CONDITIONS

Deep Vein Thrombosis

What Is Deep Vein Thrombosis

Deep vein thrombosis (DVT) occurs when blood cells thickenstick together and form a clot deep in the body’s larger, deeper veins, typically in the thigh or lower leg.

The center for disease control estimates that the number of people affected by deep vein thrombosis/pulmonary embolism each year in the USA ranges from 300,000 to 600,000. 

Possible complications of deep vein thrombosis include:

  • Pulmonary embolism. If the DVT clot breaks off the walls of the vein and travels through the bloodstream, it can get stuck in an artery of the lung, preventing oxygenated blood from reaching the rest of the body in what is known as a pulmonary embolism. Pulmonary embolism is a serious condition that can lead to chest pain, irregular heartbeat, fainting, or even death.
  • Post-thrombotic syndrome. Damage done to the vein by a DVT can cause blood to pool, resulting in lasting pain and swelling, and sores on the site of the DVT.
  • Limb ischemia. Occasionally, a severe DVT can block the flow of oxygen to the affected limb. Limb ischemia requires immediate medical attention to prevent the loss of the limb.
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What Causes Deep Vein Thrombosis

Deep vein thrombosis occurs when a blood clot forms in one of the larger, deeper veins of the body. Factors that increase the likelihood of clotting include:

  • Damage to the inner lining of the vein
  • Decreased mobility. For example, during a long plane ride  
  • Thick blood. Typically caused by certain genetic factors and/or medications
  • Recent surgeries or physical injuries
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Risk Factors For Deep Vein Thrombosis

The following risk factors can affect the likelihood of developing deep vein thrombosis (DVT):

  • Age. The incidence of deep vein thrombosis is much higher in the elderly population than adolescents and adults. 1 in every 100 people over the age of 80 will be affected by DVT.
  • Family history. A family history of deep vein thrombosis increases your risk of developing the condition. Certain inherited blood disorders can also increase the risk of DVT.
  • Recent injury or surgery, which can interfere with the structure of veins and increase the likelihood of clotting.
  • Immobility, which increases the chance of developing a blood clot anywhere in the body. Immobility is connected to obesity, old age, and severe injury/illness.
  • Pregnancy. Women who are pregnant or who have recently given birth are more likely to develop DVT.
  • High cholesterol. High levels of blood cholesterol raise the risk of blood clots and DVT.
  • Smoking. Smokers are much more likely to experience blood clots than nonsmokers.
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Diagnosing Deep Vein Thrombosis

Your doctor may conduct the following tests to arrive at a deep vein thrombosis diagnosis (DVT):

  • Physical exam. During the physical exam, the doctor will check for swelling, tenderness, palpable vein and redness in the legs (all common symptoms of DVT) as well as other physical abnormalities.
  • Medical history. A medical history allows your doctor to collect information about you and your family’s past health conditions. This can help narrow the field of the doctor’s testing and diagnosis.
  • Ultrasound. During an ultrasound, sound waves are used to capture live moving footage of blood circulating through the veins and arteries. Ultrasounds can detect clots and other circulatory irregularities.
  • D-dimer test. This test checks for the presence for a substance that is released in higher quantities by those suffering from DVT. This test has a higher risk of resulting in false-positives for the elderly population and those suffering from rheumatoid arthritis.
  • During this test, a special dye that is visible with x-ray imaging is injected into the veins. An x-ray then reveals any clots or blockages.
  • MRI imaging. In cases where blockages are especially difficult to visualize, an MRI may be conducted to produce clear image of the tissues and organs.
  • Coagulation study. This test checks the prothrombin time, or PT—a blood test that measures how long it takes blood to clot. A prothrombin time test can check for bleeding problems, and may also be utilized to see whether medication to prevent blood clots is working. This study also looks at the partial thromboplastin time, or PTT, Partial thromboplastin time (PTT) blood test that also measures the time it takes your blood to clot. Additionally, a PTT test is often used to check for bleeding problems.
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Symptoms of Deep Vein Thrombosis

Only about 50% of patients with DVT experience symptoms. These include:

  • Swelling of the leg or vein in the leg
  • Leg pain made worse by standing or walking, accompanied by warm, red skin discoloration.
  • Calf pain on the upward flexion of the foot (dorsiflexion)
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Prognosis

The prognosis for deep vein thrombosis (DVT) depends on the severity of the clot and the patient’s risk factors.

