Deep Vein Thrombosis
Deep vein thrombosis (DVT) is a condition in which a blood clot forms in one or more of the deep veins in your body, usually in your legs. Deep vein thrombosis can cause leg pain, but often occurs without any symptoms.
Clots can form in superficial veins and in deep veins. Blood clots with inflammation in superficial veins rarely cause serious problems. But clots in deep veins require immediate medical attention.
Symptoms
They occur in one leg as follows:
• Redness, a definite change in skin colour
• Increased warmth
• Leg tenderness and pain
• Edema (swelling)
Also, signs of pulmonary embolism, a life-threatening complication of DVT which include:
• Unexplained sudden onset of shortness of breath
• Discomfort or chest pain that gets worse with a deep breath or coughing
• Lightheadedness or faintness
• Feeling anxious or nervous
• Coughing up blood
Causes
DVT mainly affects the large veins in the lower leg and thigh. The clot can block blood flow. If the clot breaks off and moves through the bloodstream, it can get stuck in the brain, lungs, heart, or other areas, leading to severe damage. A thrombosis can occur at any age, but is most common in adults over 60.
Risk factors
Many factors can increase your risk of developing thromboses:
• Sitting for lengthy periods, like when driving or flying. When your legs remain still for long periods, your calf muscles don’t contract, which normally helps blood circulate. Blood clots can form in the calves of your legs if your calf muscles aren’t moving. Although sitting for long periods is a risk factor, your chance of developing deep vein thrombosis while flying or driving is relatively low.
• Inherited blood-clotting disorder. Inherit disorders can make blood clot more easily. However, it may not cause problems unless combined with one or more other risk factors.
• Prolonged bed rest, such as during a long hospital stay, or paralysis.
• Injury or surgery. Injury to your veins or surgery can slow blood flow, increasing the risk of blood clots. General anesthetics used during surgery can make your veins wider (dilate), which can increase the risk of blood pooling and then clotting.
• Pregnancy. It increases the pressure in the veins in your pelvis and legs. Women with an inherited clotting disorder are especially at risk. The risk of blood clots from pregnancy can continue for up to six weeks after you have your baby.
• Cancer. Some forms of cancer increase the amount of substances in your blood that cause your blood to clot. Conversely some forms of cancer treatment also increase the risk of blood clots.
• Heart failure. People with heart failure are at risk of DVT because a damaged heart doesn’t pump blood as effectively as a normal heart does. This increases the chance that blood will pool and clot.
• Birth control pills or hormone replacement therapy. Oral contraceptives (birth control pills) and hormone replacement therapy both can increase your blood’s ability to clot.
• A pacemaker or a thin, flexible tube (catheter) in a vein. These can irritate the blood vessel wall and decrease blood flow.
• A history of deep vein thrombosis or pulmonary embolism. Having had DVT before means you could have DVT in the future.
• A family history of deep vein thrombosis or pulmonary embolism. If someone in your family has had DVT or a pulmonary embolism, your risk is increased.
• Overweight or obesity. Can increase the pressure in the veins in your pelvis and legs.
• Smoking. Smoking affects blood clotting and circulation.
• Overproduction of red blood cells in bone marrow (polycythemia vera) or related conditions
• Fractures
• Giving birth within the last 6 months
• Some medications. Such as estrogen and birth control pills
• Recent surgery. Especially hip, knee, or female reproductive organ surgery
Tests
If your doctor suspects that you have DVT, you probably will have an ultrasound test to measure the blood flow through your veins and help find any clots that might be blocking the flow. Other tests, such as a venogram, are sometimes used if ultrasound results are unclear. A venogram is an X-ray test that takes pictures of the blood flow through the veins.
Treatment
Treatment for DVT usually involves taking blood thinners for at least 3 months to prevent existing clots from growing. Warfarin is a popular pill which is given for thinning the blood.
You would also have blood tests often to see how well the blood thinners are working. Additionally, your doctor may recommend that you prop up or elevate your leg when possible, take walks, and wear compression stockings. These measures may help reduce the pain and swelling that can happen with DVT.
Prevention
Preventing deep vein thrombosis is far easier than treating it after it has occurred. Some common preventive measures include:
• Taking prescribed medications as directed. If you’re having surgery, such as orthopaedic surgery, you’ll probably be given blood thinners while you’re in the hospital.
• Checking in with your doctor regularly to see if your medication or treatments need to be modified.
• Watching how much vitamin K you’re ingesting if you take blood thinners. Vitamin K can affect how drugs such as Warfarin work. Foods high in vitamin K include green leafy vegetables, canola and soybean oils.
• Exercising your lower calf muscles when sitting for long periods. Whenever possible, get up and walk around. If you can’t get up to walk around, try raising and lowering your heels while keeping your toes on the floor, then raising your toes while your heels are on the floor.
• Keeping on the move. If you’ve been on bed rest, because of surgery or other factors, the sooner you get moving, the less likely blood clots are to develop.
• Making lifestyle changes. Lose weight, quit smoking and control your blood pressure.
• Wearing compression stockings if your doctor recommends them.
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