A deep vein thrombosis (DVT) is a clot that forms in a vein, frequently in the lower legs, thigh or pelvis. The DVT prevents blood flow out of the extremity which results in pain and swelling. The danger of a DVT occurs when a part or the entire clot breaks free, travels through the body and blocks blood flow to the lungs. When it lodges in the lung it is called a pulmonary embolism.
There are several risk factors for developing a DVT which include inherited and acquired causes. Inherited thrombophilias are group of genetic disorders that allow the blood to clot more easily than usual. These comprise protein C or S and antithrombin deficiencies or factor V Leiden or prothrombin gene mutations. These are usually discovered when someone has a DVT without a known cause such as surgery or prolonged periods of inactivity. Some individuals also have an increased amount of clotting factors such as factor VIII.
Other conditions that increase the DVT risk are: cancer, smoking, obesity, pregnancy, increased age, medications (birth control pills, hormone replacement therapy, tamoxifen), heart failure and kidney disease. Surgeries of the knee, hip and pelvis along with prolonged periods of inactivity during recovery or long trips without movement also increase the risk of a DVT.
A DVT is diagnosed by a complete history, physical examination, blood tests (D-dimer which is elevated), compression ultrasonography, contrast venography, magnetic resonance imaging (MRI) and computed tomography (CT scan). Once discovered the DVT is treated with anti-coagulation medications (heparin, low molecular weight heparin, fondaparinux, and coumadin), thrombolytic therapy or a filter placed in the inferior vena cava to "catch" a clot should it break loose. The duration of medical treatment could be as short as three months or indefinitely but it depends on the cause of the clot.
Prevention of DVTs is paramount to avoid the complication of a pulmonary embolism. If a patient will be undergoing a surgery and is at a high risk for developing a DVT anticoagulants can be given to decrease the risk. Also, after surgery some patients will use inflatable spontaneous compression devices that fit around the calf. These appliances inflate and deflate promoting circulation of the blood therefore decreasing the DVT risk.
Travelers who will be sitting for prolonged periods of time should also take precautions to avoid DVT formation. First, move around often as possible at least once per hour including flexing and extending the foot. Other suggestions include: stop smoking, don't wear tight clothing, wear knee high stockings and stay hydrated.
If you have any concerning symptoms or at a high risk for developing a DVT, please speak to your healthcare provider as soon as possible.
What You Need to Know About Deep Vein Thrombosis
Nov 18, 2009 | By
