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For the avoidance of doubt let me state that deep vein thrombosis is different from varicose veins. Varicose veins are superficial, visible, bulging veins, while Deep Vein Thrombosis (DVT) is a dangerous blood clot in deep veins, often showing swelling, warmth, and redness in one leg. Varicose veins are generally harmless cosmetic issues, whereas DVT is a medical emergency that can cause deadly pulmonary embolism.
DVT occurs when a blood clot (thrombus) forms in one or more of the deep veins in the body, usually in the legs. Deep vein thrombosis can cause leg pain or swelling. Sometimes there are no noticeable symptoms. You can get DVT if you have certain medical conditions that affect how the blood clots. A blood clot in the legs can develop if you don’t move for a long time. For example you might not move a lot when travelling a long distance or when you are on bed rest due to surgery, an illness or an accident.
Deep vein thrombosis can be serious because blood clots in the veins can break loose. The clots can then travel through the bloodstream and get stuck in the lungs, blocking blood flow (pulmonary embolism).
When DVT and pulmonary embolism occur together it is called Venous ThromboEmbolism (VTE)
Anyone can develop DVT, but it becomes more common over the age of 40. As well as age, there are also some other risk factors, including having a history of DVT or pulmonary embolism or if you have a family history of blood clots.
Also being inactive for long periods – such as after an operation or during a long journey as I mentioned earlier. When your blood vessels are damaged, the damaged walls can result in the formation of blood clots. Being pregnant can easily predispose you to DVT just as being overweight and obese.
There are certain conditions you must pay attention to so as not to develop DVT. Are you over 60? Are you overweight? Do you smoke?
Have you had DVT before? Do you take contraceptive pills or HRT?
Do you have heart failure or cancer? Do you have varicose veins?
Are you staying in or recently left the hospital, especially if you cannot move around much like after the operation? Do you go on regular long journeys that last more than three hours? Are you pregnant or have you just had a body in the previous six weeks? Are you dehydrated?
A DVT clot usually forms in the veins of your legs or arms. Up to 30% of people with DVT don’t have symptoms, but sometimes the symptoms are very mild and may not raise concern. Some people don’t know that they have a DVT until the clot moves from the leg or arm and travels to their lungs. Symptoms of acute pulmonary embolism include chest pain, shortness of breath, cough with blood, lightheadedness and fainting.
It is important to consult your doctor, right away or go to the emergency room if you have symptoms of DVT. Do not wait to see if your symptoms will go away. Get treatment right away to prevent serious complications.
If a person suspects that he may have DVT, they should seek immediate medical attention. The doctor will ask questions about symptoms and medical history before carrying out a physical examination.
A doctor will usually not be able to diagnose DVT through symptoms alone and may recommend tests like D-dimer test, this is a protein fragment that is present in the blood clot. A test result revealing more than a certain amount of D-dimer indicates a possible blood clot. However, this test may not be reliable in individuals with certain Ultrasound scans that can detect clots in veins, alterations in blood flow and whether the clot is acute or chronic.
A doctor may request a venogram scan if the ultrasound and D-dimer tests do not provide enough information. The doctor injects a dye into a vein in the foot, knee or groin. X-ray images can track the dye as it moves to reveal the location of a blood clot.
Magnetic Resonance Imaging (MRI) and computerised Tomography (CT scan) may highlight the presence of clots. These Scans may identify blood clots while testing for other health conditions.
Three major goals to DVT treatment are, to prevent the clot from getting bigger, to prevent the clot from breaking loose and traveling to the lungs, and to reduce the chances of another DVT.
Blood thinners may be by mouth or given by IV or an injection under the skin. There are many different types of blood-thinning drugs used to treat DVT.
Together you and your doctor will discuss their benefits and risks to determine thinner pills for three months or longer. It is important to take them exactly as prescribed, to prevent serious side effects.
People who take blood thinners, called warfarin (Jantoven), need regular blood tests to monitor levels of the drug in the body. Certain blood thinning medications are not safe to take during pregnancy. Clot busters (thrombolytics) are drugs used for more-serious types of DVT, or pulmonary embolism or if other medications are not working. Clot busters are given by IV or through a tube (catheter) placed directly into the clot. They cause serious bleeding, so they are usually only used for people with severe clots.
If you cannot take medicines to thin your blood, a filter may be placed into a large vein – the vena cava – in your belly (abdomen). A vena cava filter prevents clots that break loose from lodging in the lungs.
Support stockings (compression stocking) are special knee socks that help prevent blood from pooling in the legs. They help reduce leg swelling. Wear them on your legs from your knees. For DVT; you typically wear these stockings during the day for a few years if possible.
Simple lifestyle changes may help lower your odds of getting one.
Take care of yourself, stop smoking, lose weight and get active. Get regular checkups and if your doctor has prescribed a medicine to control a health problem take it as directed.
Do not sit too long if you are traveling for four hours or more, take breaks to flex and stretch your lower leg muscles.
On long car drives, pull over every two hours to stretch your legs. Talk to your doctor on what you can do to prevent DVT after surgery. The doctor might suggest you wear compression stockings or take blood thinners. You will also want to get out of bed and start walking around.
•Always be medically guided.
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