Deep vein thrombosis (DVT) occurs when a blood clot (thrombus) forms in one or more of the deep veins in your body, usually in your legs. Deep vein thrombosis can cause leg pain or swelling, but
How DVT causes?
The blood clots of deep vein thrombosis can be caused by anything that prevents your blood from circulating or clotting normally, such as injury to a vein, surgery, certain medications and limited movement
Many things can raise your chances of getting DVT. Here are some of the most common:
→ Age. DVT can happen at any age, but your risk is greater after age 40.
→ Sitting for long periods. When you sit for long stretches of time, the muscles in your lower legs stay lax. This makes it hard for blood to circulate, or move around, the way it should. Long flights or car rides can put you at risk.
→ Bed rest, like when you’re in the hospital for a long time, can also keep your muscles still and raise your odds of DVT.
→ Pregnancy . Carrying a baby puts more pressure on the veins in your legs and pelvis. What’s more, a clot can happen up to 6 weeks after you give birth.
→ Obesity . People with a body mass index (BMI) over 30 have a higher chance of DVT. This measures how much body fat you have, compared with your height and weight.
→ Serious health issues. Conditions like Irritable bowel disease, cancer, and heart disease can all raise your risk.
→ Certain inherited blood disorders. Some diseases that run in families can make your blood thicker than normal or cause it to clot more than it should.
→ Injury to a vein. This could result from a broken bone, surgery, or other trauma.
→ Smoking makes blood cells stickier than they should be. It also harms the lining of your blood vessels. This makes it easier for clots to form.
→ Birth control pills or hormone replacement therapy. The estrogen in these raises your blood’s ability to clot. (Progesterone-only pills don’t have the same risk.)
Symptoms of DVT:
Deep vein thrombosis signs and symptoms can include:
Swelling in the affected leg. Rarely, there’s swelling in both legs.
→ Pain in your leg. The pain often starts in your calf and can feel like cramping or soreness.
→ Red or discolored skin on the leg.
→ A feeling of warmth in the affected leg.
Deep vein thrombosis can occur without noticeable symptoms.
When to see a doctor
→ If you develop signs or symptoms of deep vein thrombosis, contact your doctor.
→ If you develop signs or symptoms of a pulmonary embolism a life-threatening complication of deep vein thrombosis seek immediate medical attention.
The warning signs and symptoms of a pulmonary embolism include:
→ Sudden shortness of breath
→ Chest pain or discomfort that worsens when you take a deep breath or when you cough
→ Feeling lightheaded or dizzy, or fainting
→ Rapid pulse
→ Coughing up blood
Many factors can increase your risk of developing deep vein thrombosis (DVT). The more you have, the greater your risk of DVT. Risk factors include:
→ Inheriting a blood-clotting disorder. Some people inherit a disorder that makes their blood clot more easily. This condition on its own might not cause blood clots unless combined with one or more other risk factors.
→ Prolonged bed rest, such as during a long hospital stay, or paralysis. When your legs remain still for long periods, your calf muscles don’t contract to help blood circulate, which can increase the risk of blood clots.
→ Injury or surgery. Injury to your veins or surgery can increase the risk of blood clots.
→ Pregnancy. Pregnancy 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.
→ Birth control pills (oral contraceptives) or hormone replacement therapy. Both can increase your blood’s ability to clot.
→ Being overweight or obese. Being overweight increases the pressure in the veins in your pelvis and legs.
→ Smoking. Smoking affects blood clotting and circulation, which can increase your risk of DVT.
→ Cancer. Some forms of cancer increase substances in your blood that cause your blood to clot. Some forms of cancer treatment also increase the risk of blood clots.
→ Heart failure. This increases your risk of DVT and pulmonary embolism. Because people with heart failure have limited heart and lung function, the symptoms caused by even a small pulmonary embolism are more noticeable.
→ Inflammatory bowel disease. Bowel diseases, such as Crohn’s disease or ulcerative colitis, increase the risk of DVT.
→ A personal or family history of deep vein thrombosis or pulmonary embolism.If you or someone in your family has had one or both of these, you might be at greater risk of developing a DVT.
→ Age. Being older than 60 increases your risk of DVT, though it can occur at any age.
→ Sitting for long periods of time, such as when driving or flying. When your legs remain still for hours, 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 don’t move for long periods.
Investigation or Diagnosis:
To diagnose deep vein thrombosis, your doctor will ask you about your symptoms. You’ll also have a physical exam so that your doctor can check for areas of swelling, tenderness or discoloration on your skin. Depending on how likely you are to have a blood clot, your doctor might suggest tests, including:
→ Ultrasound. A wandlike device (transducer) placed over the part of your body where there’s a clot sends sound waves into the area. As the sound waves travel through your tissue and reflect back, a computer transforms the waves into a moving image on a video screen. A clot might be visible in the image.
Sometimes a series of ultrasounds are done over several days to determine whether a blood clot is growing or to check for a new one.
→ Blood test. Almost all people who develop severe deep vein thrombosis have an elevated blood level of a substance called D dimer.
→ Venography. A dye is injected into a large vein in your foot or ankle. An X-ray creates an image of the veins in your legs and feet, to look for clots. However, less invasive methods of diagnosis, such as ultrasound, can usually confirm the diagnosis.
