Deep Vein Thrombosis Causes, Symptoms, Diagnosis, Treatment, Prevention, Home Remedies

Deep Vein Thrombosis Causes, Symptoms, Diagnosis, Treatment, Prevention, Home Remedies


What is Deep Vein Thrombosis?


Deep vein thrombosis ( also called venous thrombosis) is a blood clot that develops in a vein deep in the body. The clot may partially or completely block blood flow through the vein. Most Deep Vein Thrombosis occur in the lower leg, thigh or pelvis, although they also can occur in other parts of the body including the arm, brain, intestines, liver or kidney.

Deep Vein Thrombosis Causes, Symptoms, Diagnosis, Treatment, Prevention, Home Remedies

Deep vein thrombosis can develop if you're sitting still for a long time, such as when traveling by plane or car, or if you have certain medical conditions that affect how your blood clots.

Deep vein thrombosis is a serious condition because a blood clot that has formed in your vein can break loose, travel through your bloodstream and lodge in your lungs, blocking blood flow (pulmonary embolism).

What is the danger of Deep Vein Thrombosis?


Even though Deep Vein Thrombosis itself is not life-threatening, the blood clot has the potential to break free and travel through the bloodstream, where it can become lodged in the blood vessels of the lung (known as a pulmonary embolism). This can be a life- threatening condition. Therefore, prompt diagnosis and treatment are necessary.

Deep Vein Thrombosis can also lead to complications in the legs referred to as chronic venous insufficiency or the post-thrombotic syndrome. This condition is characterized by pooling of blood, chronic leg swelling, increased pressure, increased pigmentation or discoloration of the skin, and leg ulcers known as venous stasis ulcers.

What is the difference between Deep Vein Thrombosis and a superficial venous thrombosis?


A superficial venous thrombosis (also called phlebitis or superficial thrombophlebitis) is a blood clot that develops in a vein close to the surface of the skin. These types of blood clots do not usually travel to the lungs unless they move from the superficial system into the deep venous system first.

What are the causes of Deep Vein Thrombosis?


Deep vein thrombosis sometimes occurs for no apparent reason. However, the risk of developing Deep Vein Thrombosis is increased in certain circumstances.

Inactivity 


When you are inactive, your blood tends to collect in the lower parts of your body, often in your lower legs. This is usually nothing to worry about because when you start to move, your blood flow increases and moves evenly around your body.

However, if you are immobile (unable to move) for a long period of time, such as after an operation, due to an illness or injury or during a long journey, your blood flow can slow down considerably. A slow blood flow increases the chances of a blood clot forming.

Blood vessel damage


If the wall of a blood vessel is damaged, it may become narrowed or blocked, which can result in the formation of a blood clot.

Blood vessels can be damaged by injuries such as broken bones or severe muscle damage. Sometimes, blood vessel damage that occurs during surgery can cause a blood clot, particularly in operations on the lower half of your body.

Conditions such as vasculitis (inflammation of the vein wall), varicose veins and some forms of medication, such as chemotherapy, can also damage blood vessels.

Medical and genetic conditions


Your risk of Deep Vein Thrombosis is increased if you have a condition that causes your blood to clot more easily than normal. These conditions include:
  • cancer (treatments such as chemotherapy and radiotherapy can increase this risk further)
  • lung and heart disease
  • infectious diseases such as hepatitis
  • inflammatory conditions such as rheumatoid arthritis
  • thrombophilia (a genetic condition that makes your blood more likely to clot) and 
  • Hughes syndrome (when your blood becomes abnormally "sticky") 

Pregnancy


Pregnancy makes your blood clot more easily. This is your body's way of preventing too much blood loss during childbirth. Around one in 1,000 pregnant women develops Deep Vein Thrombosis at some point during their pregnancy.

Contraceptive pill and hormone replacement therapy (HRT)


The combined contraceptive pill and hormone replacement therapy (HRT) both contain the female hormone oestrogen. Oestrogen causes the blood to clot slightly more easily, so your risk of getting Deep Vein Thrombosis is slightly increased. There is no increased risk from the progestogen-only contraceptive pill.

