Deep Vein Thrombosis – Causes, Symptoms and Treatment
When a blood clot forms deep in a vein in the body it is known as deep vein thrombosis (DVT). Blood clots occur because blood thickens and sticks together. While deep vein blood clots can occur anywhere in the body, most of them occur in the lower legs and thighs.
An embolus is a blood clot that has broken off and is traveling through the blood stream. It is called a pulmonary embolism (PE) when it lands in the lungs and blocks the blood flow. Pulmonary embolism is a serious condition that can damage the lungs or other organs and can even cause death. If a blood clot is located in the thigh, it is more likely to break off than clots located in the lower leg.
Deep vein thrombosis is also known under such names as venous thrombosis, blood clot in the legs, economy class syndrome and venous thromboembolism – a term used for both pulmonary embolism and deep vein thrombosis.
Fast Facts about Deep Vein Thrombosis
- A blood clot that forms in one of the body’s deep veins is known as deep vein thrombosis or DVT in short
- Only half of patients with a deep vein clot have any symptoms
- Blood clots can break off and travel to the lungs causing pulmonary embolism
- There are numerous risk factors for deep vein thrombosis. Having more than one risk factor or a previous deep vein clot increases your risk
- Medication to thin the blood is usually used to treat deep vein thrombosis
- You should contact your doctor immediately if you notice any of the symptoms of deep vein thrombosis or pulmonary embolism
Common Causes of Deep Vein Thrombosis
There are several known causes for deep vein thrombosis. Factors that can cause blood clots to form in your body’s deep veins include:
- When your blood flow is slow or sluggish. This can occur after surgery, when you are ill for a long period of time or are traveling for an extended period of time because the lack of motion causes the sluggish blood flow.
- Blood that is thicker or more likely to clot can also cause deep vein thrombosis. There are certain inherited conditions that can cause the blood to clot more than normal or be thicker. The use of hormone therapy and birth control pills can also cause the blood to clot more easily.
- Deep vein thrombosis can be also caused by damage to the vein’s internal lining. There are many factors that can cause this damage and they can be biological, chemical or physical in nature. Some of them include immune response, inflammation, serious injury and surgery.
Risk Factors for Deep Vein Thrombosis
There are several known factors that can increase your risk for deep vein thrombosis. Having more than one of these factor increases your risk for this condition even further. They include:
- Obesity or being overweight
- Being over the age of 60 (although deep vein thrombosis can obviously happen at any age)
- Having a central venous catheter in place to allow access to the bloodstream
- Having an injury to a vein from trauma, surgery or a broken bone
- Previously having a deep vein thrombosis
- Currently or recently being treated for cancer
- Having an inherited blood disorder that makes your blood more likely to clot than normal
- Taking hormones for therapy or birth control
- Being pregnant or having given birth in the last 6 weeks
Symptoms of Deep Vein Thrombosis
Pulmonary embolism and deep vein thrombosis have a separate set of symptoms. Both conditions can be life threatening and you should contact your doctor if you have symptoms of either of them. Half of the people who have deep vein thrombosis show symptoms. They include:
- Discolored or red skin on the leg
- Warmth in the part of the leg that is painful or swollen
- Swelling in the leg
- Tenderness or pain in the leg upon standing or when walking
The symptoms of a pulmonary embolism may be the first symptoms a patient has and they include:
- Pain with deep breaths
- Shortness of breath that is unexplained
- Rapid heart rate and breathing
- A cough that produces blood
Diagnosing Deep Vein Thrombosis
Your doctor will use a medical history, physical exam and diagnostic tests to diagnose a deep vein thrombosis. He/she will want to know about any medical history of cancer treatment, medications you are taking and any recent injuries or surgeries. During a physical exam the doctor will evaluate your legs for signs of deep vein thrombosis and will listen to your lungs and heart.
There are three common tests used to diagnose deep vein thrombosis:
- A D-dimer test – This test looks for a substance released into the blood when a clot dissolves. High levels of this substance in your blood are an indication that you may have a deep vein clot.
- Ultrasound – An ultrasound uses sound waves to get a moving picture of the activity of the veins and arteries in the leg where deep vein thrombosis is suspected.
- Venography – When a clear diagnosis cannot be provided by an ultrasound, your doctor may order a venography. This procedure involves injecting dye into the leg and then taking an x-ray of it. This makes the veins visible to an x-ray.
Treatment Options for Deep Vein Thrombosis
Medications and specific devices are used to treat deep vein thrombosis. The goal of the treatment is to prevent the blood clot from enlarging, breaking off and moving to the lungs and thus prevent future blood clots.
The most common treatment for deep vein thrombosis are anticoagulants. These types of medications are also known as blood thinners. While blood thinners can prevent clots from getting bigger, they cannot break up existing clots. The two most common blood thinners are warfarin and heparin. Patients who cannot take heparin are given thrombin inhibitors to interfere with the bodies clotting process. In life threatening situations, where a blood clot needs to be dissolved quickly, thrombolytics are used.
When a patient cannot take blood thinners or continues developing blood clots while taking blood thinners a vena cava filter is inserted in the large vein known at the vena cava. This filter prevents pulmonary embolism by catching clots before they reach the lungs.
After a blood clot is formed in the legs, a patient may need to wear graduated compression stockings. These stocking produce gentle pressure on the legs that keeps blood from pooling. They are tighter at the ankle and become looser towards the top of the stocking.
Prevention of Deep Vein Thrombosis
There are several steps you can take to prevent deep vein thrombosis and pulmonary embolism:
- Take your medications as recommended
- Keep your doctor appointments
- Get moving again as soon as you can after illness or surgery
- During long trips you should exercise your legs frequently
When you have previously had deep vein thrombosis or pulmonary embolism you should do all of the aforementioned and, in addition to that, consider wearing compression stockings. There are also additional steps anyone can take while traveling to decrease the risk of deep vein thrombosis:
- Avoid alcohol and drink plenty of water
- Wear comfortable and loose clothing
- Stretch your legs and flex your feet to increase blood flow to the calves
- If you are in an airplane, bus or train get up and walk around
- When you are traveling by car make frequent stops to walk around
Coping with Deep Vein Thrombosis
Once you have had a deep vein clot you are at increased risk for another. It is important that you monitor yourself for signs of another deep vein clot and talk to your doctor right away if you develop symptoms.
When you are taking blood thinners it is important that you are aware of the symptoms of internal bleeding in the digestive tract and brain. The symptoms of blood in the digestive tract are:
- Abdominal pain
- Vomit that looks like coffee grounds or is bright red
- Tarry stools or bright red blood in your stools
The symptoms of a bleed in the brain are:
- Confusion or memory loss
- Severe head pain
- Vision changes
- Loss of movement in the legs or arms that comes on suddenly
Where to Find More Information: Society for Vascular Surgery