Deep Vein Thrombosis

If blood moves too slowly through your veins, it can cause a clump of blood cells called a clot. When a blood clot forms in a vein deep inside your body, it causes what doctors call deep vein thrombosis (DVT).

Causes #

• Age - DVT can happen at any age, but your risk is greater after age 40.

• Sitting for long periods - When you sit for long stretches of time, the muscles in your lower legs stay lax. This makes it hard for blood to circulate, or move around, the way it should. Long flights or car rides can put you at risk.

• Bed rest, like when you’re in the hospital for a long time, can also keep your muscles still and raise your odds of DVT.

• Pregnancy - Carrying a baby puts more pressure on the veins in your legs and pelvis. What’s more, a clot can happen up to 6 weeks after you give birth.

• Obesity - People with a body mass index (BMI) over 30 have a higher chance of DVT. BMI is a measure of how much body fat you have, compared with your height and weight.

• Serious health issues - Conditions like irritable bowel disease, cancer, and heart disease can all raise your risk.

• Certain inherited blood disorders. Some diseases that run in families can make your blood thicker than normal or cause it to clot more than it should.

• Injury to a vein - This could result from a broken bone, surgery, or other trauma.

• Smoking makes blood cells stickier than they should be. It also harms the lining of your blood vessels. This makes it easier for clots to form.

• Birth control pills or hormone replacement therapy - The estrogen in these raises your blood’s ability to clot. (Progesterone-only pills don’t have the same risk.)

• Infection in your blood, veins, or elsewhere could lead to DVT.

• Inflammation - This could be due to infection, surgery, injury, or some other root cause.

• High cholesterol.

Symptoms #

Not everyone with DVT shows symptoms. But you might notice any of the following:

• Leg or arm swelling that comes on without warning

• Pain or soreness when you stand or walk

• Warmth in the area that hurts

• Enlarged veins

• Skin that looks red or blue

If a blood clot breaks free and moves through your bloodstream, it can get stuck in a blood vessel of your lung. Doctors call this a pulmonary embolism, or PE. It can be fatal.

Some people don’t know they have DVT until this happens. Signs of PE include:

• Shortness of breath

• Chest pain that’s worse when you take a deep breath

• Coughing up blood

• Higher heart rate

Diagnosis #

Duplex ultrasound #

This is the most common test for DVT. Ultrasound uses high-frequency sound waves that echo off the body—much like the technology used to check fetal well-being. This creates a picture of the blood vessels. Duplex ultrasound combines traditional ultrasound technology with Doppler technology, which generates a color image showing blood as it flows through the body.

Magnetic resonance imaging (MRI) scan #

An MRI produces detailed, cross-sectional images of structures inside the body, including blood vessels and veins. The test is painless and noninvasive. Although used infrequently, some doctors may use an MRI to locate blood clots in the pelvis and thigh.

MRI #

MRI allows both legs to be viewed at the same time. However, it cannot be used for patients with certain implanted devices, such as pacemakers.

Venography #

In venography, the doctor injects a contrast solution (or dye) into a vein. The solution mixes with the blood and flows throughout the veins. An x-ray of the affected leg will then show whether there are any blockages in the veins of the calf and thigh.

Prevention #

• 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.

• Don’t sit for too long. If you’re traveling for 4 hours or more, take breaks to flex and stretch your lower leg muscles. If you’re on a flight, walk up and down the aisle every hour. On long car drives, pull over every 2 hours to stretch. Wear loose-fitting clothes, and drink plenty of water.

• Plan surgery after-care. Talk to your doctor about what you can do to prevent DVT after surgery. They might suggest you wear compression stockings or take blood thinners. You’ll also want to get out of bed and start moving around.

Treatment #

Medicine #

Blood thinners are the most common medications used to treat DVT. They cut your blood’s ability to clot. You may need to take them for 6 months. If your symptoms are severe or your clot is very large, your doctor may give you a strong medicine to dissolve it. These medications, called thrombolytics, have serious side effects like sudden bleeding. That’s why they’re not prescribed very often.

Inferior vena cava (IVC) filter #

If you can’t take a blood thinner or if one doesn’t help, your doctor may insert a small, cone-shaped filter inside your inferior vena cava. That’s the largest vein in your body. The filter can catch a large clot before it reaches your lungs.

Compression stockings #

These special socks are very tight at the ankle and get looser as they reach your knee. This pressure prevents blood from pooling in your veins. You can buy some types at the drugstore. But your doctor might prescribe a stronger version that can be fitted by an expert.