Other causes of Deep Vein Thrombosis


Your risk of developing Deep Vein Thrombosis is also increased if you or a close relative have previously had Deep Vein Thrombosis, and if you are:
  • overweight or obese
  • a smoker
  • dehydrated 
  • over 60 (particularly if you have a condition that restricts your mobility)

What are the signs and symptoms of Deep Vein Thrombosis?


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

Deep Vein Thrombosis


Only about half of the people who have Deep Vein Thrombosis 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
  • Enlargement of the superficial veins in the affected leg or arm

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:

  • (Sudden) shortness of breath
  • Sharp chest pain, often aggravated by coughing or movement
  • Pain in the back
  • Cough with or without bloody sputum
  • Excessive sweating
  • Rapid pulse or breathing
  • Lightheadedness or passing out
Some people only find out they have Deep Vein Thrombosis after the clot has moved from the leg or arm and traveled to the lung.

When to see a doctor


If you develop signs or symptoms of deep vein thrombosis, contact your doctor for guidance.

If you develop signs or symptoms of a pulmonary embolism — a life-threatening complication of deep vein thrombosis — seek medical attention immediately.

It is important to notify your doctor immediately or go to the emergency room if you have symptoms of a pulmonary embolism or Deep Vein Thrombosis. Do not wait to see if the symptoms will “go away.” Get treatment right away to prevent serious complications.

How is Deep Vein Thrombosis diagnosed?


Your doctor will ask you questions about your medical history and perform a physical exam as part of your diagnostic evaluation. Several tests will also be performed.

A duplex venous ultrasound


A duplex venous ultrasound is the most common test used to diagnose deep vein clots. It is used to evaluate the blood flow in the veins and to detect the presence and specific location of blood clots. During a venous ultrasound, the technologist applies pressure when scanning your arm or leg. If the vein does not compress with pressure, it may indicate a blood clot is present.

Venography


Venography is an X-ray procedure used to examine the deep veins. During the procedure, a contrast material (dye) is injected into the veins before the X-rays are taken. Venography may be performed if the Duplex ultrasound does not provide a clear diagnosis. The dye makes the vein and the blood clot visible on the x-ray. If the blood flow in the vein is blocked, it may also show on the x-ray.

Other tests that may be performed to detect a blood clot include:


Magnetic Resonance Imaging (MRI) or Magnetic Resonance Venography (MRV): MRI shows pictures of organs and structures inside the body, while MRV shows pictures of the blood vessels in the body. Radio waves are used in MRI and MRV to create the images. In many cases, MRI and MRV can provide information that may not show up on an x-ray. However, MRV is a more expensive technology and not always readily available.

Computed tomography (CT) scan is a type of x-ray that can provide pictures of structures inside the body. A CT scan may be used to diagnose deep vein thrombosis in the abdomen or pelvis, as well as blood clots in the lung to diagnose pulmonary embolism.

If your doctor suspects that an inherited disorder could be causing the clots, he or she may conduct a series of blood tests. This may be important if:

  • You have repeated blood clots that cannot be linked to any other cause
  • You have a blood clot in a vein at an unusual location, such as in a vein from the intestines, liver, kidney or brain
  • You have a strong family history of blood clots

How is Deep Vein Thrombosis treated?


Depending on your condition, you may be admitted to the hospital for Deep Vein Thrombosis treatment, or you may receive treatment on an outpatient basis.

Treatments include medications, compression stockings, elevation of the affected leg, and if the blood clot is extensive, more invasive diagnostic and treatment procedures. The main goals in treating deep vein thrombosis are to:

  • Stop the clot from getting bigger
  • Prevent the clot from breaking off in your vein and moving to your lungs
  • Reduce the risk of another blood clot
  • Prevent long term complications from the blood clot (chronic venous insufficiency or the post-thrombotic syndrome)

Medications for Deep Vein Thrombosis


There are several medications used to treat and/or prevent Deep Vein Thrombosis:

Anticoagulants (sometimes called blood thinners) decrease your blood’s ability to clot. They are used to stop clots from getting bigger and to prevent a blood clot from moving. They are also often used in patients who are hospitalized to prevent clots from forming. Anticoagulants do not break up blood clots that have already formed. Your body’s natural system may help dissolve the clot. In some cases, however, the clot will not completely dissolve.

