What is Deep Vein Thrombosis (DVT)?
Deep vein thrombosis (DVT) is a serious condition that occurs when a blood clot forms in a vein located deep inside your body. A blood clot is a clump of blood that’s turned to a solid state.
Deep vein blood clots typically form in your thigh or lower leg, but they can also develop in other areas of your body. Other names associated with this condition may include thromboembolism, post-thrombotic syndrome, and postphlebitic syndrome.
Deep vein thrombosis can cause leg pain or swelling, but also can occur with no symptoms. Deep vein thrombosis can be very serious because blood clots in your veins can break loose, travel through your bloodstream and lodge in your lungs, blocking blood flow (pulmonary embolism).
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Before Deep Vein Thrombosis (DVT) Treatment
Symptoms of DVT only occur in about half of the people who have this condition. Common symptoms include:
. Swelling in your foot, ankle, or leg, usually on one side
. Cramping pain in your affected leg that usually begins in your calf
. Severe, unexplained pain in your foot and ankle
. An area of skin that feels warmer than the skin on the surrounding areas
. Skin over the affected area turning pale or a reddish or bluish color
People with an upper extremity DVT, or a blood clot in the arm, may also not experience symptoms. If they do, common symptoms include:
. Neck pain
. Shoulder pain
. Swelling in the arm or hand
. Blue-tinted skin color
. Pain that moves from the arm to the forearm
. Weakness in the hand
People may not find out that they have deep vein thrombosis until they’ve gone through emergency treatment for a pulmonary embolism (blood clot in the lung).
A pulmonary embolism can happen when a DVT clot has moved from the arm or leg into the lung. When an artery in the lung becomes blocked, it’s a life-threatening condition and requires emergency care.
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.
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DVT is caused by a blood clot. The clot blocks a vein, preventing blood from properly circulating in your body. Clotting may occur for several reasons. These include:
. Injury. Damage to a blood vessel’s wall can narrow or block blood flow. A blood clot may form as a result.
. Surgery. Blood vessels can be damaged during surgery, which can lead to the development of a blood clot. Bed rest with little to no movement after surgery may also increase your risk for developing a blood clot.
. Reduced mobility or inactivity. When you sit frequently, blood can collect in your legs, especially the lower parts. If you’re unable to move for extended periods of time, the blood flow in your legs can slow down. This can cause a clot to develop.
. Certain medications. Some medications increase the chances your blood will form a clot.
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.
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A serious complication associated with deep vein thrombosis is pulmonary embolism.
. Pulmonary embolism
A pulmonary embolism occurs when a blood vessel in your lung becomes blocked by a blood clot (thrombus) that travels to your lung from another part of your body, usually your leg.
A pulmonary embolism can be life-threatening. It's important to watch for signs and symptoms of a pulmonary embolism and seek medical attention if they occur. 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
. Postphlebitic syndrome
A common complication that can occur after deep vein thrombosis is known as postphlebitic syndrome, also called postthrombotic syndrome. Damage to your veins from the blood clot reduces blood flow in the affected areas, which can cause:
. Persistent swelling of your legs (edema)
. Leg pain
. Skin discoloration
. Skin sores
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.
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.
During Deep Vein Thrombosis (DVT) Treatment
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.
Deep vein thrombosis treatment options include:
. 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.
The injectable medications can be given as a shot under the skin or by injection into your arm vein (intravenous).
Heparin is typically given intravenously. Other similar blood thinners, such as enoxaparin (Lovenox), dalteparin (Fragmin) or fondaparinux (Arixtra), are injected under the skin.
You might receive an injectable blood thinner for a few days, after which pills such as warfarin (Coumadin, Jantoven) or dabigatran (Pradaxa) are started. Once warfarin has thinned your blood, the injectable blood thinners are stopped.
Other blood thinners can be given in pill form without the need for an injectable blood thinner. These include rivaroxaban (Xarelto), apixaban (Eliquis) or edoxaban (Savaysa).
You might need to take blood thinner pills for three months or longer. It's important to take them exactly as your doctor instructs because taking too much or too little can cause serious side effects.
If you take warfarin, you'll need periodic blood tests to check how long it takes your blood to clot. Pregnant women shouldn't take certain blood-thinning medications.
. 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.
These drugs are either given through an IV line to break up blood clots or through a catheter placed directly into the clot. These drugs can cause serious bleeding, so they're generally reserved for severe cases of blood clots.
. 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.
This pressure helps reduce the chances that your blood will pool and clot. You should wear these stockings during the day for at least two years, if possible.
