Deep Vein Thrombosis

Blood is one of the most important components that keep us alive. We cannot survive without blood. All other vital organs also depend on blood for their nutrition and oxygen. Without blood our body could not keep itself warm or cold, fight infection, or dispose the waste products, without it we would die. Read on to know about one such condition where the circulation of blood is hindered by blood itself.

About deep vein thrombosis (DVT)

The body knows the importance of blood, therefore, when we bleed due to injury or accident, it reacts instantly by sending its clotting factors to the bleeding site to stop excess loss of blood. But sometimes in some people, blood clots in the blood vessels, this usually occurs in one of the deep vein in the legs or thighs. They can also occur in other parts of the body. As a clot is also called as thrombus, this condition is named Deep Vein Thrombosis.

Sometimes, the blood clot gets detached from the walls of the vein and travels up towards the lungs. A free blood clot is called as embolus and it is called as pulmonary embolism (PE) when it reaches the lungs and blocks blood circulation. PE is a very serious condition that requires immediate medical aid. A blood clot in the thigh has higher chance of reaching the lungs than a clot in the lower leg.

Deep Vein Thrombosis Causes and risk factors

DVT usually and commonly occurs after 60 years of age, but can occur in any age. There are many factors which are the causes of DVT. The more the risk factors the higher the chance of DVT. Damage to the inner vein due to injury during accident, surgery, immune response, and inflammation may increase the risk of DVT.

In addition, slow or sluggish blood flow that may occur after fracture in the pelvis or leg, after surgery or prolonged illness and bed rest or travelling for a long time also increases likelihood of DVT.

There are certain inherited factors that cause blood to become thicker and clot more than normal (thrombophilia). This happens with using estrogen or birth-control pills. Conditions like heart failure, cancer and cancer treatment, and obesity are important risk factors for DVT. Smoking also increases the risk of developing DVT.

Deep vein thrombosis symptoms may be because of DVT itself or may be due to PE. If the person is experiencing any of the following symptoms they are asked to see a doctor immediately as it can result in fatal complications.

Only half of the people experience symptoms of DVT and they are:

  • Blood clot in the leg
  • Pain and swelling in the leg or along one single vein in the leg
  • Pain while walking or standing
  • Swollen area may feel warm
  • Color of skin becomes red or discolored
  • Sudden shortness of breath
  • Pain while breathing deep
  • Spitting blood while coughing
  • Rapid heartbeat

Being silent and difficult to find out, DVT poses a great challenging in diagnosis. But despite these hurdles, DVT is diagnosed based on medical history, physical examination and few laboratory testing.

A detailed medical history is required to know whether the person had or still taking any medicines, any recent surgeries, any injury or whether undergone any treatment for cancer.

Physical examination includes looking at the leg with symptoms and checking blood pressure and the condition of heart and lungs.

Ultrasound, the most common diagnostic technique for DVT, may detect the flow of blood through arteries and veins. If ultrasound does not give any detailed picture then a venography will be done.

Venography starts with injecting a dye into the vein and then taking an X-ray of the affected leg. The X-ray identifies the blood clot in the vein.

A D-dimer test is done to measure the amount of a substance that is released when a blood clot is dissolved. If the substance is in high level in the blood then the risk of DVT is more likely.

Sometimes, a blood test will be done to check whether the person has inherited clotting disorder that may cause DVT.

Sometimes a magnetic resonance imaging and computer tomography will be done to look for structure and organs inside which is useful for the DVT diagnosis.

DVT treatment aims at stopping the blood clot to grow further, preventing breaking of the blood clot, and decreasing the chance of another blood clot. Treatment for DVT disease includes medicines and therapies.

Medicines: Medicines include

  • Anticoagulant: Anticoagulants are blood thinners that reduce the chance of another blood clot but they do not dissolve the already existing blood clot; however, they can stop the already present blood clot from growing bigger. Most common anticoagulants used are heparin, which is given intravenously and warfarin that is taken orally. Warfarin usually takes 2 – 3 days to start working therefore heparin is prescribed until warfarin starts working. Warfarin is dangerous during pregnancy therefore only heparin is used.
  • Thrombin inhibitors: Patients who can’t take heparin are treated with thrombin inhibitors, which hinders the clotting process.
  • Thrombolytics: They are used only under life-threatening situations as they can cause sudden bleeding. Thrombolytics are given in severe cases to dissolve a blood clot more quickly.

Compression stockings: The person may be asked to wear compression stockings to reduce pain, swelling, and to avoid post-thrombotic symptoms.

Surgical treatment includes placing a vena cava filter. If the person cannot take anticoagulants or is taking anticoagulants but blood clots are still developing then a filter is inserted in the vena cava vein. This filter breaks and prevents the entry of blood clot into the heart and into the lungs.

Anticoagulants are drugs that act against coagulation or clotting process. Therefore taking them may result in easy bleeding and longer clotting time. The person may be easily bruised. Any excess prolonged bleeding should be treated as emergency. Anticoagulant warfarin can cause birth defects if taken by a pregnant woman.

Taking other over-the-counter medicines, vitamins, and foods that are rich in vitamin K can interfere with anticoagulant. Therefore, before taking any drugs or making any changes in the diet consulting the doctor is important.

If the person knows that he/she is at risk for DVT, few tips can help them prevent DVT.

  • Going for regular check-ups
  • Following all instruction and medicines prescribed by the doctor
  • Trying not to be on bed for a long time after illness and surgery
  • Exercising or moving the lower leg during long journey
  • During long journey, more than 4 hours, walking up and down the aisle of bus, train or plane will help
  • If travelling by car make it a point to stop and walk every one hour
  • Wearing loose and comfortable clothes while travelling
  • Controlling blood pressure
  • Reducing weight
  • Avoiding alcohol and drink lots of fluids
  • Quitting smoking

For people who are at risk of developing DVT, and are undergoing surgery, they may be given DVT prophylaxis to prevent DVT post-surgery.