Anticoagulants can either come as a pill, such as warfarin (Coumadin) or as an injection or shot, such as heparin or low molecular weight heparin [including enoxaparin sodium (Lovenox) or Fragmin (dalteparin sodium)]. A new medication called fondaparinux sodium (Arixtra) can also be used and is given as an injection.

Heparin (or low molecular weight heparin), fondaparinux and warfarin may be given at the same time. Heparin and fondaparinux will act quickly, while the warfarin will take 4 to 5 days before it starts to work. Once the warfarin is working, the other anticoagulants will be stopped, but usually only after a minimum of 4 to 5 days of combined therapy. Pregnant women cannot take warfarin and will be treated with heparin or low molecular weight heparin only.

Treatment for Deep Vein Thrombosis with anticoagulants usually lasts for 3 to 6 months. The following situations may change the length of treatment:

  • If your blood clot occurred after a short-term risk like surgery or trauma, your treatment with anticoagulants may be shorter
  • If you have had clots before, you may need longer treatment
  • If you are being treated for another illness (such as cancer), you may need to take an anticoagulant as long as the risk factor is present
The most common side effect of anticoagulants is bleeding. You should call your doctor right away if you are taking warfarin, heparin, low molecular weight heparin, or fondaparinux and experience easy bruising or bleeding.

Thrombolytics are medications given to quickly dissolve the blood clot. These medications are delivered through a catheter that is directed into the area of the clot. They are used to treat large clots causing severe symptoms. Because they increase the risk of bleeding, they are only used in special situations determined by your physician. These situations may include massive swelling of an arm or leg or in situations where a blood clot in the lungs (pulmonary embolism) has left the patient very short of breath or with low blood pressure.

Direct thrombin inhibitors are medications that interfere with the clotting process. They are used to treat some types of clots and may be prescribed for patients who cannot take heparin or low molecular weight heparins.

Compression Stockings


Your doctor should prescribe graduated compression stockings to reduce the chronic swelling that can occur in the leg after a blood clot has developed. The swelling often occurs because the valves in the leg veins have become damaged or the vein remains blocked from the blood clot.

Most compression stockings are worn just below the knee. These stockings are tight at the ankle and become more loose as they go up the leg. This causes gentle external compression (or pressure) on your leg.

Activity Guidelines


Once Deep Vein Thrombosis occurs, getting around may become more difficult at first. You should gradually return to your normal activities. If your legs feel swollen or heavy, lie in bed with your heels elevated 5 to 6 inches. This will help improve circulation and decrease your leg swelling.

In addition:

  • Exercise your lower leg muscles if you are sitting still for long periods of time.
  • Stand up and walk for a few minutes every hour while awake.
  • Don’t wear tight-fitting clothing that could decrease the circulation in your legs.
  • Wear compression stockings as recommended by your doctor.
  • Avoid activities that may cause a serious injury.

Prevention and Home Remedies for Deep Vein Thrombosis


You can take steps to prevent deep vein thrombosis and pulmonary embolism (PE). If you're at risk for these conditions:

  • See your doctor for regular checkups.
  • Take any prescribed medications as directed. If you're having surgery, such as orthopedic surgery, you'll probably be given blood thinners while you're in the hospital.
  • Check in with your doctor regularly to see if your medication or treatments need to be modified.
  • Watch how much vitamin K you're eating if you take blood thinners. Vitamin K can affect how drugs such as warfarin work. Foods high in vitamin K include green leafy vegetables and canola and soybean oils.
  • Exercise your lower calf muscles if you'll be sitting a long time. Whenever possible, get up and walk around. If you can't get up to walk around, try raising and lowering your heels while keeping your toes on the floor, then raising your toes while your heels are on the floor.
  • Move. If you've been on bed rest, because of surgery or other factors, the sooner you get moving, the less likely blood clots will develop.
  • Make lifestyle changes. Lose weight, quit smoking and control your blood pressure. Obesity, smoking and high blood pressure all increase your risk of deep vein thrombosis.
  • Wear compression stockings to help prevent blood clots in the legs if your doctor recommends them.
If you've had Deep Vein Thrombosis 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

Travelling


If you are at risk of getting a Deep Vein Thrombosis, or have had a Deep Vein Thrombosis previously, consult your GP before embarking on long-distance travel. If you are planning a long-distance plane, train or car journey (journeys of six hours or more), ensure that you:
  • drink plenty of water
  • avoid excessive alcohol as it can lead to dehydration
  • avoid taking sleeping pills as it can cause immobility
  • perform simple leg exercises, such as regularly flexing your ankles
  • take occasional short walks when possible
  • take advantage of refuelling stopovers where it may be possible to get out and walk about
  • wear elastic compression stockings

What are the complications of deep vein thrombosis?


Pulmonary embolism is the major complication of deep vein thrombosis. It can present with chest pain and shortness of breath and is a life-threatening condition. Most often pulmonary emboli arise from the legs.

Post-phlebitic syndrome can occur after a deep vein thrombosis. The affected leg can become chronically swollen and painful with skin color changes and ulcer formation around the foot and ankle.

When should I seek medical care for deep vein thrombosis?


The diagnosis of a superficial or deep thrombosis often relies on the clinical skill of the health care practitioner. Diagnostic tests need to be tailored to each situation.

Leg swelling, redness, and pain may be indicators of a blood clot and should not be ignored. These symptoms may be due to other causes (for example, cellulitis or infection), but it may be difficult to make the diagnosis without seeking medical advice.

If there is associated chest pain or shortness of breath, then further concern exists that a pulmonary embolus may be the cause. Once again, seeking immediate advice is appropriate.

Living With Deep Vein Thrombosis (Blood Clot in the Legs)


If you've had a deep vein blood clot, you're at greater risk for another one. During treatment and after:

  • Take steps to prevent deep vein thrombosis. 
  • Check your legs for signs of DVT. These include swollen areas, pain or tenderness, increased warmth in swollen or painful areas, or red or discolored skin on the legs.
  • Contact your doctor right away if you have signs or symptoms of Deep Vein Thrombosis.

Ongoing Health Care Needs


Deep Vein Thrombosis often is treated with blood-thinning medicines. These medicines can thin your blood too much and cause bleeding (sometimes inside the body). This side effect can be life threatening.

Bleeding can occur in the digestive system or the brain. Signs and symptoms of bleeding in the digestive system include:

  • Bright red vomit or vomit that looks like coffee grounds
  • Bright red blood in your stools or black, tarry stools
  • Pain in your abdomen
Signs and symptoms of bleeding in the brain include:

  • Severe pain in your head
  • Sudden changes in your vision
  • Sudden loss of movement in your arms or legs
  • Memory loss or confusion
If you have any of these signs or symptoms, seek medical care right away.

You might want to wear a medical ID bracelet or necklace that states you're at risk of bleeding. If you're injured, the ID will alert medical personnel of your condition.

Talk with your doctor before taking any medicines other than your Deep Vein Thrombosis medicines. This includes over-the-counter medicines. Aspirin, for example, also can thin your blood. Taking two medicines that thin your blood may raise your risk of bleeding.

Ask your doctor about how your diet affects these medicines. Foods that contain vitamin K can change how warfarin (a blood-thinning medicine) works. Vitamin K is found in green, leafy vegetables and some oils, like canola and soybean oils. Your doctor can help you plan a balanced and healthy diet.

Discuss with your doctor whether drinking alcohol will interfere with your medicines. Your doctor can tell you what amount of alcohol is safe for you.