Your doctor may suggest surgery to remove a DVT clot in your arm or leg. This is typically only recommended in the case of very large blood clots or clots that are causing serious issues, like tissue damage.
During a surgical thrombectomy, or surgery to remove a blood clot, your surgeon will make an incision into a blood vessel. They’ll locate and remove the clot. Then, they’ll repair the blood vessel and tissue.
In some cases, they may use a small inflating balloon to keep the blood vessel open while they remove the clot. When the clot is found and removed, the balloon is removed with it.
Surgery isn’t without risks, so many doctors will only use this treatment in severe cases. Risks include infection, damage to the blood vessel, and excess bleeding.
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After Deep Vein Thrombosis (DVT) Treatment
Lifestyle and home remedies
Once you receive treatment for deep vein thrombosis (DVT), you need to watch your diet and watch for signs of excessive bleeding, as well as take steps to prevent another DVT. Some things you can do include:
. Check in with your doctor regularly to see if your treatment needs to be modified. If you're taking warfarin (Coumadin, Jantoven), you'll need a blood test to see how well your blood is clotting.
. Take your blood thinners as directed. If you've had DVT, you'll be on blood thinners for at least three to six months.
. Watch for excessive bleeding, which can be a side effect of taking blood thinners. Talk to your doctor about activities that could cause you to bruise or get cut, as even a minor injury could become serious if you're taking blood thinners.
. Move. If you've been on bed rest because of surgery or other factors, the sooner you get moving, the less likely blood clots will develop.
. Wear compression stockings to help prevent blood clots in the legs if your doctor recommends them.
The longer you sit, the greater your risk of developing a blood clot. If you have to be seated for long periods, there are exercises you can do while sitting to keep your legs moving and help circulate blood.
. Knee pulls
Bend your leg, and raise your knee toward your chest. Wrap your knee with your arms for a greater stretch. Hold this position for several seconds, then do the same exercise on the other side. Repeat these stretches several times.
. Foot pumps
Place your feet flat on the floor. Keeping the balls of your feet on the floor, raise your heels. Hold for a few seconds, then lower the heels. Raise the balls of your feet off the floor, keeping your heels in place. Hold for a few seconds, then lower the balls of your feet.
Repeat these pumps several times.
. Ankle circles
Lift both feet off the floor. Draw circles with your toes in one direction for a few seconds. Switch directions, and draw circles for a few seconds. Repeat this exercise several times.
DVT in pregnancy
Being pregnant increases your risk of DVT. In fact, pregnant women are 5 to 10 times more likely to develop DVT than women who aren’t pregnant.
While pregnant, the level of blood-clotting proteins increases, and the level of anticlotting proteins falls. Plus, increased hormone levels, and a slower blood flow as your uterus expands and restricts blood flowing back from your lower extremities, contribute to this risk.
The elevated risk continues until about six weeks after giving birth. Being on bed rest or having a cesarean delivery also increases your risk of having DVT.
Remain watchful for symptoms of DVT while you’re pregnant.
DVT and flying
Your risk of developing blood clots is higher when flying because sitting for long periods of time increases the chances of DVT.
The longer the flight, the greater the risk. It’s especially significant for people taking flights that last more than eight hours. Your risk also increases if you’re flying and already have other risk factors for DVT.
These measures can help you reduce your risk for a blood clot while flying:
. Sit in an exit row or bulkhead seat so you have more room to stretch and move your legs.
. Wear compression stockings, which reduce blood pooling and help maintain blood flow.
. Take any prescription blood thinners or aspirin as prescribed by your doctor.
. Do exercises with your feet and legs to keep blood flowing.
. Get up and walk around the cabin during the flight.
Symptoms of a blood clot may not develop immediately after flying.
DVT and diet
A healthy lifestyle is important for preventing DVT and helping to avoid life-threatening complications. Plus, a healthy lifestyle incorporates many of the changes that are necessary to prevent blood clots. This includes moving more, quitting smoking, and losing weight.
You can lower your risk for DVT and blood clots with a healthy diet. Fruits, vegetables, and whole grains deliver essential vitamins and minerals.
A vegan, vegetarian, or Mediterranean diet may be best for people at risk of DVT or people who’ve had DVT before, but research is needed to support this. Eating these herbs in small amounts may help you reduce your risk of DVT, too.
But some vitamins and minerals can interfere with DVT medications. For example, too much vitamin K can bypass warfarin’s ability to thin your blood and prevent a clot.
Review any vitamins or supplements you take with your doctor and ask about possible interactions with medications. It’s also important you talk with your doctor about any foods or nutrients you should avoid.