Deep vein thrombosis (DVT)

Alternative Names

DVT

What is Deep vein thrombosis (DVT)

Deep vein thrombosis (also called DVT) is a blood clot that forms in a vein deep in the body. Most deep vein clots usually occur in the lower leg or thigh. If the vein swells, the condition is called thrombophlebitis. A deep vein thrombosis can break loose and may cause a serious problem in the lung, called a pulmonary embolism, or a heart attack or stroke.

Signs and symptoms

The signs and symptoms of DVT may belong to DVT itself or pulmonary embolism (PE). It is important to contact your doctor once you have noticed any signs and symptoms. Because both DVT and PE can cause serious, possibly life-threatening problems if not treated.

Deep Vein Thrombosis

Only half of the people with DVT have signs and symptoms. These signs and symptoms occur in the leg affected by the deep vein clot. They include:

• Swelling of the leg or along a vein in the leg
• Pain or tenderness in the leg, which you may feel only when standing or walking
• Increased warmth in the area of the leg that's swollen or painful
• Red or discolored skin on the leg

Pulmonary Embolism

Sometimes people are not aware of a deep vein clot until they have signs and symptoms of PE such as:

• Unexplained shortness of breath
• Pain with deep breathing
• Coughing up blood

Rapid breathing and a fast heart rate also may be signs of PE.

Possible complications

The main complication of deep vein thrombosis is a pulmonary embolism.

Pulmonary embolism. It occurs when a blood vessel in your lung becomes blocked by a blood clot (thrombus) that travels to your lungs from another part of your body, usually your leg.

Postphlebitic syndrome. A common complication that can occur after deep vein thrombosis is a condition known as postphlebitic syndrome, also called postthrombotic syndrome.

What causes

There is a set of factors which promote the development of deep vein thrombosis:

• surgery, particularly surgery of the hip or leg, or abdominal surgery
• a long period of bed rest or sitting for a long time (e.g., on an airplane or in a car)
• birth control pills or hormones taken for symptoms of menopause

certain diseases and conditions, such as:

• varicose veins
• chronic atrial fibrillation
• inflammatory bowel disease
• lupus erythematosus, a disease of the immune system
• cancer
• heart failure
• heart attack
arterial disease spinal cord injury and resulting paralysis
• previous blood clot (thrombosis)
• pregnancy
• intensive care treatment involving placement of a central venous catheter
• persons with cancer receiving chemotherapy

Prevention

You can prevent yourself from deep vein thrombosis if you take these steps such as:

• See your doctor for regular tests.
• Take all medicines as your doctor prescribes.
• Get out of bed and move around as soon as possible after surgery or illness (as your doctor recommends). Moving around decreases your chance of developing a blood clot.
• Exercise your lower leg muscles during long trips. This helps prevent blood clots from forming.

If you've had DVT or PE before, you can help prevent future blood clots by:

• Taking all medicines that your doctor prescribes to prevent or treat blood clots
• Following up with your doctor for checkups and treatment
• Using compression stockings as your doctor directs to prevent leg swelling

Treatment

People who have deep vein thrombosis (DVT) will need to take a medicine called an anticoagulant.

Anticoagulation

Anticoagulants are medicines that are used to prevent a blood clot from getting bigger. They can also help stop part of the blood clot from breaking off and becoming lodged in another part of your bloodstream (an embolism). Although they are often referred to as "blood-thinning" medicines, anticoagulants do not actually thin the blood. They alter chemicals within it, which prevents clots forming so easily.

There are two types of anticoagulants that are used to treat DVT:

• Heparin. It is usually prescribed first, because it works immediately to prevent further clotting. After this initial treatment you may also need to take warfarin to prevent another blood clot forming.
• Warfarin. It is taken as a tablet. You may need to take it after an initial heparin treatment to prevent further blood clots occurring. Your doctor may recommend that you take warfarin for three to 6 months. In some cases, warfarin may need to be taken for longer, even for life.