Deep vein thrombosis (DVT) is an often underdiagnosed and yet serious condition in which blood clots usually form in deep veins in the lower leg, thigh, or pelvis or other areas of the body such as in the arm. These veins are located deep in the body away from the skin’s surface. Veins are blood vessels that carry blood from the body’s tissues to the heart carrying deoxygenated blood. It is believed that as many as 900,000 Americans each year are affected by DVT with 60,000 – 100,000 who will die from it.
Complications of DVT
The complication that is the most serious of DVT is when a part of the clot breaks off and travels through the bloodstream to the lungs, causing a blockage called a pulmonary embolism. If the clot is small a person can recover from it with appropriate treatment. If the clot is large it can stop blood from reaching the lungs and is fatal.
Even if a person recovers from having DVT, up to one-third will have long-term complications from damage caused by the clot. This damage occurs to the valves in the vein called post-thrombotic syndrome (PTS). PTS can cause symptoms of swelling, pain, discoloration, along with ulcers in the area that was affected by DVT. Once a person has had DVT, it can turn into a chronic condition as around 30% of people who have had DVT are at a greater risk for it to happen again.
Risk factors associated with DVT
DVT can happen to anyone but there are certain risk factors that can increase the risk. The more risk factors a person has, the more likely DVT can occur. Risk factors include the following:
· Long periods without moving (long airplane flights, sitting, bed rest, long car rides)
· Past history of DVT
· Cancer and its treatment
· Advanced age
· Pregnancy and 4-6 weeks after giving birth
· Use of birth control containing estrogen or hormone therapy
· Varicose veins
· Heart failure, inflammatory bowel disease and some kidney disorders
· A catheter in a central vein
· Inherited clotting disorders
Signs of DVT
One problem of DVT is that only one-half of all people who develop it will have symptoms which include:
· Swelling in the affected leg
· Pain in the leg which often starts in the calf and will feel like cramping or a soreness
· Warmth or tenderness
· Redness of the skin
· Constant pain in one leg while standing or walking
Anyone noticing these signs should see their doctor right away. DVT can develop into a more life-threatening complication called pulmonary embolism. Warning signs of pulmonary embolism include:
· Unexplained sudden onset of shortness of breath
· Chest pain or discomfort that worsens when taking a deep breath or when you cough
· Feeling lightheaded or dizzy, or fainting
· Rapid pulse
· Coughing up blood
Diagnosis and treatment of DVT
Diagnosing DVT relies on several tests such as blood tests, Doppler ultrasound, Magnetic Resonance Imaging (MRI) and venogram where dye is put into a vein with an x-ray taken. The dye can show where a clot may be in the vein.
Treatment for DVT is usually with medications which may include anticoagulants or blood thinners which reduce the blood’s ability to clot. Blood thinners don’t break up existing blood clots but they can prevent clots from getting bigger or reduce the risk of developing additional clots. Another treatment that might be used are a medication known as thrombolytics or clotbusters. These medications can break up blood clots however they can cause serious bleeding and are usually only used in life-threatening situations.
How to prevent DVT
· After surgery – Often a doctor may prescribe medications to prevent DVT from forming both before and after surgery. Wearing special elastic stockings or inflatable boots to squeeze muscles helping to keep blood flowing will often be used while in the hospital to reduce the risk of DVT. Most people are encouraged to move around as soon as possible after surgery or being confined to a bed after an illness.
· During pregnancy – If a woman has a strong family history of DVT, needs bed rest or likely to have a cesarean birth, she may be prescribed medication to prevent DVT.
· During travel – Anytime a person will have to be in a sitting position for many hours while traveling, they can be at risk for DVT. To reduce this chance, a person should walk and stretch at regular intervals, wear special stockings that compress the legs below the knee to prevent blood clots from forming (consult with a doctor before wearing these), wear loose fitting clothing, and drink lots of water. It is advisable to get up and walk around every 2-3 hours. There are also exercises one can do while sitting to keep blood movement flowing – raising and lowering heels while keeping toes on the floor, raising and lowering toes while keeping heels on the floor, and tightening and releasing your leg muscles.
· Wearing compression stockings – These help prevent swelling associated with DVT and are worn from the feet up to the knees. The very tight pressure these stockings provide reduce the chance of the blood from pooling and clotting. A doctor will give advice on how frequently to wear them throughout the day.