What are the signs of deep vein thrombosis. How is DVT diagnosed and treated. Can deep vein thrombosis be prevented. What are the risk factors for developing blood clots in leg veins. How long does it take for a DVT to resolve. What complications can arise from untreated DVT.

Understanding Deep Vein Thrombosis (DVT)

Deep vein thrombosis (DVT) is a serious medical condition characterized by the formation of blood clots in the deep veins of the body, typically in the legs. These clots can pose significant health risks if left untreated, potentially leading to life-threatening complications such as pulmonary embolism. While DVT itself is not immediately life-threatening, its potential consequences make early detection and prompt treatment crucial.

DVT occurs when blood clots form in one or more of the deep veins, most commonly in the legs but occasionally in the arms. The condition is often underdiagnosed, which underscores the importance of awareness and vigilance regarding its symptoms and risk factors.

The Prevalence and Impact of DVT

DVT affects a considerable number of individuals worldwide, with varying prevalence rates across different populations. Its impact extends beyond immediate health concerns, often resulting in long-term complications and reduced quality of life for those affected. Understanding the nature of DVT, its symptoms, and risk factors is essential for both prevention and timely intervention.

Recognizing the Symptoms of Deep Vein Thrombosis

Identifying the symptoms of DVT is crucial for early detection and treatment. However, it’s important to note that DVT can sometimes occur without any noticeable symptoms, making regular check-ups and awareness of risk factors all the more important.

Common Symptoms of DVT

• Swelling in one leg (rarely in both legs)
• Pain or tenderness in the affected leg
• Skin discoloration, often appearing red or darker than usual
• Warmth in the affected area

These symptoms typically manifest in the calf or thigh of the affected leg. While not all individuals with DVT will experience all of these symptoms, the presence of one or more should prompt medical consultation.

Warning Signs of Pulmonary Embolism

A potentially life-threatening complication of DVT is pulmonary embolism, which occurs when a blood clot breaks loose and travels to the lungs. Recognizing the signs of pulmonary embolism is critical, as it requires immediate medical attention.

• Sudden shortness of breath
• Chest pain that worsens with deep breathing
• Rapid pulse
• Dizziness or fainting
• Coughing up blood

If you experience any of these symptoms, especially in combination with signs of DVT, seek emergency medical care immediately.

Causes and Risk Factors of Deep Vein Thrombosis

Understanding the causes and risk factors associated with DVT is essential for prevention and early intervention. Various medical conditions, lifestyle factors, and circumstances can contribute to the development of blood clots in deep veins.

Medical Conditions Associated with DVT

• Inherited blood clotting disorders
• Cancer and certain cancer treatments
• Heart failure
• Inflammatory bowel diseases (e.g., Crohn’s disease, ulcerative colitis)
• Obesity

Lifestyle and Environmental Factors

• Prolonged immobility (e.g., long hospital stays, bed rest)
• Long periods of sitting (e.g., during air travel or car trips)
• Smoking
• Use of birth control pills or hormone replacement therapy
• Pregnancy and the postpartum period

Age is also a significant risk factor, with individuals over 60 being at higher risk for DVT. However, it’s important to note that DVT can occur at any age, especially in the presence of other risk factors.

Diagnosis and Treatment of Deep Vein Thrombosis

Prompt diagnosis and treatment of DVT are crucial for preventing complications and ensuring the best possible outcomes. Healthcare providers employ various diagnostic tools and treatment strategies to address DVT effectively.

Diagnostic Methods for DVT

• Duplex ultrasound: A non-invasive imaging technique to visualize blood flow in veins
• D-dimer blood test: Measures a substance released when blood clots break down
• Venography: An X-ray procedure using contrast dye to visualize veins
• CT or MRI scans: Advanced imaging techniques for detailed views of blood vessels

Treatment Options for DVT

The primary goals of DVT treatment are to prevent the clot from growing, reduce the risk of pulmonary embolism, and minimize the likelihood of recurrence. Common treatment approaches include:

1. Anticoagulants (blood thinners): Medications such as heparin, warfarin, or newer direct oral anticoagulants (DOACs) to prevent clot growth and formation
2. Thrombolytics: Clot-dissolving medications used in severe cases or when other treatments are ineffective
3. Compression stockings: To reduce swelling and improve blood flow in the affected limb
4. Inferior vena cava (IVC) filters: Implanted devices to prevent clots from reaching the lungs, used in patients who cannot take anticoagulants

Treatment duration varies depending on the individual case, but typically lasts for at least three months. Some patients may require long-term or even lifelong anticoagulation therapy.

