Deep vein thrombosis ( DVT )

An Overview

Deep vein thrombosis, or DVT, is caused by a blood clot in a deep vein and can be life-threatening. Symptoms may include swelling, pain and tenderness, often in the legs. Risk factors include immobility, hormone therapy and pregnancy. Deep vein thrombosis can develop if you have certain medical conditions that affect how your blood clots. It can also happen if you don’t move for a long time, such as after surgery or an accident, or when you’re confined to bed. If blood moves too slowly through your veins, it can cause a clump of blood cells called a clot. When a blood clot forms in a vein deep inside your body, it causes what doctors call deep vein thrombosis (DVT). This is most likely to happen in your lower leg, thigh, or pelvis. But it can occur in other parts of your body, too. Deep vein thrombosis can be very serious because blood clots in your veins can break loose, travel through your bloodstream and lodge in your lungs, blocking blood flow (pulmonary embolism).

Symptoms for DVT

Deep vein thrombosis signs and symptoms can include:
Swelling in the affected leg. Rarely, there’s swelling in both legs.

  • Pain in your leg. The pain often starts in your calf and can feel like cramping or soreness.
  • Red or discolored skin on the leg.
  • Shortness of breath
  •  Leg or arm swelling that comes on without warning
  •  Warmth in the area that hurts
  •  Enlarged veins
  •  Higher heart rate
  •  Skin that looks red or blue
  •  A feeling of warmth in the affected leg.
  • Deep vein thrombosis can occur without noticeable symptoms.

Causes of DVT

The blood clots of deep vein thrombosis can be caused by anything that prevents your blood from circulating or clotting normally, such as injury to a vein, surgery, certain medications and limited movement.

When a blood clot forms in one of your deep veins, it’s called deep vein thrombosis (DVT). This can cause pain and swelling. If the clot breaks free, it can move through your bloodstream to other parts of your body. In rare cases, it can even cut off blood flow to your lungs.

You have a family history of it. If a parent or sibling had DVT, you’re more at risk. If both your parents have been diagnosed, your chances may be even higher.

You’re over age 40. The odds that you’ll get DVT increase with your age.
You’re pregnant or just gave birth. When you’re expecting a baby, your levels of the female hormone estrogen rise. This causes your blood to clot more easily. If you take birth control pills or hormone replacement therapy, your chances of DVT also go up.

Sitting for long periods. When you sit for long stretches of time, the muscles in your lower legs stay lax. This makes it hard for blood to circulate, or move around, the way it should. Long flights or car rides can put you at risk.

Diagnosis

There are other conditions with signs and symptoms similar to those of DVT and PE. For example, muscle injury, cellulitis (a bacterial skin infection), and inflammation (swelling) of veins that are just under the skin can mimic the signs and symptoms of DVT.

• Ultrasound. A wandlike 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.

• Duplex ultrasonography is an imaging test that uses sound waves to look at the flow of blood in the veins. It can detect blockages or blood clots in the deep veins. It is the standard imaging test to diagnose DVT.

• Magnetic resonance imaging (MRI)—a test that uses radio waves and a magnetic field to provide images of the body—and computed tomography (CT) scan—a special x-ray test—are imaging tests that help doctors diagnose and treat a variety of medical conditions. These tests can provide images of veins and clots, but they are not generally used to diagnose DVT.

• Anticoagulants. Anticoagulants (commonly referred to as “blood thinners”)

• Blood test. Almost all people who develop severe deep vein thrombosis have an elevated blood level of a substance called D

• Venography. A dye is injected into a large vein in your foot or ankle. An X-ray 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.

• Thrombolytics. Thrombolytics (commonly referred to as “clot busters”)

When to see a doctor

If you develop signs or symptoms of deep vein thrombosis, contact your doctor.
If you develop signs or symptoms of a pulmonary embolism — a life-threatening complication of deep vein thrombosis — seek immediate medical attention

Treatment

Anticoagulants. Anticoagulants (commonly referred to as “blood thinners”) are the medications most commonly used to treat DVT or PE. Although called blood thinners, these medications do not actually thin the blood.
Anticoagulants that are taken orally (swallowed) include
• Warfarin
• Dabigatran
• Rivaroxaban
• Apixaban
• Edoxaban.
Inferior vena cava filter
• When anticoagulants cannot be used or don’t work well enough, a filter can be inserted inside the inferior vena cava (a large vein that brings blood back to the heart) to capture or trap an embolus (a clot that is moving through the vein) before it reaches the lungs.

Prevention

• Drink lots of fluids.
• Wear loose-fitting clothing.
• Lose weight.
• Exercise.
• Don’t stay still for long periods — move every 2 hours or so when you’re on a plane or long car trip.
• Wear loose clothes and drink lots of water when you travel.
• Walk and stretch at regular intervals (for example, when traveling by car.
• Special stockings that compress the legs below the knee may help prevent blood clots.
• If you smoke, quit. Nicotine patches, gums, or sprays and prescription medications, along with support groups, can make kicking the habit easier.

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