Deep vein thrombosis (DVT) is a disorder that many people have not heard about, and few people realize how serious it is. If not successfully treated complications can develop that can be life -threatening.
What Is Deep Vein Thrombosis?
Deep vein thrombosis refers to a blood clot that develops inside a larger vein – usually deep within the lower leg or thigh. The danger is that part of the clot can break off and travel through the bloodstream, where it can lodge in the lungs causing a blockage in blood flow, organ damage, and death.
What are the Symptoms of Deep Vein Thrombosis?
Unfortunately, many individuals might have DVT and have no symptoms. About half of people with DVT have no warning signs. Symptoms may include:
• Redness
• Swelling
• Tenderness or pain
Dangers of DVT: Pulmonary Embolism
If part of the clot breaks loose and travels through the bloodstream, the results can be life-threatening. A clot that blocks the blood supply to the lungs is called a pulmonary embolism. Symptoms include trouble breathing, low blood pressure, fainting, faster heart rate, chest pain, and coughing up blood. If you have any of these symptoms, call 911 or go to the emergency room at the hospital immediately.
What Causes DVT?
Anything that damages the inner lining of a vein, including surgery, injury, or an immune system response, may contribute to DVT. Blood that is thick or flows too slowly is more likely to form a clot, especially in a vein that is already damaged. Other things that increase risk for blood clotting include genetic disorders, hormone changes, and lack of movement.
Who is at Risk for DVT?
People with a higher risk of DVT include:
• People who have cancer
• People who have had surgery
• Anyone on extended bed rest
• The elderly
• Smokers
• Long-distance travelers
• People who are overweight or obese
DVT and Pregnancy
Women have a greater risk of developing DVT during pregnancy and the four to six weeks after giving birth. This is due to higher levels of oestrogen which may make blood easier to clot. The pressure of an expanding uterus can also impede blood flow of the veins as well. Certain blood disorders can boost the risk even more.
DVT and Hormonal Birth Control
Like pregnancy, hormonal birth control and post-menopausal hormone therapy change blood chemistry, and may increase risk of DVT even in women who do nothave blood disorders. If you are on these you should discuss the risks with your health care provider.
DVT and Travel
Traveling to new and faraway places can be exciting, but traveling on very long flights have its risks. Studies show long-distance travel lasting more than four hours doubles your risk of developing DVT. This includes travel by air, bus, train, or car. Not moving around in these cramped conditions can cause sluggish blood flow.
How is DVT diagnosed?
An ultrasound is most often used to diagnose DVT. It uses sound waves to create a picture of blood flow in the affected area and can reveal a clot. Before recommending an ultrasound, your doctor will examine you and check you for signs of DVT. You may be asked about your medical history, medications you are taking, family history, and about any other factors that could raise your risk of DVT.
Treatment
Anticoagulants, which make the blood thinner, are the most common DVT treatment. They include warfarin, which is taken as a pill, as well as heparin, which is injected. They cannot break up an existing clot, but they can stop it from getting bigger – giving the body time to dissolve the clot on its own. Anticoagulants can also prevent new clots from forming.
Medications that actually dissolve blood clots are called thrombolytics (clot busters). They can cause sudden, severe bleeding, so they are used only in emergencies, for example, to dissolve a life-threatening blood clot that has traveled to the lungs and is causing severe symptoms. Thrombolytics are given intravenously in a hospital setting.
Side Effects of DVT Medications
Because anticoagulants thin the blood, people who take them may get bruises often or bleed more easily. Internal bleeding can be life-threatening so if you take an oral anticoagulant your doctor will test your blood to make sure it is not too thin. You will need close monitoring at all times.
Warning Signs of Internal Bleeding
Signs of internal bleeding in the belly include pain, vomit that is red or looks like coffee grounds, and bright red or black stools. Bleeding in the brain can cause severe headache or symptoms of stroke such as vision changes, abnormal movement and confusion. Call 911 or go to the emergency room if you develop any of these symptoms. Also check with your health care provider if you bleed a lot from minor injuries.
Filters
If you cannot take anticoagulants, or if they are not working, your doctor may recommend inserting a filter into a large vein called the vena cava. This filter catches breakaway clots and prevents them from traveling to the lungs. The filter would not stop new clots from forming or cure DVT itself, but it can prevent a life-threatening pulmonary embolism.
Compression Stockings
Compression stockings apply pressure to keep the blood in the legs from pooling and clotting. They reduce swelling and help relieve discomfort in a leg where a clot has already formed. You can get compression stockings over the counter or by prescription. Prescription stockings provide greater pressure.
Home Care
To reduce swelling and discomfort, keep the affected leg raised when possible. If your doctor has recommended compression stockings, be sure to wear them even when you are at home.
Long-Term Complications of DVT
Once a blood clot is gone, DVT sometimes leaves behind some unpleasant complications. You may have long-term swelling, changes in skin color, and pain where the clot was. These symptoms, known as post-thrombotic syndrome, sometimes show up even a year after the clot.
Can you prevent DVT?
In some cases it is impossible to prevent a DVT from developing. There are some preventative measures that have proven to be beneficial. They include the following:
Exercise
Being active increases your blood flow, keeping it from pooling and clotting. Exercising the lower leg muscles in particular can help prevent DVT. When you are not active – at your desk, for example – take breaks to stretch your legs. Get up and walk around if you can. Frequent exercise also reduces the risk of obesity, which contributes to DVT risk.
Travel Tips
When traveling for more than four hours, avoid tight clothing and drink plenty of water (avoid alcoholic beverages). Get up and walk around at least every two to three hours. If you have to stay in your seat, find ways to keep the legs active. Try clenching and releasing your leg muscles or lifting and lowering your heels with your toes on the floor.
Conclusion
Deep vein thrombosis (DVT) is the formation of a blood clot (“thrombus”) in a deep vein. It commonly affects theleg veins.A DVT can occur withoutsymptoms, but in many cases the affected extremity will be painful, swollen, red, and warm, and the superficial veins may be engorged. If you have symptoms suggestive of a DVT you should seek medical advice as soon as possible as complications can develop if not correctly treated.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. Dr Brett Hodge is an Obstetrician/Gynaecologist and Family Doctor who has over twenty eight years in clinical practice. Dr Hodge has a medical practice in theJohnsonBuildingin The Valley.