Prevention Strategies for Deep Vein Thrombosis

While not all cases of DVT can be prevented, there are several strategies individuals can employ to reduce their risk, especially those with known risk factors.

Lifestyle Modifications

• Maintain a healthy weight through proper diet and regular exercise
• Stay active and avoid prolonged periods of immobility
• Quit smoking and limit alcohol consumption
• Stay hydrated, especially during long trips

Travel Precautions

For individuals embarking on long journeys, particularly air travel, the following precautions can help reduce the risk of DVT:

• Perform simple leg exercises while seated
• Walk and stretch during breaks or layovers
• Wear loose, comfortable clothing
• Consider wearing compression stockings for flights longer than 4 hours

Medical Interventions

In some cases, healthcare providers may recommend preventive measures for high-risk individuals:

• Prophylactic anticoagulation for hospitalized patients or those undergoing surgery
• Careful monitoring and management of underlying conditions that increase DVT risk
• Personalized risk assessment and prevention strategies for pregnant women

Long-Term Management and Complications of DVT

Managing DVT extends beyond the initial treatment phase. Long-term care and monitoring are essential to prevent recurrence and address potential complications.

Post-Thrombotic Syndrome

Post-thrombotic syndrome (PTS) is a common long-term complication of DVT, affecting up to 50% of patients. Symptoms of PTS include:

• Chronic pain and swelling in the affected limb
• Skin discoloration and hardening
• Venous ulcers in severe cases

Management of PTS focuses on symptom relief and prevention of further complications through compression therapy, leg elevation, and, in some cases, surgical interventions.

Recurrence Prevention

Preventing DVT recurrence is a crucial aspect of long-term management. Strategies may include:

• Continued use of anticoagulants as prescribed by healthcare providers
• Regular follow-up appointments to assess treatment efficacy and adjust as needed
• Ongoing lifestyle modifications to minimize risk factors
• Use of compression stockings to improve circulation and reduce swelling

Monitoring for Complications

Patients with a history of DVT require vigilant monitoring for potential complications, including:

• Signs of pulmonary embolism
• Development of post-thrombotic syndrome
• Bleeding complications from anticoagulant therapy

Regular check-ups and open communication with healthcare providers are essential for effective long-term management of DVT.

Advances in DVT Research and Treatment

The field of DVT research is continually evolving, with new developments in diagnosis, treatment, and prevention emerging regularly. These advancements offer hope for improved outcomes and quality of life for individuals affected by DVT.

Novel Anticoagulants

Recent years have seen the introduction of direct oral anticoagulants (DOACs), which offer several advantages over traditional anticoagulants like warfarin:

• More predictable anticoagulant effects
• Fewer food and drug interactions
• Reduced need for regular blood monitoring
• Potentially lower risk of bleeding complications

Ongoing research continues to refine these medications and explore their potential in various patient populations.

Improved Diagnostic Techniques

Advancements in imaging technologies and biomarker analysis are enhancing the accuracy and efficiency of DVT diagnosis. Emerging techniques include:

• Point-of-care ultrasound for rapid bedside assessment
• Advanced MRI protocols for detailed vein visualization
• Novel blood tests for more precise risk stratification

Personalized Treatment Approaches

The future of DVT management lies in personalized medicine, tailoring treatment strategies to individual patient characteristics and risk profiles. This approach may involve:

• Genetic testing to identify inherited thrombophilia
• Risk assessment models incorporating multiple factors
• Tailored anticoagulation regimens based on individual patient needs

These advancements promise to improve treatment outcomes and reduce the burden of DVT-related complications.

Living with DVT: Patient Perspectives and Support

Coping with DVT extends beyond medical management, encompassing emotional, social, and practical challenges. Understanding the patient experience is crucial for comprehensive care and support.

