What is deep vein thrombosis(DVT)?
Deep vein thrombosis, also known as deep thrombophlebitis, is a blood clot (thrombus) in a deep vein, usually in the legs.
Clots can form in superficial veins and in deep veins.
Deep veins are the veins near the bones that are surrounded by muscle. These veins lie deeper under the skin and return more blood to the heart than surface (superficial) veins.
Blood clots with inflammation in superficial veins (called superficial thrombophlebitis or phlebitis) rarely cause serious problems. But clots in deep veins (deep vein thrombosis) require immediate medical care.
These clots are dangerous because they can break loose, travel through the bloodstream to the lungs, and block blood flow in the lungs (pulmonary embolism ). A pulmonary embolism is often life-threatening. DVT can also lead to long-lasting problems. DVT may damage the vein and cause the leg to ache, swell, and change color. It can also lead to leg sores after years of having a DVT.
Blood clots most often develop in the calf and thigh veins, and less often in the arm veins or pelvic veins. This topic focuses on blood clots in the deep veins of the legs, but diagnosis and treatment of DVT in other parts of the body are similar.
What causes deep vein clots to form?
Blood clots can form in your body’s deep veins when damage occurs to a vein’s inner lining, if blood flow is sluggish or your blood is thicker or more likely to clot than usual.
Blood clots can occur when you are inactive. For example, clots can form if you are paralyzed or bedridden or must sit while on a long flight or car trip. Surgery or an injury can damage your blood vessels and cause a clot to form. Cancer can also cause deep vein thrombosis. Some people have blood that clots too easily, a problem that may run in families.
What are the symptoms?
Symptoms of DVT include swelling of the affected leg. Also, the leg feels warm and looks redder than the other leg. Usually the calf or thigh aches and feels tender when you touch or squeeze it or when you stand or move. Pain may get worse and last longer or become constant.
If a blood clot is small, it may not cause symptoms. In some cases, pulmonary embolism is the first sign that you have DVT.
How is deep vein thrombosis diagnosed?
The main way to diagnose is with an ultrasound of the veins. A doppler ultrasound test to measures the blood flow through your veins and finds any clots that might be blocking the flow.
How is it treated?
Treatment begins right away to reduce the chance that the blood clot will grow or that a piece of the clot might break loose and flow to your lungs.
Treatment for DVT usually involves taking blood thinners (anticoagulants) such as heparin and warfarin (Coumadin, for example). Heparin is given through a vein (intravenously, or IV) or as an injection. Warfarin is given as a pill. Treatment usually involves taking blood thinners for at least 3 months to prevent existing clots from growing.
Your doctor may need to adjust the dose of your medicine. You will have blood tests often so he or she can see how well the blood thinners are working.
Your doctor also may recommend that you prop up or elevate your leg when possible, use a heating pad, take walks, and wear tight-fitting, elastic stockings (compression stockings). These measures may help reduce the pain and swelling that can happen with DVT.
In rare cases, a vena cava filter may be used. A vena cava filter is inserted into the vena cava, the large vein that returns blood to the heart from the abdomen and legs. A vena cava filter helps prevent blood clots from traveling to the lungs. This device is usually only used if a person is at high risk for pulmonary embolism and is not able to take blood thinners. It may also be used if you have DVT that comes back again or you had a sudden blockage of blood flow in the lung (pulmonary embolism) while taking blood thinners.
How can deep vein thrombosis be prevented?
There are things you can do to prevent deep vein thrombosis.
- Wearing compression stockings. Especially when traveling.
- Increase fiber intake can help digestive health as well as reduce the pressure put on varicose veins.
- Adding additional amounts of vitamin C to the diet can ensure that blood vessels are getting the support they need.
- Bioflavonoids are thought by some to strengthen vein walls due to antioxidant and anti-inflammatory properties.
- Hot and cold baths are used by some who find that soaking their legs first in a warm, then cool water bath helps reduce pain and improve circulation in the legs afflicted with varicose veins.
- Simply lying horizontally on a couch or bed can be helpful in reducing pressure in the legs. If the feet are elevated on pillows to rest a few inches above the level of the heart, the blood is encouraged to drain back towards the body which releases pressure on the veins and valves in the legs.