Deep vein thrombosis
Deep vein thrombosis (DVT, also called venous thrombosis) is a blood clot that develops in a vein deep in the body. The clot may partially or completely block blood flow through the vein. Most DVTs occur in the lower leg, thigh or pelvis, although they also can occur in other parts of the body including the arm, brain, intestines, liver or kidney.
What is the danger of DVT?
Even though DVT itself is not life-threatening, the blood clot has the potential to break free and travel through the bloodstream, where it can become lodged in the blood vessels of the lung (known as a pulmonary embolism). This can be a life- threatening condition. Therefore, prompt diagnosis and treatment are necessary.
DVT can also lead to complications in the legs referred to as chronic venous insufficiency or the post-thrombotic syndrome. This condition is characterized by pooling of blood, chronic leg swelling, increased pressure, increased pigmentation or discoloration of the skin, and leg ulcers known as venous stasis ulcers.
A DVT usually forms in one leg or one arm. Not everyone with a DVT will have symptoms, but symptoms can include:
- Swelling of the leg or arm (sometimes this happens suddenly)
- Pain or tenderness in the leg (may only happen when standing or walking)
- The area of the leg or arm that is swollen or hurts may be warmer than usual
- Skin that is red or discolored
- The veins near the skin’s surface may be larger than normal
Symptoms of a pulmonary embolism include:
Some people do not know they have a DVT until the clot moves from their leg or arm and travels to their lung.
It is important to call your doctor right away or go to the emergency room if you have symptoms of a pulmonary embolism or DVT. Do not wait to see if the symptoms “go away.” Get treatment right away to prevent serious complications.
Causes
The following conditions can increase your risk of a DVT:
- An inherited (genetic) condition that increases your risk of blood clots
- Cancer and some of its treatments (chemotherapy)
- Limited blood flow in a deep vein, due to injury, surgery, or immobilization
- Pregnancy and the first 6 weeks after giving birth
- Being over age 40 (although a DVT can affect people of any age)
- Being overweight
- Taking birth control pills or hormone therapy
- Having a central venous catheter or pacemaker
How is DVT diagnosed?
A duplex venous ultrasound. This is the most common test used to diagnose a DVT. It shows the blood flow in the veins and any blood clots that exist. An ultrasound technician will apply pressure while scanning your arm or leg. If the pressure does not cause the vein to compress, it could mean there is a blood clot.
Venography. This test uses X-rays to show your deep veins. A special dye (contrast material) is injected into your veins so the X-rays show the veins and any blood clots. Any blockage in blood flow may also be seen. Venography may be used if the results of the duplex ultrasound aren’t clear.
Other tests you may have include:
- Magnetic Resonance Imaging (MRI) or Magnetic Resonance Venography (MRV): MRI shows pictures of organs and structures inside the body, and MRV shows pictures of the blood vessels in the body. In many cases, MRI and MRV can offer more information than an X-ray.
- Computed tomography (CT) scan is a type of X-ray that shows structures inside the body. A CT scan may be used to find a DVT in the abdomen or pelvis, as well as blood clots in the lung (pulmonary embolism).
If your doctor thinks you may have a genetic disorder that causes blood clots, you may need blood tests. This may be important if:
- You have a history of blood clots that cannot be linked to any other cause
- You have a blood clot in an unusual location, such as in a vein from the intestines, liver, kidney or brain
- You have a strong family history of blood clots
What treatments are available for patients with a DVT?
Patients with a DVT may need to be treated in the hospital. Others may be able to have outpatient treatment.
Treatments include medications, compression stockings and elevating the affected leg. If the blood clot is extensive, you may need more invasive testing and treatment. The main goals of treatment are to:
You can reduce the risk of certain complications by sticking to your treatment plan and the following tips.
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- Sudden shortness of breath or fast breathing
- Sharp chest pain that often comes with coughing or movement
- Pain in the back
- Skin that is red or discolored
- Cough (sometimes with bloody sputum/phlegm)
- Sweating more than normal
- Fast heartbeat
- Feeling dizzy or fainting
What are the symptoms of DVT?
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- Stop the clot from getting bigger
- Prevent the clot from breaking off in your vein and moving to your lungs
- Reduce the risk of another blood clot
- Prevent long-term complications from the blood clot (chronic venous insufficiency).
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