Deep Vein Thrombosis
A deep vein thrombosis (DVT) is a blood clot that develops in a deep, large vein, usually in the lower leg or thigh. Deep veins pass through the center of the leg and are surrounded by muscles. The clot can cause pain in the leg and lead to serious complications. The clot may occur when the blood moves more slowly than normal. The clot can interfere with blood circulation and may break off and travel through the blood stream, becoming an embolism
The resulting embolus can lodge in the brain, lungs, heart or other area, causing severe damage to that organ. Normal blood clotting occurs outside the blood vessel and is a normal process which protects the body against losing blood. If you cut your finger and put pressure on
the cut, the blood clots and the bleeding stops.
Risks for DVT
- Prolonged sitting, bed rest or lack
of movement (such as on long plane
or car trips)
- Recent surgery or trauma (especially
hip, knee or pelvic surgery),
- Childbirth within the last
- Use of medications such as estrogen
or birth control pills
- Malignant tumors, inherited
- It is most common in adults over
age 60 but can occur in any group
- Varicose veins
- Stroke, congestive heart failure
About half of the people with DVT have no symptoms until a clot blocks a major vein and obstructs blood flow. Symptoms may include:
- Leg pain or tenderness in one
- A swelling or redness in the calf ankle foot or thigh
- Increased warmth in the leg
- Bluish discoloration of the skin on the leg or toes
Your doctor will ask about your medical history and your symptoms. He/she will examine you, especially any abnormal areas, such as a swollen leg. Tests are needed to confirm the diagnosis.
The most common tests are:
- IPG (impedance
plethysmography) - a pressure
cuff is placed on your arm or leg
to measure how fast the veins
- Duplex ultrasound - uses
signals to make pictures. The
ultrasound bounces sound waves
off the deep veins in an arm or leg.
The pictures help locate the
blockages. It also measures how
fast the blood flows through
- Contrast venograpyhy - A dye is
injected into the vein while x-ray
pictures are being taken. It usually
shows the blockage. A CT scan can
discover clots in the pelvis.
If you have had DVT or have risk
factors, you can help prevent DVT by
- Avoid sitting for long periods of time.
- When traveling, move your feet and
- Go for short walks if possible.
- Avoid crossing your legs and ankles when you sit.
- Get regular exercise, according to your
- Maintain a healthy body weight
- Ask your doctor about special stockings
you can wear to prevent clots and make
sure you wear them correctly.
- Keep your legs elevated when you are in
bed or sitting down.
- Leg exercises are important to prevent
blood from pooling in the legs.
- Walking as soon as possible after
surgery will help lower your risk.
- If you are unable to exercise, ask your
doctor if someone should massage your
lower legs through some range of
- If you are currently being treated for DVT, do not massage your legs as the
clot may break loose.
- Stop smoking. Smoking increases the
risk of blood clots.
The goals are to prevent clots from forming and/or to prevent complications of the clot such as a stroke. Treatment also allows time for the clot to dissolve and helps to prevent new clots.
- Blood thinners – are used to treat
Deep Vein Thrombosis. These medicines are prescribed very
carefully because they can cause internal bleeding. Examples are Heparin, Coumadin and Lovenox. Treatment requires balance of the
risks of internal bleeding and the
risk of clots. You will have blood
tests to check the effects of the
medicine on your blood clotting.
- Your doctor may prescribe bed rest.
This may seem odd but bed rest
may reduce the risk of a piece of
the clot breaking off and causing
- Treatment may start in the hospital.
When your blood test is at a safe level you may go home and keep
taking a blood thinner. You
may learn to inject yourself with
the medication or be switched to
Coumadin to take by mouth.
- You will have your blood checked
often to make sure your blood
clotting ability is in the safe range.
- You may need to take a blood
thinner for many weeks, maybe
even for 6 months after your clot
has been diagnosed. You may have
a condition that keeps you at high
risk for clots. In this case you may
need to take a blood thinner for the
rest of your life.
Take care of yourself
If you take anticoagulants
- Be sure to take the right amount
of medicine at the right time
- You will need blood tests on a
regular basis to check how fast your
blood clots. Follow your doctor’s
schedule for these tests.
- Wear a medic alert bracelet listing
the drugs you take.
- Before taking any new medicines, even nonprescription drugs,
contact your doctor. Most
medicines and antibiotics can
interfere with or increase the effects
of the anticoagulants.
- Tell your health care providers, such as dentists and podiatrists that you are taking anticoagulants.
- Do not take aspirin unless specifically prescribed by your doctor.
Call your Doctor right away if
you have any of these symptoms:
- Severe headaches
- Severe stomach pain
- Increased weakness
- Red or brown urine
- Bruises that increase in size without further injury
- Red or black bowel movements
- Cuts that do not stop bleeding
- Coughing up blood
- Unexpected bleeding from any part of your body
It is uncommon for DVT to cause further problems but potential complications include the following:
- Pulmonary embolism happens
when a piece of the blood clot
breaks off and travels in the blood
stream to become lodged in the
lungs and blocks blood flow. This can happen hours or even days
after the formation of a clot in the
calf veins. It may cause chest pains
and shortness of breath. You
should seek emergency medical
treatment as a pulmonary embolism
can be fatal in severe cases.
- Post thrombotic syndrome happens
if a DVT damages the valves in
the vein, so that instead of flowing upwards, the blood pools in the
lower leg. This can result in pain,
swelling and ulcers on the leg.
Medline Plus, A service of the U.S. National Library and the National Institute of Health.
Adult Health Advisor, http://www.med.umich.edu/1libr/aha/aha_dvthromb_crs.htm