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Deep vein thrombosis (DVT) is a blood clot or thrombus in a deep vein. DVTs are most common in the leg, but one may develop in a large vein deep inside the arm, or other part of the body. Part of the clot, called an embolus, can break off and travel to the lungs. This is a pulmonary embolus (PE). This can cut off the flow of blood. PE is an emergency and may cause death.
Two other complications of deep vein thrombosis are chronic venous insufficency and post-thrombotic syndrome.
Chronic venous insufficiency
may occur following deep vein thrombosis of a leg vein. It means that a vein no longer works well. It is a long-term condition where blood pools in the vein instead of flowing back to the heart. Pain and swelling in the leg are common symptoms.
Post-thrombotic syndrome may also occur following deep vein thromobosis of a leg vein. It is a long-term problem with pain, swelling, and redness. Ulcers and sores can also occur. All of these symptoms may make it difficult to walk and take part in daily activities.
Health care providers use the term venous thromboembolism (VTE) to describe both DVT and PE. They use the term VTE because the two conditions are very closely related. And, because their prevention and treatment are also closely related.
Risk factors include:
Blood clotting disorder
Age over than 60 years
A long period of not moving, for example, when in the hospital or on a long trip
Birth control pills or hormone replacement therapy
Certain diseases and conditions, such as:
Previous blood clot
Heart problems, such as heart failure, or heart attack
Inflammatory bowel disease
Lupus, a disease of the immune system
Cancer and some cancer treatments
Having a central venous catheter, for example, in a large vein in the chest
Deep vein thrombosis may occur without symptoms. When symptoms do occur, they may include:
Pain, redness, swelling, or warmth in the leg, arm, or other area
Dull ache or tight feeling when walking or standing (for a deep vein thrombosis in the leg)
Rapid heart beat
More visible surface veins
The symptoms of deep vein thrombosis may look like other medical conditions or problems. Always see your doctor for a diagnosis.
Along with a medical history and physical exam, your doctor may do other tests including:
Duplex ultrasound. This procedure involves placing ultrasound gel on the affected area and then moving a handheld device across it. A picture of the blood flow is displayed on a monitor. Duplex ultrasound is the most common test for DVT.
Lab work. Blood work may be done to look for evidence of blood clotting and other problems.
Specific treatment will be determined by your doctor based on:
How old you are
Your overall health and medical history
How sick you are
How well you can handle specific medications, procedures, or therapies
How long the condition is expected to last
Your opinion or preference
The goal of treatment is to prevent the clot from getting larger, to prevent pulmonary embolism, and to decrease the chance of another blood clot forming.
Treatment may include:
Blood thinners (anticoagulant m
edications). These medications decrease the ability of the blood to clot. Examples of anticoagulants include warfarin (Coumadin) and heparin. Newer anticoagulants may also be used, including rivaroxaban, apixaban, dabigatran and enoxaparin. Warfarin (Coumadin) pills or heparin shots (injections). The most common side effect of blood-thinning medication is bleeding. Report bruising or bleeding to your doctor right away.
(fibrinolytics or thrombolytics). These medicines are used to break up clots.
Vena cava filter. In some cases a filter is placed in the vena cava (the large vein which returns blood from the body to the heart). This filter prevents clots from reaching the heart and lungs.
Preventing deep vein thrombosis can include:
Anticoagulant medications are given to certain surgical patients to prevent deep vein thrombosis.
Wiggling the toes and moving the ankles helps to prevent deep vein thrombosis caused by long periods of sitting or lying down.
When you travel and must sit for long periods of time you can reduce your risk of DVT by doing the following:
Walk up and down the aisles (if traveling by plane or bus)
Stop about every hour and walk a little (if traveling by car)
While sitting, move your legs, ankles, and toes
Wear loose clothing
Drink plenty of fluids
Prevention may also include:
Walking. Getting up and moving as soon as possible after surgery or illness
neumatic compression device. A machine that applies gentle pressure to the legs
Elastic or compression stockings
Consult your doctor for diagnosis and treatment.
Bayhealth is Southern Delaware’s healthcare leader with hospitals in Dover and in Milford. Bayhealth provides a wide range of medical services, including cardiovascular, cancer, orthopaedics and rehabilitation, pediatrics, respiratory care, sleep care, surgical weight loss and women’s services.