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What Is Deep Vein Thrombosis?

Deep vein thrombosis (DVT) is an illness that develops when the blood clots in a vein. Affected veins are usually deep in leg muscles but can also be in other areas. The clot (thrombus) causes blood flow to slow. The area becomes swollen, red, and painful. If the clot moves to the lungs, a pulmonary embolism (blocked vein in the lungs) occurs and life threatening breathing problems can develop.

DVT most often affects people who are physically inactive, elderly, pregnant, or have blood disorders that increase the risk of blood clotting.

What Causes DVT?

Prolonged bed rest (more than 3 days), recent surgery (with anesthesia for more than 30 minutes), smoking, being overweight, air or car travel for prolonged periods, using certain oral contraceptives and estrogen replacement therapies, cancer, and family or personal history of blood clotting problems can increase the risk of DVT.

What Are the Symptoms of DVT?

Symptoms are pain, tenderness, warmth, swelling, and redness in the area. Initially there may be no symptoms.

How Is DVT Diagnosed?

The health care provider will ask about symptoms and do an examination. If DVT is suspected, the health care provider may recommend a sonogram (ultrasound) of the swollen leg or other part to measure blood flow in the area and a blood test (D-dimer). Only in rare cases when the diagnosis is suspected but sonogram and blood tests are inconclusive, the health care provider may also order a special x-ray study (venography) in which a dye is injected into the vein to see whether a clot is blocking blood flow.

How Is DVT Treated?

Treatment is immediate injection of a blood thinner (heparin) to thin the blood and prevent growth of blood clots. Heparin can be given intravenously or injected under the skin (subcutaneously). Your health care provider will decide which option is best for you. The health care provider will also prescribe blood thinning pills (warfarin) to prevent the clot from enlarging and stop new ones from forming. For a few days, both heparin and warfarin are given. When warfarin reaches the desired level in blood, heparin will be stopped and warfarin will be continued, usually for 3-6 months, at times longer, depending on the cause of the DVT. Lifetime treatment may sometimes be needed. Blood tests to make sure that the warfarin dose is correct must be done. Instead of warfarin, you may be prescribed newer blood thinners such as rivaroxaban (Xarelto) or apixaban (Eliquis); these medications do not require periodic blood tests to monitor levels.

The health care provider may also recommend special stockings to control swelling in the legs. Overweight people should lose weight and become more active to prevent future clots.

DOs and DON’Ts in Managing DVT:

  • DO take medicine and go for the blood tests (INR) as directed by your health care provider to monitor the blood thinner level if you are taking warfarin.
  • DO follow your doctor’s advice about losing weight and exercising more to lower your risk of recurrence of DVT.
  • DO walk around and stretch your legs if you sit for long periods
  • DO call your health care provider if your symptoms don’t get better.
  • DO call your health care provider immediately if you have chest pain or cough up blood.
  • DO call your health care provider before you go on a long trip and ask your health care provider about taking aspirin if you are no longer taking warfarin or other blood thinners.
  • DO try to keep your legs elevated when sitting or lying down.
  • DON’T stand or sit in one spot for a long time.
  • DON’T wear clothing that restricts blood flow in your legs.
  • DON’T smoke.
  • DON’T participate in contact sports when taking blood thinners because you’re at risk of bleeding from trauma.

Contact the following sources:

  • The Center for Outcome Research and the Venous Education Institute of North America (VEIN)
  • The American Heart Association
    Tel: (800) 242-8721

Copyright © 2016 by Saunders, an imprint of Elsevier, Inc.

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