What is Deep Vein Thrombosis?

Deep vein thrombosis or DTV happens when a blood clot or thrombus forms in a deep vein in the body, usually in one of the legs. Deep vein thrombosis may occur without symptoms or it could cause leg pain and swelling.

DVT can happen if you have a variety of medical problems that affect how your blood clots. DVT also may happen if you do not move for a long period of time, such as after an accident, after surgery or if you are confined to a bed.

DVT is a serious problem because blood clots can form in your veins and then break loose, go through the blood and lodge in the heart or lungs, causing a pulmonary embolism.

Symptoms of DVT

DVT symptoms may include swelling in the leg. In a few cases, there could be swelling in both legs. You also may experience considerable pain in your leg. It could start in the calf and feel like a cramp.

However, note that DVT may occur without any symptoms at all.

You should see a doctor if you develop these signs of DVT. If you experience symptoms of a pulmonary embolism, you need medical attention immediately.

Warning Signs of Pulmonary Embolism

  • Shortness of breath without any explanation
  • Chest pain that gets worse when you cough or take a deep breath
  • Lightheadedness or dizziness
  • Rapid pulse
  • Cough up blood

Risk Factors for DVT

There are many factors that can boost your risk of developing deep vein thrombosis, which include:

  • Blood clotting disorders in your family: Some people have blood clotting disorders in the family that makes the blood clot more easily. This condition that is inherited may not cause you problems unless you have other risk factors below.
  • Long periods of bed rest, including a long hospital stay or paralysis. If your legs do not move for long periods of time, the calf muscles do not move and contract to assist in blood circulation, which may increase the risk of clots.
  • Surgery and/or injury: Any type of surgery or injury to the veins could boost your risk of blood clots.
  • Pregnancy: Increases the pressure in your veins in the legs and pelvis. Women who have a clotting disorder are at higher risk during pregnancy. Risk of blood clots from pregnancy can continue for several weeks after you deliver.
  • Taking birth control pills: Oral contraceptives and hormone replacement therapy increase the blood’s ability to clot.
  • Smoking: Affects circulation and blood clotting, which can cause DTV.
  • Obesity: Increases pressure on the veins in the legs and pelvis.
  • Cancer: Some types of cancer increase the substances in the blood that increase the ability to clot. Some types of cancer treatment also can cause blood to clot more easily.
  • Heart failure: People who have heart failure have a higher risk of DVT and embolism. If you have heart failure, you already have reduced lung and heart function. Symptoms of a small pulmonary embolism are more pronounced.
  • Age: Being over 60 will increase your risk of deep vein thrombosis.
  • Sitting for long periods: When your legs do not move for many hours, the calf muscles do not contract, which helps your blood to move. Clots can form in the calves if the muscles do not move for many hours.

Complications of DVT

The main complication of having DVT is pulmonary embolism. This is a condition that happens where the blood vessel in the lung is blocked by a blood clot or thrombus that goes into the lungs from other areas of the body, usually the legs.

This condition can be fatal, so it is very important to look for signs of pulmonary embolism and to get medical help if they occur. Signs of pulmonary embolism include:

  • Shortness of breath without explanation
  • Chest pain that gets worse when you take a deep breath or cough
  • A feeling of lightheadedness or dizziness or fainting
  • Rapid pulse
  • Coughing up blood

Another common complication of DVT is postphlebitic syndrome that includes these signs: swelling of the legs or edema, pain in the legs, skin discoloration and skin sores.

How We Test for DVT

To diagnose DVT, your health care provider will ask you several questions about your symptoms. You also will have a physical examination so that your doctor can see if you have any swelling or tenderness in your legs. Depending upon your symptoms, your doctor could order a variety of tests:

  • Blood test: Most people who have DVT have higher levels of D dimer in their blood, which is a clot dissolving substance.
  • Venography: A dye will be inserted into a vein in your ankle or foot. An x-ray will be done that creates an image of your veins in your legs to look for clots.
  • Ultrasound: A wand device is put over part of the body where it is thought that there are clots. Sound waves are sent to that region and as the waves go through the tissue and come back, the computer will transform those waves into an image on the screen. If there is a clot, it should be visible on the screen.
  • CT or MRI: Either of these imaging tests can provide a good visual image of veins in the legs and can show if you have a clot.

How DVT is Treated

DVT treatments are made to prevent clots from getting larger, and also to stop the clot from breaking loose and traveling to the lungs or heart. Some of the most common options to treat DVT include:

  • IVC filters: If you are not able to tolerate blood thinners, a filter can be put into the vena cava in the abdomen. This can prevent clots that break loose from getting into the lungs.
  • Blood thinners: DVT most often is treated with anticoagulants or blood thinners. These drugs decrease the ability of the body to clot. They will not break up current clots but they can stop clots from getting larger. You will probably have to take a blood thinner for three months or more. Blood thinners have side effects, so you need to check with your doctor if you are able to tolerate them.

Resources:

http://www.mayoclinic.org/diseases-conditions/deep-vein-thrombosis/basics/treatment/con-20031922