→ CT or MRI scans. Either can provide visual images of your veins and might show if you have a clot. Sometimes these scans performed for other reasons reveal a clot.
Deep vein thrombosis (DVT) treatment is aimed at preventing the clot from getting bigger and preventing it from breaking loose and causing a pulmonary embolism. Then the goal becomes reducing your chances of deep vein thrombosis happening again.
→ Inferior vena cava filters. Inferior vena cava (IVC) filters are sometimes used as an alternative to anticoagulant medicines. This is usually because anticoagulant treatment needs to be stopped, isn’t suitable or isn’t working.IVC filters are small mesh devices that can be placed in a vein. They trap large fragments of a blood clot and stop it travelling to the heart and lungs. They can be used to help prevent blood clots developing in the legs of people diagnosed with:
→ pulmonary embolism
→ multiple severe injuries
IVCs can be placed in the vein permanently, or newer types of filters can be placed temporarily and removed after the risk of a blood clot has decreased. The procedure to insert an IVC filter is carried out using a local anesthetic (where you’re awake but the area is numb). A small cut is made in the skin and a catheter (a thin, flexible tube) is inserted into a vein in the neck or groin area. The catheter is guided using an ultrasound scan. The IVC filter is then inserted through the catheter and into the vein.
→ Catheter directed thrombolysis. Catheter Directed Thrombolysis is a percutaneous procedure used to dissolve blood clots (thrombus) by administering a lytic directly into the clot through catheter. The current standard of care to treat deep vein thrombosis (DVT) is to prescribe anticoagulants such as heparin. Catheter-directed thrombolysis is a minimally invasive treatment that dissolves abnormal blood clots in blood vessels to help improve blood flow and prevent damage to tissues and organs. When blood does not flow smoothly through a vessel, it can begin to coagulate, turning from a free-flowing liquid to a semi-solid gel, or blood clots. A blood clot, or thrombus, that forms within a blood vessel may continue to grow, blocking off the blood supply to certain parts of the body and causing damage to tissues and organs. In some patients, blood clots come from one site, dislodge, travel downstream, and lodge in relatively small vessels causing a blockage, or embolisation. Untreated, a vascular blockage due to thrombosis or embolisation can result in the loss of an organ or extremity, with potentially life-threatening consequences. In a catheter-directed thrombolysis procedure, x-ray imaging is used to help guide a special medication or medical device to the site of blood clots to dissolve the blockage.
→ Blood thinners. Deep vein thrombosis is most commonly treated with anticoagulants, also called blood thinners. These drugs, which can be injected or taken as pills, decrease your blood’s ability to clot. They don’t break up existing blood clots, but they can prevent clots from getting bigger and reduce your risk of developing more clots.
→ Clot busters. If you have a more serious type of deep vein thrombosis or pulmonary embolism, or if other medications aren’t working, your doctor might prescribe drugs that break up clots quickly, called clot busters or thrombolytics.
→ Filters. If you can’t take medicines to thin your blood, you might have a filter inserted into a large vein the vena cava in your abdomen. A vena cava filter prevents clots that break loose from lodging in your lungs.
→ Compression stockings. To help prevent swelling associated with deep vein thrombosis, these are worn on your legs from your feet to about the level of your knees.
After you receive treatment for deep vein thrombosis, we’ll remain by your side. You’ll have regular visits with your vascular doctor to see if your medication or treatments need to be modified.
Deep vein thrombosis follow-up care also includes nutrition services. What you eat and drink plays a vital role in keeping you healthy and strong, preventing disease and helping you recover when you’re sick. Our registered dietitians at Lehigh Valley Health Network will provide information and practical tools to help you reach your nutrition goals and get maximum benefit from the foods you eat.
Simple lifestyle changes may help lower your odds of getting one. Try these simple tips to keep your blood circulating the way it should:
→ Take care of yourself. Stop smoking, lose weight, and get active.
→ Get regular checkups. And if your doctor has prescribed a medicine to control a health problem, take it as directed.
→ Don’t sit for too long. If you’re traveling for 4 hours or more, take breaks to flex and stretch your lower leg muscles. If you’re on a flight, walk up and down the aisle every half-hour. On long car drives, pull over each hour to stretch. Wear loose-fitting clothes, and drink plenty of water
→ Plan surgery after-care. Talk to your doctor about what you can do to prevent DVT after surgery. She might suggest you wear compression stockings or take blood thinners. You’ll also want to get out of bed and start moving around.
Measures to prevent deep vein thrombosis include:
→ Avoid sitting still. If you have had surgery or have been on bed rest for other reasons, try to get moving as soon as possible. If you’re sitting for a while, don’t cross your legs, which can hamper blood flow. If you’re traveling a long distance by car, stop every hour or so and walk around.
If you’re on a plane, stand or walk occasionally. If you can’t do that, exercise your lower legs. Try raising and lowering your heels while keeping your toes on the floor, then raising your toes with your heels are on the floor.
→ Make lifestyle changes. Lose weight and quit smoking.
→ Exercise. Regular exercise lowers your risk of blood clots, which is especially important for people who sit a lot or travel frequently.