  • If left untreated: the risk of DVT escalating to pulmonary embolism is 40-50%.
  • However with proper treatment, this risk can be as low as 5-10%.
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Living With Deep Vein Thrombosis

If you’ve had deep vein thrombosis (DVT) in the past, you are more likely to develop it again. The following tips can help prevent a future DVT:

  • Keep moving. Inactivity increases your chance of blood clots.
  • Eat a balanced, low-cholesterol diet. High-cholesterol foods such as saturated fats (butter, lard, coconut oil, etc.), egg yolk, red meat, and dairy.   
  • Take time to stretch out your legs during travel or long days at work. Remaining seated and stationary for an extended period of time can increase your chances of developing DVT.
  • Take all of your prescribed medications. Even though you may feel no physical symptoms, you may still be at risk for developing another blood clot.
  • Get regular checkups. Only 50% of people with DVT experience symptoms. Regular checkups are essential to catching the early warning signs of DVT.
  • Wear compression socksto prevent clots and swelling.
  • Stop smoking. Smoking increase your risk of blood clots, making it more likely that you’ll develop DVT. 
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Screening

Deep vein thrombosis (DVT) is most often only screened for in at-risk populations – smokers, the elderly, obese patients, and those with other high-risk levels. In order to screen for DVT, a doctor may conduct a physical exam, ultrasound, or MRI imaging.

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Prevention

The following preventative measures can be taken to decrease your chance of developing deep vein thrombosis (DVT):

  • Keep moving. Inactivity increases your chance of blood clots.
  • Get regular checkups. Only 50% of people with DVT experience symptoms. Regular checkups are essential to catching the early warning signs of DVT.
  • Take preventative medicines if your doctor prescribes them for you. 
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Medication And Treatment

Deep vein thrombosis (DVT) can be treated with a variety of medications and treatments.

The following classes of medications are common treatment methods for DVT:

  • Anticoagulants, which interfere with the blood’s ability to clot and stop the growth of existing clots. Warfarin and heparin are the two most common anticoagulants.
  • Thrombolytics.Thrombolytics are used in situations where the clot is so severe that it needs to be immediately dissolved.  because of their potential for serious side effects, are used only in emergency settings.

In cases where anticoagulants are not working, doctors may suggest a vena cava filter. Vena cava filters are inserted into the vena cava to block blood clots from travelling to the heart and lungs. Vena cava filters can be inserted surgically on a temporary or permanent basis.

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Complementary and Alternative Treatment

The following alternative treatments may help relieve DVT:

Dietary supplements. The following supplements may help prevent blood clots:

  • Salicylate
  • Coumarin
  • Vitamin E
  • Vitamin D
  • Fish oil (omega 3 fatty acid)
  • Garlic
  • Nattokinase
  • Chocolate
  • Evening primrose oil

Herbal supplements. The following herbal supplements may help prevent blood clots:

  • Chamomile
  • EGCG (green tea extract)
  • Ginkgo biloba
  • Nettle

Acupuncture. Acupuncture is an ancient form of Chinese medicine that uses the insertion of small needles to restore the bodily flow of energy. Acupuncture may help reduce overall stress levels, improve circulation, and help prevent blood clots.

Mind/body techniques. Techniques such as yoga, tai chi, and meditation can help reduce stress and improve general feelings of well-being.

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Care Guide

If you are caring for someone with deep vein thrombosis (DVT), be sure to take the following steps to lessen the risk of DVT reoccurrence:

  • Keep them moving. Accompany them on daily walks or find other creative ways to exercise around the house. If they are completely bed ridden, be sure to change their position often enough to prevent blood from settling and clotting.
  • Provide healthy, low-cholesterol meals. A diet high in cholesterol can increase the risk of blood clots, DVT, pulmonary embolism, heart attack, and stroke.
  • Be a source of encouragement during their treatment and recovery. Positivity can make all the difference for a recovering patient.
  • Encourage them to attend regular checkups with their doctor. Since people who have already had DVT are at a higher risk of reoccurrence, frequent checkups are recommended.
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When To Contact A Doctor

Contact a doctor if you experience any of the following symptoms, as these may be signs of deep vein thrombosis:

  • Swelling of the leg or vein in the leg
  • Leg pain made worse by standing or walking, accompanied by warm, red skin discoloration.

 

If you experience any of the following symptoms, call emergency services immediately. These may be signs of a pulmonary embolism or limb ischemia:

  •  Shortness of breath
  • Difficulty breathing
  • Chest pain
  • Coughing (bloody or non-bloody)
  •  Irregular heartbeat
  • Dizziness
  • Pain or numbness in the extremities
  • Shiny, smooth, dry skin of legs/feet
  • Thickening of the toenails
  • Absent or diminished pulse
  • Sores that will not heal
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Questions For Your Doctor

To find a hematologist (blood-disease specialist), visit The American Society of Hematology.

To find a doctor that specializes in deep vein thrombosis or visit www.legpaindoctor.org and select “deep vein thrombosis (DVT)” as the area of expertise.

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Questions For A Doctor

You may want to ask your doctor the following questions about your condition:

  • How likely is my condition to develop into a pulmonary embolism or other complication?
  • What are the available treatment options?
  • What are the treatment side effects?
  • What can I do to lower my risk of developing another DVT?
  • Is my condition hereditary?
  • How long will recovery take?
  • How will this affect my activity level?
  • What long–term changes should I make for a healthier lifestyle?
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Resources

For more information on deep vein thrombosis, visit:

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