis of thrombophlebitis is usually made clinically by the attending physician. Further tests may be required to determine whether the thrombophlebitis is superficial or deep. These include:

• Blood tests: The determination of the levels of fibrin degradation product called D dimer could indicate the presence of a blood clot and the propensity of its recurrence.
• Ultrasonography: Sonographic images of the affected leg or arm will reveal the blood clot that causes the phlebitis. Doppler studies with ultrasound can demonstrate the efficiency of the peripheral circulation. 
• Computed Tomography (CT-scan): Complications of thrombophlebitis like pulmonary embolism could be investigated by the use of CT-scan imaging. 

The patients suffering from superficial thrombophlebitis may only need warm compress to relieve the discomfort and inflammation. The use of non-steroidal anti-inflammatory drugs (NSAIDs) can afford some pain control. Blood thinning medications like injectable low molecular weight heparin can effectively relieve both superficial and deep vein thrombosis [9].

Oral warfarin can prevent the formation of new clots and prevent small clots from growing. Thrombolytics like alteplase may be indicated for deep vein thrombosis and pulmonary embolism. Preventive compression stockings reduce the risk of thromboembolic recurrence in high-risk individuals. Surgical stripping of varicose veins can be performed for patients with recurrent thrombophlebitis of the lower extremities [10].

Both superficial thrombophlebitis and deep venous thrombosis respond well to early therapeutic interventions. Deep venous thrombosis below the knee level are more prone to pulmonary embolic events which increases mortality among patients. Patients who are incapacitated with long periods of immobility carry a higher morbidity rate.

In general, thrombophlebitis is caused by a blood clot that initiates an inflammatory reaction. There are a number of events that lead to the formation of blood clots in the body. These include:

• Direct injuries to the vein
• Long periods of inactivity
• Blood clotting disorders
• Varicose veins
• History of previous thrombophlebitis
• Malignancies 
• Prolonged intravenous cannulation
• Estrogen therapy
• Pregnancy

Nations in the western hemisphere have an annual incidence of 1 case of thrombophlebitis per 1000 population [1]. The relative incidence of symptomatic thrombophlebitis only reaches 5 cases for every 10,000 individuals [2]. The precise prevalence is difficult to establish because it is grossly under reported. An Italian based study reveals that pain and edema are the two dominant symptoms of deep venous thrombosis (DVT) occurring in almost three-fourths of the cases [3].

Superficial thrombophlebitis is more prone to recurrence as compared to deep venous thrombosis. The mortality and morbidity of thrombophlebitis correlates with pulmonary embolic events. Almost a third of the patients with superficial thrombophlebitis in the lower extremities have a concurrent deep venous thrombosis [4]. There is no racial predilection to thrombophlebitis; however, women are more prone to this condition with a higher risk for those in estrogenic therapy. The mean age of onset for both superficial and deep venous thrombosis is at 66 years according to European studies [5].

Almost two-thirds of the patients who develop thrombophlebitis have a pertinent medical history of hypercoagulable states like the inherited disease thrombophilia, which are are genetically transmitted and include specific hypercoagulable diseases like antithrombin deficiency, heparin cofactor II deficiency, thrombomodulin defiency, and tissue factor pathway inhibitor deficiency [6]. An inherent deficiency in any of the anticoagulant factors can also lead to thrombophlebitis [7]. Deficiency in protein S, anti-thrombin III and protein C renders the vascular endothelium incapacitated to self-repair during trivial vascular injuries.

Low dose estrogen therapy propagates thrombosis in vascular structures [8]. When estrogens are discontinued after prolonged use, the associted thrombogenesis may take up to a week to resolve.

During pregnancy, procoagulant factors like plasma fibrinogen increases in concentration to more than twice its normal concentration. Fibrinolysis is also greatly impaired during this gestational period.

Mucin producing visceral carcinoma can trigger a hypercoagulable state in affected patients.

High risk patients on long rides or flights should regularly move their lower extremities to prevent hemostasis and blood clot formation. Avoidance of tight clothing lowers the risk of thrombophlebitis. Regular and adequate hydration is needed to prevent hypercoagulable states. Patients prescribed with blood thinning medications must comply with it religiously to prevent thrombosis and embolic events from happening.

Thrombophlebitis occurs when blood clots start to obstruct one or more veins of the lower extremities; although thrombophlebitis can sometimes affect the superficial veins of the neck and arms.

Thrombophlebitis is often associated with long periods of inactivity, trauma and surgery. Patients with pronounced varicose veins can develop superficial thrombophlebitis. Clotting and inflammation of the deep veins is more prone to embolus formation, which can adversely be lodged to the lungs and cause life-threatening pulmonary embolism. Both superficial and deep thrombophlebitis are effectively treated with blood thinning medications.

Thrombophlebitis refers to the development of clots in one or more veins in the body with subsequent inflammation. This leads to pain, reddening and swelling of the affected region. Long periods of inactivity, injuries to the veins and inherited disorders of blood clotting are important risk factors for this condition. A number of medicines and surgical procedures can effectively treat this disease. Early treatment prevents the dangerous complication of dislodgement of the clot into the lungs. 

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