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Deep Vein Thrombosis (DVT)

Heart image

What is deep vein thrombosis?

Deep vein thrombosis is a blood clot or thrombus in a deep vein. They are most common in the leg. But they may develop in the arm or other parts of the body. Part of the clot called an embolus can break off and travel to the lung. This is a pulmonary embolus (PE). This can cut off the flow of blood to all or part of the lung. PE is an emergency and may cause death.

Two other complications of a blood clot are chronic venous insufficiency and post-thrombotic syndrome.

  • Chronic venous insufficiency - may happen following a blood clot in a leg vein. It means that a vein no longer works well. It is a long-term condition where blood pools in the vein instead of flowing back to the heart. Pain and swelling in the leg are common symptoms.

  • Post-thrombotic syndrome - may also happen following a blood clot in a leg vein. It is a long-term problem with pain, swelling, and redness. Ulcers and sores can also happen. All of these symptoms may make it difficult to walk and take part in daily activities.

What are the risk factors of deep vein thrombosis?

Risk factors include:
  • Overweight or obesity
  • Blood clotting disorder
  • Age over 60 years
  • Surgery
  • A long period of not moving, for example, when in the hospital or on a long trip
  • Birth control pills or hormone replacement therapy
  • Certain diseases and conditions, such as:
    • Previous blood clot
    • Varicose veins
    • Heart problems, such as heart failure, or heart attack
    • Inflammatory bowel disease
    • Lupus, a disease of the immune system
    • Cancer and some cancer treatments
  • Paralysis
  • Pregnancy
  • Having a central venous catheter, for example, in a large vein in the chest

What are the symptoms of deep vein thrombosis?

Deep vein thrombosis may happen without symptoms. Common symptoms include pain, swelling, and redness in the leg, arm, or other areas.

These symptoms may mean that you have a blood clot. The symptoms of a blood clot may also look like other medical conditions. Always see your healthcare provider for a diagnosis.

How is deep vein thrombosis diagnosed?

Along with a medical history and physical exam, your healthcare provider may do other tests including:

  • Duplex ultrasound - this procedure involves placing ultrasound gel on the affected area and then moving a handheld device across it. A picture of the blood flow is displayed on a monitor. This is the most common test for deep vein thrombosis.

  • Lab work - blood work may be done to look for blood clotting and other problems.

What are the treatment options for deep vein thrombosis?

The goal or treatment is to prevent the clot from getting larger, to prevent a blood clot from traveling to the lungs, and to decrease the chance of another blood clot forming.

Treatment may include:

These medicines decrease the ability of the blood to clot. Examples of anticoagulants include warfarin and heparin. Other anticoagulants may also be used, including rivaroxaban, apixaban, dabigatran, and enoxaparin. The most common side effect of blood-thinning medicine is bleeding. Report bruising or bleeding to your healthcare provider right away. You may have blood in the urine, bleeding with bowel movements, a bloody nose, bleeding gums, a cut that will not stop bleeding, or vaginal bleeding.

These medicines are used to break up clots.

In some cases, a filter is placed in the vena cava (the large vein which returns blood from the body to the heart). This filter prevents clots from reaching the heart and lungs.