Deep Vein Thrombosis
Deep vein thrombosis, also known as DVT, is a serious condition that occurs when a blood clot, also known as a thrombus, forms in a vein deep within the body. Such clots most frequently form in the legs, but may occur in other parts of the body.
Causes of DVT
There are several reasons blood clots may occur in the veins: damage to veins, slow blood flow, or thickened blood consistency. Most patients who develop DVT are over 60 years old, but this condition can occur at any age. Causes of changes to veins and blood flow may include:
- Prolonged periods of inactivity or bed rest
- Long periods of sedentary travel
- Pressure from obesity or pregnancy
- Some inherited conditions
- Vein damage from surgery or injury
- Reactions to certain medications
- Hormone replacement or birth control pills
- Certain cancer treatments
Symptoms of DVT
About half of all patients who develop DVT are asymptomatic. When symptoms occur they may include:
- Red or discolored skin
- Swelling along the vein
- Swelling in the legs, ankles and feet
- Pain or tenderness at the site
- Increased warmth in the area
Diagnosis of DVT
A variety of methods are used to diagnose DVT. After a thorough physical examination of the legs and feet, the physician will check blood pressure and breathing and listen to heart sounds. Diagnostic tests for DVT may include:
- Blood tests
- D-dimer test
- MRI scan
- CT scan
Treatment of DVT
Treatment of DVT is focused on preventing the discovered clot from enlarging, preventing the development of another clot, and averting an embolism. An embolism occurs when a clot or piece of plaque breaks loose from its site of origin and travels somewhere else in the body, such as the lungs, heart or brain. An embolism is a life-threatening event which may result in many dangerous consequences, including a stroke or heart attack.
There are two basic treatments for DVT: medication and compression. The physician will determine which medication may be appropriate and whether the use of compression stockings will be helpful.
These elastic stockings produce pressure on the veins and keep blood from pooling and clotting. In mild cases of venous insufficiency, these stocking may keep the condition under control without medication.
Anticoagulants, or blood thinners, are medications which thin the blood and provide for easier blood flow. Common blood thinners are heparin and warfarin. Heparin is administered through injection or intravenous tube. Warfarin is prescribed in pill form.
Thrombolytics are medications used to quickly break up the clot and are usually used only in extreme situations since they present a risk of sudden bleeding. Thromboytics are most often used immediately following a heart attack or stroke.
Thrombin inhibitors interfere with the clotting process by directly inhibiting the enzyme thrombin. Thrombin inhibitors are increasingly used as anticoagulants in place of thrombolytics.
Vena Cava Filter
This filter is inserted inside the vena cava, the large vein that carries blood from the lower half of the body back to the heart for oxygenation. The filter is designed to prevent a pulmonary embolism by catching blood clots before they travel to the lungs.
Risks of DVT
The greatest risk of DVT is an embolism which occurs when a blood clot breaks off and travel through the bloodstream to do damage at another site. If the thrombosis happens in the thigh, the chances it will break off and travel to produce complications is greater than if the clot is in the lower legs or other parts of the body. When an embolism occurs in the lungs as a pulmonary embolism, in the brain as a stroke, or in the heart as a heart attack, it is extremely dangerous. Organ damage and death can easily result. Symptoms of an embolism may include:
- Sharp chest pain, worsened by a deep breath or a cough
- Sudden shortness of breath
- Cough with pink, foamy mucus
Prevention of DVT
There are several ways to lessen the risk of DVT or to slow the progression of the condition. A patient in danger of DVT may improve vascular health by:
- Remaining physically active
- Not sitting or standing in one place for too long
- Losing weight
- Managing blood pressure
- Refraining from smoking