Emotional Impact

A DVT diagnosis can have significant psychological effects on patients, including:

• Anxiety about recurrence or complications
• Depression related to lifestyle changes or physical limitations
• Fear of anticoagulant-related bleeding

Addressing these emotional aspects is essential for overall well-being and treatment adherence.

Support Systems

Various support systems can help individuals navigate life with DVT:

• Patient support groups for sharing experiences and coping strategies
• Educational resources provided by healthcare organizations
• Counseling services for managing anxiety and depression
• Family and caregiver education to enhance understanding and support

Adapting to Lifestyle Changes

Living with DVT often requires lifestyle adjustments. Patients may need to:

• Incorporate regular exercise while managing activity restrictions
• Adapt travel plans to accommodate DVT prevention strategies
• Navigate dietary considerations, especially when on certain anticoagulants
• Balance work and daily activities with treatment requirements

Healthcare providers play a crucial role in guiding patients through these adaptations, ensuring a balance between DVT management and quality of life.

As research continues to advance our understanding of deep vein thrombosis, the outlook for prevention, diagnosis, and treatment continues to improve. By staying informed about the latest developments and working closely with healthcare providers, individuals affected by DVT can look forward to better outcomes and improved quality of life. The journey with DVT may be challenging, but with proper care, support, and ongoing advancements in medical science, it is a condition that can be effectively managed, allowing patients to lead fulfilling lives while minimizing risks and complications.

What Is DVT (Deep Vein Thrombosis): Symptoms, Causes, Diagnosis, Treatment, and Prevention

Deep vein thrombosis (DVT) is caused by a blood clot that forms in one or more of the deep veins in your body, typically in your legs. Clots can also occur in the arms.

DVT can be serious and is often underdiagnosed, according to the Centers for Disease Control and Prevention (CDC).

The condition itself is not life-threatening, according to the Cleveland Clinic, but blood clots in the veins can break loose and move to the lungs, causing a potentially life-threatening pulmonary embolism.

When this happens, the clot blocks blood flow to the lungs, which can be fatal, making it imperative to get prompt diagnosis and lifesaving treatment.

Fortunately, DVT is preventable and treatable if detected early.

Signs and Symptoms of DVT

If you have DVT, you may experience discomfort in your leg. However, the condition can occur without any symptoms.

According to the Mayo Clinic, signs of DVT can include:

• Swelling in one leg (it’s rare that swelling would occur in both legs)
• Pain in the affected leg
• Skin that is red or discolored on the affected leg
• Skin that is warm to the touch on the affected leg

If you see signs or symptoms of DVT, talk to your doctor. If you have symptoms of a pulmonary embolism, seek emergency medical assistance immediately.

According to the Mayo Clinic, signs of a pulmonary embolism include the following:

• Unexplained or sudden shortness of breath
• Chest pain or discomfort that worsens when you take a deep breath or cough
• Dizziness or fainting
• Rapid pulse
• Coughing up blood

Causes and Risk Factors of DVT

Deep vein thrombosis can result from certain medical conditions that affect how your blood clots, according to the Mayo Clinic:

• Inherited blood clot disorders
• Medical treatment requiring long hospital stays or bed rest
• Paralysis
• Injuries to the legs that affect the veins
• Being overweight or obese
• Use of birth control pills or hormone replacement therapy
• Pregnancy
• Cancer
• Congestive heart failure
• Inflammatory bowel disease (Crohn’s disease or ulcerative colitis)

Some types of cancer or cancer treatment may increase levels of certain substances in your blood that cause clots.

If you have heart failure, you are at an increased risk for DVT and pulmonary embolism due to limited heart and lung function.

Being overweight or obese increases the pressure in the veins of your legs and pelvis, raising the risk of clots.

This risk increases during pregnancy (women with an inherited clotting disorder are at higher risk) and for up to six weeks after giving birth. Using birth control pills (oral contraceptives) or hormone replacement therapy can also increase your blood’s clotting abilities.

Smoking adversely affects blood clotting and circulation, which can increase your risk of DVT.

If you or someone in your family has had DVT or a pulmonary embolism before, you are more likely to develop DVT.

Being over 60 increases your risk of DVT, even though it can occur at any age.

Finally, sitting for long periods of time (as in airplane travel or long car trips) can increase your risk for DVT.

