DEEP VEIN THROMBOSIS (DVT)
Deep vein thrombosis is the formation of a blood clot in one or more of the deep veins located in the body, usually in the legs.
- Most deep vein blood clots typically form in the thigh or lower leg, but they can develop in other areas of the body.
- Two types of veins exist in the arms or leg: superficial veins and deep veins.
- Superficial veins are easily seen on the surface and lie just below the skin while the deep veins are located deep within the muscles of the arms or leg.
- Blood flows through small perforator veins from the superficial veins to the deep venous system.
- A blood clot in the deep venous system of the leg is not dangerous until it breaks loose, travel through the circulation system of the heart and lodge in the lungs, blocking blood flow and decreases the amount of oxygen absorbed and distributed back to the body. This condition is called pulmonary embolism and it is a life-threatening complication of deep vein thrombosis.
CAUSES
The blood clots associated with deep vein thrombosis can be caused by anything that prevents the blood from clotting normally, such as an injury or trauma to the vein, certain medications, and surgery.
A thrombus can form if one or more of the following situations are present:
- Injury to the veins
- Surgery especially those in the lower extremities such as joint replacement surgery
- Pregnancy
- Obesity or being overweight
- Smoking especially heavily
- Heart failure
- Cancer
- Age, being older than 60 increases risk
- Hereditary blood clotting disorder
- Inflammatory bowel disease
- A family history of the condition
- Staying seated for a long period of time such as when flying or driving
- Having a catheter in the vein.
SYMPTOMS
The National Heart, Lung and, Blood Institute provides that about 50% of people with the condition will have symptoms. Symptoms may include:
- Swelling in the affected leg
- Pale or reddish or bluish skin on the leg
- Feeling of warmth in the affected leg
- Pain in the leg
- Warmth on the affected leg
DIAGNOSIS AND TREATMENT
The diagnosis of deep vein thrombosis is based on the symptoms, and physical exam to check for areas of swelling, tenderness, and discoloration of the skin.
Your doctor may suggest tests including:
Ultrasound to visualize and check whether a clot exists, where it is located in the leg and how large it is. Sometimes ultrasound may be done over several days and results compared over time to see whether a clot has grown, is growing, or has resolved.
Blood test to check the level of a substance called D-dimer. If the D-dimer is elevated, the possibility of a deep vein thrombosis exist.
CT or MRI scans to provide visual images and show if there is the presence of a clot.
TREATMENT
The aim of the treatment is to keep the clot from growing, prevent a pulmonary embolism and lower your risk of having more clots.
Treatment options include medications such as heparin, enoxaparin (Lovenox), fondaparinux are blood thinners that can be taken intravenously or orally decreases the ability of the blood to clot.
If your condition is severe and other medications are not working, the doctor may prescribe clot busters or thrombolytic that breaks clot up quickly.
A filter inserted into the large abdominal vein called the vena cava may be used if you can’t take medicines to thin your blood
Compression stockings may be worn on your legs from the feet to above the level of the knees or just above it to help prevent swelling associated with the condition. The doctor may recommend you wear it every day