Is your left leg a little swollen and heavier than the other? Sometimes it just hurts and feels like it's tingling? Many people don't pay much attention to these symptoms. But sometimes the reason behind this can be a little more serious than you think. One such reason could be this condition called 'May-Thurner Syndrome'. Let's take a simple look at what it is.
Simply put, what is May-Thurner Syndrome?
Very simple. There are two types of blood vessels in our body. We call the veins that carry oxygenated blood from the heart to the rest of the body 'Arteries' . Similarly, we call the veins that carry used, oxygenated blood back to the heart 'Veins' .
In this condition called Turner syndrome, the main artery that carries blood to your right leg (right iliac artery) passes over the main vein that carries blood back to your heart from your left leg (left iliac vein) and compresses it. Think of it like someone stepping on a water pipe. Then the water flow is interrupted, right? In the same way, when that artery compresses the vein, the blood flow from the left leg is interrupted. This condition is also called `(Cockett syndrome)`.
How does this condition affect the body?
When the blood flow from the left leg to the top is obstructed, some blood starts to pool or stagnate in the left leg. The most dangerous thing about this is that when blood pools in one place like this, the chances of a blood clot forming inside that vein increase significantly. In medical terms, we call this 'deep vein thrombosis' (DVT) .
DVT is a serious condition that can occur suddenly. If this blood clot breaks loose and gets stuck in a vein in the lungs, it can be life-threatening.
Typically, symptoms like these can occur when a DVT develops.
| Symptoms of DVT | |
|---|---|
| Swelling and heaviness | Swelling and a feeling of heaviness, often in one leg (in this case, the left leg). |
| Pain | A sharp pain or a throbbing sensation in the leg, especially in the groin area. |
| Skin discoloration | Red or blue discoloration of the skin on the leg. |
| Vein protrusion | The veins in the legs become swollen and start to appear on the surface. |
Additionally, some women may develop a condition called pelvic congestion syndrome along with May-Turner syndrome, which is a condition in which problems with the veins in the lower abdomen cause chronic pain.
Who is most likely to see this condition?
May-Turner syndrome is slightly more common in women , and is also common in adults between the ages of 20 and 50 .
But the surprising thing is that about one in five people has this condition called ``iliac vein compression.`` But not everyone has symptoms. Many people only find out they have May-Turner syndrome after they develop a DVT. Until then, they may be symptom-free.
How is May-Turner syndrome diagnosed?
After you tell your doctor about your symptoms, he or she will examine you and may recommend some special tests that examine your blood vessels to confirm the condition.
| Test type | Simply explained |
|---|---|
| Ultrasound scan `(Ultrasound)` | A painless test that uses sound waves to look at blood vessels inside the body. This is the first step in checking for DVT. |
| CT scans | Taking detailed pictures of blood vessels with a special X-ray machine. |
| MRI Scans (MRIs) | Obtaining very clear images of blood vessels using magnets and radio waves. |
| Venogram | A special liquid (contrast dye) is injected into a vein and X-rays are used to observe the blood flow. This can help pinpoint the exact location of the vein blockage. |
| Intravascular Ultrasound | A very accurate method in which a tube (catheter) with a very small camera is inserted into a blood vessel and the vessel is examined from the inside. |
What are the treatments for this?
The main goal of treatment for May-Turner syndrome is to restore the constricted vein to normal, improve blood flow, and reduce the risk of DVT.
If there are only symptoms
Typically, for someone who does not have DVT and only has symptoms such as leg swelling and pain, the doctor may recommend the following treatments:
- Angioplasty and stenting: This involves inserting a very small balloon-tipped tube into the vein and inflating the balloon at the narrowed area. This opens the vein and allows blood to flow. A mesh-like cylindrical device called a stent is then placed inside the vein to keep it from narrowing again.
- Surgery: In some cases, surgery can be done to move the narrowed artery away from the vein. Or, bypass surgery can be done to create a new path for blood to flow around the narrowed area.
If accompanied by DVT
If you have a DVT due to May-Turner syndrome, in addition to the treatments mentioned above, you will also need to do the following:
- Anticoagulants: These medications are given to prevent blood clots from forming and to stop existing clots from getting bigger.
- Clot-dissolving medication: Sometimes, medication is injected directly into the blood clot through a catheter to dissolve it and remove it.
- Vena cava filter: Rarely, a device called a filter is temporarily or permanently placed in a major vein in our body (inferior vena cava) to prevent a blood clot in the leg from dislodging and traveling to the lungs.
The most dangerous complication: Pulmonary Embolism
The most dangerous thing about May-Turner syndrome is the development of DVT. What's even more dangerous is when a piece of that DVT breaks off, travels with the blood, and gets stuck in a blood vessel there. We call this `Pulmonary Embolism` .
This is a very serious, life-threatening medical emergency! If you or someone you know suddenly develops any of the following symptoms, take them to a hospital's Emergency Department (ETU) immediately.
- Sudden difficulty breathing (dyspnea)
- Severe chest pain that increases when breathing
- Bleeding with mucus
- Heart palpitations (palpitations)
Things we can do to reduce the risk
There is no specific way to prevent May-Turner syndrome, as its exact cause is unknown. However, the following can help keep your blood circulation good and reduce your risk of blood clots:
- Don't stay in the same position for long periods of time. Especially if you have a sedentary job, get up and walk around at least once an hour.
- Drink plenty of water.
- Exercise regularly, especially aerobic exercise.
- If you have other diseases like diabetes or hypertension, control them well according to your doctor's instructions.
- If you smoke, stop immediately.
- If your doctor recommends it, wear special compression stockings.
If you have any more questions about May-Turner syndrome, don't be afraid to ask your doctor. He or she will explain everything to you.
Take-Home Message
- May-Turner syndrome is a condition in which the artery that carries blood to the right leg and the vein that carries blood from the left leg are compressed.
- This can cause blood flow to the left leg to be obstructed, leading to symptoms such as leg swelling and pain.
- The main and most dangerous complication of this condition is the formation of deep vein thrombosis (DVT).
- Pulmonary embolism (a clot that breaks off from a DVT and lodges in the lungs) is a life-threatening emergency.
- If you have unexplained swelling, pain, or heaviness in your left leg, it is important to seek medical advice.
- This is a condition that can be successfully managed with treatment.
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