Deep vein thrombosis (DVT) occurs when a blood clot (thrombus) forms in one or more of the deep veins in your body, usually in your legs. Deep vein thrombosis can cause leg pain or swelling, but may occur without any symptoms.
Deep vein thrombosis can develop if you have certain medical conditions that affect how your blood clots. Deep vein thrombosis can also happen if you don't move for a long time, such as after surgery, following an accident, or when you are confined to a hospital or nursing home bed.
Deep vein thrombosis is a serious condition because blood clots in your veins can break loose, travel through your bloodstream and lodge in your lungs, blocking blood flow (pulmonary embolism).
SYMPTOMS
Deep vein thrombosis signs and symptoms can include:
Swelling in the affected leg. Rarely, there may be swelling in both legs.Pain in your leg. The pain often starts in your calf and can feel like cramping or a soreness.
Deep vein thrombosis may sometimes occur without any noticeable symptoms.
CAUSES
Deep vein thrombosis occurs when a blood clot forms in the veins that are deep in your body, often in your legs. Blood clots can be caused by anything that prevents your blood from circulating normally or clotting properly.
COMPLICATIONS
A concerning complication associated with deep vein thrombosis is pulmonary embolism.
Pulmonary embolism
A pulmonary embolism occurs when a blood vessel in your lung becomes blocked by a blood clot (thrombus) that travels to your lungs from another part of your body, usually your leg.
A pulmonary embolism can be fatal. So, it's important to be on the lookout for signs and symptoms of a pulmonary embolism and seek medical attention if they occur. Signs and symptoms of a pulmonary embolism include:
Unexplained sudden onset of shortness of breathChest pain or discomfort that worsens when you take a deep breath or when you coughFeeling lightheaded or dizzy, or faintingRapid pulseCoughing up blood
Postphlebitic syndrome
A common complication that can occur after deep vein thrombosis is a condition known as postphlebitic syndrome, also called postthrombotic syndrome. This syndrome is used to describe a collection of signs and symptoms, including:
Swelling of your legs (edema)Leg painSkin discolorationSkin sores
This syndrome is caused by damage to your veins from the blood clot. This damage reduces blood flow in the affected areas. The symptoms of postphlebitic syndrome may not occur until a few years after the DVT.
DIAGNOSIS
To diagnose deep vein thrombosis, your doctor will ask you a series of questions about your symptoms. You'll also have a physical exam so that your doctor can check for any areas of swelling, tenderness or discoloration on your skin. Depending on how likely you are to have a blood clot, your doctor may suggest further testing, including:
Ultrasound. A wand-like device (transducer) placed over the part of your body where there's a clot sends sound waves into the area. As the sound waves travel through your tissue and reflect back, a computer transforms the waves into a moving image on a video screen. A clot may be visible in the image.
Sometimes a series of ultrasounds are done over several days to determine whether a blood clot is growing or to be sure a new one hasn't developed.
Blood test. Almost all people who develop severe deep vein thrombosis have an elevated blood level of a clot-dissolving substance called D dimer.Venography. A dye (contrast agent) is injected into a large vein in your foot or ankle. An X-ray procedure creates an image of the veins in your legs and feet, to look for clots. However, less invasive methods of diagnosis, such as ultrasound, can usually confirm the diagnosis.CT or MRI scans. Both computerized tomography (CT) scan and magnetic resonance imaging (MRI) can provide visual images of your veins and may show if you have a clot. Sometimes a clot is found when these scans are performed for other reasons.
TREATMENT
Deep vein thrombosis treatment is aimed at preventing the clot from getting any bigger, as well as preventing the clot from breaking loose and causing a pulmonary embolism. After that, the goal becomes reducing your chances of deep vein thrombosis happening again.
Deep vein thrombosis treatment options include:
Blood thinners. Medications used to treat deep vein thrombosis include the use of anticoagulants, also sometimes called blood thinners, whenever possible. These are drugs that decrease your blood's ability to clot. While they don't break up existing blood clots, they can prevent clots from getting bigger or reduce your risk of developing additional clots.
Usually, you'll first be given a shot or infusion of the blood thinner heparin for a few days. After starting heparin injections, your treatment may be followed by another injectable blood thinner, such as enoxaparin (Lovenox), dalteparin (Fragmin) or fondaparinux (Arixtra). Other blood thinners can be given in pill form, such as warfarin (Coumadin, Jantoven) or rivaroxaban (Xarelto). Newer blood thinners also may offer additional options in the near future.
You may need to take blood thinners for three months or longer. If you're prescribed any of these blood thinners, it's important to take your medication exactly as your doctor instructs. Blood-thinning medications can have serious side effects if you take too much or too little.
You may need periodic blood tests to check how long it takes your blood to clot. Pregnant women shouldn't take certain blood-thinning medications.
Clotbusters. If you have a more serious type of deep vein thrombosis or pulmonary embolism, or if other medications aren't working, your doctor may prescribe different medications.
One group of medications is known as thrombolytics. These drugs, called tissue plasminogen activators (TPA), are given through an IV line to break up blood clots or may be given through a catheter placed directly into the clot. These drugs can cause serious bleeding and are generally used only in life-threatening situations. For these reasons, thrombolytic medications are only given in an intensive care ward of a hospital.
Filters. If you can't take medicines to thin your blood, a filter may be inserted into a large vein — the vena cava — in your abdomen. A vena cava filter prevents clots that break loose from lodging in your lungs.
Compression stockings. These help prevent swelling associated with deep vein thrombosis. These stockings are worn on your legs from your feet to about the level of your knees.