Blood clots may form in your calves if the muscles aren’t moved for extended periods.

Duration of DVT

It’s possible to have DVT and have no symptoms. However, if you do have symptoms of DVT, it’s important to get a diagnosis and treatment quickly. According to the American Academy of Family Physicians, it takes three to six months for a blood clot to go away.

If DVT leads to a pulmonary embolism, patients will need to take medication regularly for at least for three months and up to an indefinite period of time, according to the American Lung Association.

Treatment and Medication Options for DVT

According to the CDC, treatments for DVT include the following options:

Anticoagulants

Anticoagulants, or blood thinners, are usually the first-choice treatment for DVT. Although anticoagulants don’t break up existing clots, they can prevent the clot from growing in size and prevent new clots from forming.

When you start anticoagulation therapy by injection, your doctor will often administer the first few doses, after which you may be able to administer the injections on your own.

Injectable blood thinners include these examples:

• Lovenox (enoxaparin)
• Fragmin (dalteparin)
• Aritxtra (fondaparinux)
• Heparin

If your doctor prescribes oral anticoagulation therapy — such as Coumadin (warfarin), Xarelto (rivaroxaban), Eliquis (apixaban), or Savaysa (exoxaban) — you will typically take these medications for three months or longer.

Your doctor may recommend regular blood tests to check how long it takes for your blood to clot. All blood thinners must be taken as prescribed to avoid serious side effects.

Thrombolytics

Also known as tissue plasminogen activators, thrombolytics are given intravenously (by IV) or through a catheter positioned near an existing blood clot. They are designed to break up clots.

Thrombolytics can cause serious bleeding. They are used only in life-threatening situations and only if you are hospitalized.

Filters

If you are unable to take blood thinners for any reason, your doctor may recommend a minor surgical procedure in which a filter is inserted into a large vein in your abdomen, known as the inferior vena cava.

This filter is designed to prevent any clots that break loose from traveling to your lungs.

Surgery and Socks

In rare cases, clots may need to be removed by surgery.

Finally, wearing compression stockings on your legs can help prevent swelling associated with DVT. The pressure they create lowers the risk of blood pooling and clotting.

Related Conditions and Causes of DVT

Being overweight or obese greatly increases the risk of DVT. According to the American Heart Association, people who are obese have twice the risk of blood clots than those who are a healthy weight.

Pregnancy also increases the risk of DVT. According to the CDC, pregnant women are 5 times more likely to get a blood clot than women who are not pregnant.

The risk remains during pregnancy, through childbirth, and up to three months after delivery.

Pregnancy increases the risk of DVT for a number of reasons. A woman’s blood clots more easily during pregnancy to prevent excess blood loss during labor and for a period of time after delivery, according to the CDC.

Later in pregnancy, the extra weight from the growing baby puts pressure on the pelvis and can decrease blood flow to the legs. Finally, pregnant women may have limited mobility during pregnancy and after delivery, which can increase the risk of blood clots.

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Deep Vein Thrombosis | Kaiser Permanente

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Condition Basics

What is deep vein thrombosis (DVT)?

Deep vein thrombosis (DVT) is a blood clot (thrombus) in a deep vein, usually in the legs. These clots require medical care right away.

These clots are dangerous because they can break loose, travel through the bloodstream to the lungs, and block blood flow in the lungs (pulmonary embolism). Pulmonary embolism is often life-threatening. DVT can also lead to long-lasting problems. It may damage the vein and cause the area near the clot to ache, swell, and change color.

Blood clots most often form in the calf and thigh veins, and less often in the arm veins or pelvic veins. Diagnosis and treatment of DVT in other parts of the body are similar.

What causes it?

Causes of a blood clot in a deep vein (DVT) include slowed blood flow, which can happen when you’re not active for long periods of time, and abnormal clotting problems, which make the blood clot too easily or too quickly. Surgery or an injury to the blood vessels can also cause a blood clot.

What are the symptoms?

Symptoms of DVT include swelling of the affected leg or arm. The leg or arm may swell, feel warm, or look red. The calf or thigh may ache or feel tender. Pain may get worse and last longer or become constant. If a blood clot is small, it may not cause symptoms.

How is it diagnosed?

