The topic this month is an overview of Deep Vein Thrombosis/DVT. It occurs when a thrombus (blood clot) develops in veins deep in your body because your veins are injured or the blood flowing through them is too sluggish. Blood clots may partially or completely block blood flow. Most DVTs happen in lower legs, thighs or pelvis, but can occur in other parts of the body including arms, brain, intestines, liver or kidney. As many as half of those who get a DVT in their legs develop symptoms of intermittent leg pain and swelling that may last months to years because of damage to the valves and inner lining of the veins that leads to blood “pooling” more than it should.
Even though a DVT may itself not be life-threatening, blood clots have the potential to break free and travel through your bloodstream. A pulmonary embolus (PE) happens when the traveling blood clots/emboli become lodged in the blood vessels of the lung. Since this can be a life-threatening condition, a quick diagnosis and treatment is needed.
There is a difference between a DVT and a superficial venous thrombosis. A superficial venous thrombosis, called “phlebitis” occurs when blood clots develop in a vein close to the surface of your skin. These types of blood clots rarely travel to your lungs unless they move from the superficial system into the deep venous system.
Potential risks for developing a DVT: (a) genetic/family history; (b) having cancer and chemotherapy; (c) deep vein “damage” due to an injury, surgery or immobilization – not moving or sitting for long periods of time, i.e., in a car, bus, train, airplane trip, or being immobile after surgery; (d) being overweight; (e) having an autoimmune disease, i.e., lupus, vasculitis; (f) inflammatory bowel disease; (g) smoking; (h) having varicose veins; (i) taking hormone therapy; (j) having a central venous catheter or pacemaker; (k) having COVID-19.
Symptoms of an acute DVT include: chronic arm/leg swelling/pain, warmer than usual – sometimes occurring suddenly, arm/leg tenderness – may only happen when standing or walking, skin that’s red/discolored, leg ulcers – “venous stasis ulcers,” veins near your skin’s surface may be larger than normal, abdominal/flank pain when blood clots affect the veins deep inside your abdomen, severe headache – usually sudden onset, and/or seizures when blood clots affect the veins in the brain. IF you have leg cramps DO NOT massage your leg(s) as you are at risk of getting a possible clot moving.
It’s the third most common vascular disease causing death. It can occur at any age, although it is more common in adults over 60. More than half of all DVTs happen as a result of being in the hospital for a medical illness or following surgery. The reason is being immobilized in bed. That is why they put compression stockings on you. Some people don’t know they have a DVT until the clot moves from their leg or arm and travels to their lung. Symptoms of acute PE can include chest pain, shortness of breath, cough with blood, and light-headedness/fainting. It’s important to call your doctor right away or go to the emergency room if you have symptoms of a DVT. Don’t wait to see if your symptoms go away. Get treatment right away to prevent serious complications.
To help determine if you have a DVT/PE, a physical exam, review of medical history, and possible imaging tests (venous ultrasound, CT scan or an MRI) may be performed. If your doctor thinks you may have a genetic or acquired clotting disorder, you may need to have specialized blood tests. You may be hospitalized for treatment if your condition cannot be treated as an outpatient, depending on the severity of the situation.
Treatment may include: (a) medications to decrease the risk of clot formation; (b) wearing compression stockings; (c) elevating your affected leg(s) throughout the day, not sitting for long periods of time (like at the computer!) If prescribed medications take exactly as prescribed. Don’t stop or start taking any medication (including any supplements) without asking your provider. You may need to make medication changes, depending on the medication you take. If you are prescribed an anticoagulant medication, bleeding is the most common side effect. Call your doctor immediately if you notice that you bruise/bleed easily, see bright blood in your urine, vomit or bowel movement. Keep your follow-up doctor appointments andordered laboratory testing. Blood tests may be ordered to monitor the effectiveness of the anti-coagulant. If you are having any surgical or dental procedures, tell that health provider aboutallofyour medications especially if on an anticoagulant. You may need to make dietary changes, depending on the medication you take. This is a serious medical condition. Take it seriously.
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