This pressure helps reduce the chances that your blood will pool and clot. You should wear these stockings during the day for at least two to three years if possible. Compression stockings can help prevent postphlebitic syndrome.
Deep vein thrombosis can develop if you have certain medical conditions that affect how your blood clots. Deep vein thrombosis can also happen if you don't move for a long time, such as after surgery, following an accident, or when you are confined to a hospital or nursing home bed.
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Deep vein thrombosis |
SYMPTOMS
Deep vein thrombosis signs and symptoms can include:
Swelling in the affected leg. Rarely, there may be swelling in both legs.Pain in your leg. The pain often starts in your calf and can feel like cramping or a soreness.
Deep vein thrombosis may sometimes occur without any noticeable symptoms.
CAUSES
Deep vein thrombosis occurs when a blood clot forms in the veins that are deep in your body, often in your legs. Blood clots can be caused by anything that prevents your blood from circulating normally or clotting properly.
COMPLICATIONS
A concerning complication associated with deep vein thrombosis is pulmonary embolism.
Pulmonary embolism
A pulmonary embolism occurs when a blood vessel in your lung becomes blocked by a blood clot (thrombus) that travels to your lungs from another part of your body, usually your leg.
A pulmonary embolism can be fatal. So, it's important to be on the lookout for signs and symptoms of a pulmonary embolism and seek medical attention if they occur. Signs and symptoms of a pulmonary embolism include:
Unexplained sudden onset of shortness of breathChest pain or discomfort that worsens when you take a deep breath or when you coughFeeling lightheaded or dizzy, or faintingRapid pulseCoughing up blood
A common complication that can occur after deep vein thrombosis is a condition known as postphlebitic syndrome, also called postthrombotic syndrome. This syndrome is used to describe a collection of signs and symptoms, including:
Swelling of your legs (edema)Leg painSkin discolorationSkin sores
This syndrome is caused by damage to your veins from the blood clot. This damage reduces blood flow in the affected areas. The symptoms of postphlebitic syndrome may not occur until a few years after the DVT.
DIAGNOSIS
To diagnose deep vein thrombosis, your doctor will ask you a series of questions about your symptoms. You'll also have a physical exam so that your doctor can check for any areas of swelling, tenderness or discoloration on your skin. Depending on how likely you are to have a blood clot, your doctor may suggest further testing, including:
Ultrasound. A wand-like device (transducer) placed over the part of your body where there's a clot sends sound waves into the area. As the sound waves travel through your tissue and reflect back, a computer transforms the waves into a moving image on a video screen. A clot may be visible in the image.
Sometimes a series of ultrasounds are done over several days to determine whether a blood clot is growing or to be sure a new one hasn't developed.
Blood test. Almost all people who develop severe deep vein thrombosis have an elevated blood level of a clot-dissolving substance called D dimer.Venography. A dye (contrast agent) is injected into a large vein in your foot or ankle. An X-ray procedure creates an image of the veins in your legs and feet, to look for clots. However, less invasive methods of diagnosis, such as ultrasound, can usually confirm the diagnosis.CT or MRI scans. Both computerized tomography (CT) scan and magnetic resonance imaging (MRI) can provide visual images of your veins and may show if you have a clot. Sometimes a clot is found when these scans are performed for other reasons.
TREATMENT
Deep vein thrombosis treatment is aimed at preventing the clot from getting any bigger, as well as preventing the clot from breaking loose and causing a pulmonary embolism. After that, the goal becomes reducing your chances of deep vein thrombosis happening again.
Deep vein thrombosis treatment options include:
Blood thinners. Medications used to treat deep vein thrombosis include the use of anticoagulants, also sometimes called blood thinners, whenever possible. These are drugs that decrease your blood's ability to clot. While they don't break up existing blood clots, they can prevent clots from getting bigger or reduce your risk of developing additional clots.
Usually, you'll first be given a shot or infusion of the blood thinner heparin for a few days. After starting heparin injections, your treatment may be followed by another injectable blood thinner, such as enoxaparin (Lovenox), dalteparin (Fragmin) or fondaparinux (Arixtra). Other blood thinners can be given in pill form, such as warfarin (Coumadin, Jantoven) or rivaroxaban (Xarelto). Newer blood thinners also may offer additional options in the near future.
You may need to take blood thinners for three months or longer. If you're prescribed any of these blood thinners, it's important to take your medication exactly as your doctor instructs. Blood-thinning medications can have serious side effects if you take too much or too little.
You may need periodic blood tests to check how long it takes your blood to clot. Pregnant women shouldn't take certain blood-thinning medications.
Clotbusters. If you have a more serious type of deep vein thrombosis or pulmonary embolism, or if other medications aren't working, your doctor may prescribe different medications.
One group of medications is known as thrombolytics. These drugs, called tissue plasminogen activators (TPA), are given through an IV line to break up blood clots or may be given through a catheter placed directly into the clot. These drugs can cause serious bleeding and are generally used only in life-threatening situations. For these reasons, thrombolytic medications are only given in an intensive care ward of a hospital.
Filters. If you can't take medicines to thin your blood, a filter may be inserted into a large vein — the vena cava — in your abdomen. A vena cava filter prevents clots that break loose from lodging in your lungs.
Compression stockings. These help prevent swelling associated with deep vein thrombosis. These stockings are worn on your legs from your feet to about the level of your knees.
This pressure helps reduce the chances that your blood will pool and clot. You should wear these stockings during the day for at least two to three years if possible. Compression stockings can help prevent postphlebitic syndrome.
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