Deep Vein Thrombosis

Most deep vein clots occur in the lower leg or thigh. If the vein swells, the condition is called thrombophlebitis. A deep vein thrombosis can break loose and cause a serious problem in the lung, called a pulmonary embolism.

Sitting still for a long time can make you more likely to get a DVT. Some medicines and disorders that increase your risk for blood clots can also lead to DVTs. Common symptoms are

• Warmth and tenderness over the vein
• Pain or swelling in the part of the body affected
• Skin redness

Treatment includes medicines to ease pain and inflammation, break up clots and keep new clots from forming. Keeping the affected area raised and applying moist heat can also help. If you are taking a long car or plane trip, take a break, walk or stretch your legs and drink plenty of liquids.

Prevention

You can take steps to prevent deep vein thrombosis (DVT) and pulmonary embolism (PE).

IF YOU’RE AT RISK FOR THESE CONDITIONS:

• See your doctor for regular checkups.
• 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 lowers 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.

FOLLOW THE STEPS ABOVE AND:

• Take all medicines that your doctor prescribes to prevent or treat blood clots
• Follow up with your doctor for tests and treatment
• Use compression stockings as your doctor directs to prevent leg swelling

Contact your doctor at once if you have any signs or symptoms of DVT or PE.

TRAVEL TIPS

The risk of developing DVT while traveling is low. The risk increases if the travel time is longer than 4 hours or you have other DVT risk factors.

During long trips, it may help to:

• Walk up and down the aisles of the bus, train, or airplane. If traveling by car, stop about every hour and walk around.
• Move your legs and flex and stretch your feet to improve blood flow in your calves.
• Wear loose and comfortable clothing.
• Drink plenty of fluids and avoid alcohol.

If you have risk factors for DVT, your doctor may advise you to wear compression stockings while traveling. Or, he or she may suggest that you take a blood-thinning medicine before traveling.

Risk Factors

THE RISK FACTORS FOR DEEP VEIN THROMBOSIS (DVT) INCLUDE:

• A history of DVT.
• Conditions or factors that make your blood thicker or more likely to clot than normal. Some inherited blood disorders (such as factor V Leiden) will do this. Hormone therapy or birth control pills also increase the risk of clotting.
• Injury to a deep vein from surgery, a broken bone, or other trauma.
• Slow blood flow in a deep vein due to lack of movement. This may occur after surgery, if you’re ill and in bed for a long time, or if you’re traveling for a long time.
• Pregnancy and the first 6 weeks after giving birth.
• Recent or ongoing treatment for cancer.
• A central venous catheter. This is a tube placed in a vein to allow easy access to the bloodstream for medical treatment.
• Older age. Being older than 60 is a risk factor for DVT, although DVT can occur at any age.
• Overweight or obesity.
• Smoking.

Your risk for DVT increases if you have more than one of the risk factors listed above.

Causes

BLOOD CLOTS CAN FORM IN YOUR BODY’S DEEP VEINS IF:

• A vein’s inner lining is damaged. Injuries caused by physical, chemical, or biological factors can damage the veins. Such factors include surgery, serious injuries, inflammation, and immune responses.
• Blood flow is sluggish or slow. Lack of motion can cause sluggish or slow blood flow. This may occur after surgery, if you’re ill and in bed for a long time, or if you’re traveling for a long time.

Your blood is thicker or more likely to clot than normal. Some inherited conditions (such as factor V Leiden) increase the risk of blood clotting. Hormone therapy or birth control pills also can increase the risk of clotting.

Symptoms

The signs and symptoms of deep vein thrombosis (DVT) might be related to DVT itself or pulmonary embolism (PE). See your doctor right away if you have signs or symptoms of either condition. Both DVT and PE can cause serious, possibly life-threatening problems if not treated.

DEEP VEIN THROMBOSIS

Only about half of the people who have 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

Some people aren’t aware of a deep vein clot until they have signs and symptoms of PE. Signs and symptoms of PE include:

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

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

Diagnosis

Your doctor will diagnose deep vein thrombosis (DVT) based on your medical history, a physical exam, and test results. He or she will identify your risk factors and rule out other causes of your symptoms.

For some people, DVT might not be diagnosed until after they receive emergency treatment for pulmonary embolism (PE).

MEDICAL HISTORY

To learn about your medical history, your doctor may ask about:

• Your overall health
• Any prescription medicines you’re taking
• Any recent surgeries or injuries you’ve had
• Whether you’ve been treated for cancer

PHYSICAL EXAM

Your doctor will check your legs for signs of DVT, such as swelling or redness. He or she also will check your blood pressure and your heart and lungs.

DIAGNOSTIC TESTS

Your doctor may recommend tests to find out whether you have DVT.

The most common test for diagnosing deep vein blood clots is ultrasound. This test uses sound waves to create pictures of blood flowing through the arteries and veins in the affected leg. Your doctor also may recommend a D-dimer test or venography.

Treatment

Doctors treat deep vein thrombosis (DVT) with medicines and other devices and therapies.

MEDICINES

Your doctor may prescribe medicines to prevent or treat DVT.

Anticoagulants are the most common medicines for treating DVT. They’re also known as blood thinners. These medicines decrease your blood’s ability to clot. They also stop existing blood clots from getting bigger. However, blood thinners can’t break up blood clots that have already formed. (The body dissolves most blood clots with time.)

Blood thinners can be taken as a pill, an injection under the skin, or through a needle or tube inserted into a vein (called intravenous, or IV, injection).

Treatment for DVT using blood thinners usually lasts for 6 months. The following situations may change the length of treatment:

• If your blood clot occurred after a short-term risk (for example, surgery), your treatment time may be shorter.
• If you’ve had blood clots before, your treatment time may be longer.
• If you have certain other illnesses, such as cancer, you may need to take blood thinners for as long as you have the illness.

The most common side effect of blood thinners is bleeding. Bleeding can happen if the medicine thins your blood too much. This side effect can be life threatening. Sometimes the bleeding is internal (inside your body). People treated with blood thinners usually have regular blood tests to measure their blood’s ability to clot. These tests are called PT and PTT tests.

These tests also help your doctor make sure you’re taking the right amount of medicine. Call your doctor right away if you have easy bruising or bleeding. These may be signs that your medicines have thinned your blood too much.

GRADUATED COMPRESSION STOCKINGS

Graduated compression stockings can reduce leg swelling caused by a blood clot. These stockings are worn on the legs from the arch of the foot to just above or below the knee. Compression stockings are tight at the ankle and become looser as they go up the leg. This creates gentle pressure up the leg. The pressure keeps blood from pooling and clotting.

Talk with your doctor about how long you should wear compression stockings.