Perna pesada, inchada, dolorida e com mancha pode ser sinal de TVP (trombose venosa profunda). Apesar de a doença cardiovascular ser mais prevalente em idosos, os médicos alertam que há vários fatores de risco que levam jovens e adultos a desenvolver trombose. Entre eles, pessoas que passam por cirurgias longas e mulheres fumantes que usam pílulas anticoncepcionais.
Segundo Caio Cesar Focássio, membro da SBACV (Sociedade Brasileira de Angiologia e Cirurgia Vascular), a TVP é uma formação de um coágulo sanguíneo, chamado também de trombo, que obstrui a veia e impede a circulação de sangue no local.
— A veia são todos os vasos que levam o sangue de volta para o coração. As veias profundas são as que ficam dentro da musculatura e são responsáveis pela maior parte das tromboses. A TVP pode afetar qualquer parte do corpo, porém, geralmente, ocorre nos membros inferiores.
A SBACV (Sociedade Brasileira de Angiologia e de Cirurgia Vascular) estima que a cada 100 mil pessoas 60 terão a doença em um ano. A incidência é maior após os 40 anos de idade. Entre 25 e 35 anos, a taxa fica em 30 casos para 100 mil. Já entre 70 a 79 anos, o índice chega entre 300 e 500 casos. Uma das hipóteses para a doença ser mais comum em idosos é a possível diminuição da resistência da parede venosa, que poderia propiciar dilatação da veia, e consequentemente diminuir a velocidade do fluxo sanguíneo, facilitando o desenvolvimento da trombose.
Há diversos fatores que podem levar à doença, explica o angiologista e cirurgião vascular do Hospital São Luiz Eduardo Brigidio.
— Cirurgias longas, passar muito tempo sentado, como dentro de um avião, ficar acamado por doença, a trombofilia (doença do sangue) e a gravidez são fatores que podem aumentar o risco para a trombose.
Mulheres fumantes que utilizam anticoncepcional também “têm o risco aumentado em muitas vezes”, alerta o médico.
— Não é que todo mundo que toma anticoncepcional vai ter trombose. Mas quem fuma e usa pílula tem mais chance que as outras pessoas, pois a nicotina e o hormônio associados modificam o sangue facilitando a formação de coágulo.
Trombose após fratura
Foi logo após a gravidez que a engenheira química, Ana Cristina Campos, 37 anos, descobriu que tinha risco de desenvolver trombose. Ela teve infarto placentário (morte da placenta) e a causa poderia ter sido trombofilia (um dos fatores de risco mencionado pelos especialistas que predispõe à TVP). Os exames confirmaram a doença sanguínea. Pouco tempo depois, ela teve trombose.
— A trombose mesmo tive e descobri após imobilizar o joelho (ela sofreu uma fratura na patela após uma queda no quintal de casa), pois a imobilização é uma situação que aumenta o risco, já que há mais dificuldade do sangue circular. Senti ardência na parte interna da coxa. Incomodava bastante para andar. Ficou até com umas marcas/manchas vermelhas.
Pernas doloridas e inchadas podem ser sinais de doença grave
Além das dores, a trombose pode provocar embolia pulmonar, o que é “muito perigoso”, explica Brigidio.
— A embolia se dá quando um trombo se desprende do local e para no pulmão. Então, ele [o trombo] interrompe artéria do pulmão e pode trazer complicações respiratórias e levar até mesmo levar a pessoa à morte. Por isso, é necessário tratamento assim que o problema for descoberto.
Tratamento e prevenção
Os médicos explicam que o tratamento para a doença são os remédios anticoagulantes, que têm como função “afinar” o sangue e evitar a formação de coágulos. Foi com um destes medicamentos que, depois do susto, Ana Cristina começou a tomar.
— Como minha TVP foi alta, pois pegou até a parte superior da perna, o tratamento mínimo com anticoagulante é de seis meses, mas tomei por um ano. O vascular recomendou tomar o resto da vida, pois tenho trombofilia. O hematologista não acha necessário o resto da vida, mas no momento tomo AAS.
O especialista do Hospital São Luiz explica que, geralmente, a pessoa toma remédio por cerca de 30 dias, mas o uso da meia elástica é necessária para o resto da vida, especialmente em situações especiais, como, por exemplo, ao andar de avião.
No caso de Ana Cristina, ela terá que tomar o remédio “a vida toda”, assim como o uso da meia elástica. A engenheira também conta que segue outras recomendações médicas para prevenir o problema.
— Vou seguir o para o resto da vida: movimentar a perna (a panturrilha é como uma bomba e é essencial o seu movimento na circulação do sangue da perna) e fazer exercícios físicos: os médicos me recomendaram hidroginástica, pois a pressão da água auxilia, manter o peso sob controle, já que o aumento de peso significa aumento do risco, tomar bastante líquido e não tomar nunca mais anticoncepcional.
Exame genético pode ajudar mulheres
Um dos fatores de risco para trombose, a trombofilia pode ser diagnosticada com simples exame genético. Hoje em dia, os convênios médicos são obrigados a ofertar o teste, explica o obstetra e geneticista diretor da clínica Chromosome Medicina Genômica, Ciro Martinhago.
— Se a pessoa tem o gene portador da trombofilia, o risco de ter trombose aumenta de seis a oito vezes. Com o uso de anticoncepcional esse número pode subir para 30.
O especialista afirma que, com o exame, a mulher portadora pode se prevenir em “três fases de sua vida”.
— Se ela sabe o resultado, quando, ainda adolescente, procura o médico para tomar anticoncepcional, saberá do risco. Depois, quando resolve ser mãe [gravidez aumenta risco de trombose], o médico poderá prescrever um remédio para afinar o sangue e, assim, ela se previne. Por último, na plenitude da vida quando ela vai precisar do uso da reposição hormonal saberá que pode correr riscos. Não é porque tem o gene da trombofilia, que a mulher terá trombose, mas se é possível prevenir, melhor.
Fonte: R7 Notícias
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