If your doctor thinks that you have DVT, you probably will have an ultrasound test to measure the blood flow through your veins and help find any clots that might be blocking the flow. You will also have a physical exam, and the doctor will ask you questions about your past health.

How is DVT treated?

Treatment for DVT usually involves taking blood thinners (anticoagulants) for at least 3 months. How long you take them depends on your health, where the blood clot is, and your risk for a pulmonary embolism. At home, you can take walks and you can prop up or elevate your leg or arm.

How can you prevent DVT?

To help prevent DVT, you might take an anticoagulant medicine. After an illness or surgery, you can try to get up and out of bed often. You might wear compression stockings. You may try leg exercises that can help blood flow.

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Cause

Causes of a blood clot in a deep vein (DVT) include:

• Slowed blood flow. This can happen when you’re not active for long periods of time. For example, clots can form if you are paralyzed, are confined to bed, or must sit while on a long flight or car trip.
• Abnormal clotting problems that make the blood clot too easily or too quickly. This may be caused by certain health problems, such as cancer or a genetic clotting disorder. Pregnancy, hormonal birth control, and hormone therapy can also make blood more likely to clot.
• Surgery or an injury to the blood vessels. Blood is more likely to clot in veins shortly after they are injured.

What Increases Your Risk

Many things increase your risk for DVT. These include:

• Being older than 40.
• Being overweight.
• Not taking anticoagulant medicine as prescribed.
• Having to stay in bed for more than 3 days (such as in a hospital).
• Sitting for a long time, especially when traveling long distances.
• Being pregnant, using hormonal birth control, or using hormone therapy.
• Having a recent surgery or injury that involved the legs, hips, belly, or brain.
• Having certain health problems, such as cancer, blood vessel disease, or an inherited clotting disorder.
• Smoking.

Prevention

• Exercise your lower leg muscles to help blood flow in your legs. Point your toes up toward your head so the calves of your legs are stretched, then relax and repeat. This is a good exercise to do when you are sitting for long periods of time.
• Get out of bed as soon as you can after an illness or surgery. If you need to stay in bed, do the leg exercise noted above every hour when you are awake.
• Use special stockings called compression stockings. These stockings are tight at the feet with a gradually looser fit on the leg. Many doctors recommend that you wear compression stockings during a journey longer than 8 hours.
• Take breaks when you are on long trips. Stop the car and walk around. On long airplane flights, walk up and down the aisle hourly, and flex and point your feet every 20 minutes while sitting.
• Take blood-thinning medicines after some types of surgery if your doctor recommends it. Blood thinners also may be used if you are likely to develop clots.

Learn more

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• How to Put on Compression Stockings
• Preventing Deep Vein Thrombosis (DVT) in the Hospital
• Deep Vein Thrombosis: 7 Ways to Help Prevent DVT

Symptoms

DVT often doesn’t cause symptoms. Or it may cause only minor ones. When symptoms happen, they include:

• Swelling in the affected area of the leg or arm.
• Redness and warmth in the affected area.
• Pain or tenderness. You may have pain only when you touch the affected area or when you stand or walk.

Sometimes a pulmonary embolism is the first sign that you have DVT.

If your doctor thinks you may have DVT, you will probably have an ultrasound test. You may have other tests as well.

What Happens

A blood clot in a deep vein (DVT) may break loose. It if does, it can travel to the lungs and block blood flow (pulmonary embolism). This is an emergency.

The risk of a pulmonary embolism can depend on the location of the blood clot. A pulmonary embolism is more likely if a blood clot is at or above the knee than if it is in the calf. But a blood clot in a calf also has a chance of causing a pulmonary embolism.

After the first time you have DVT, there is a risk of having blood clots again. Your risk can depend on what caused the clot and how it was treated. Your doctor will treat you to try to prevent clots from happening again.

If you have had DVT, you have a risk of a painful complication called post-thrombotic syndrome. Anticoagulant medicine may help lower the risk of this complication.

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When to Call a Doctor

Call 911 or other emergency services if you have pulmonary embolism symptoms, including:

• Sudden shortness of breath.
• Sharp chest pain that sometimes gets worse with deep breathing or coughing.
• Coughing up blood.
• Fainting.
• Rapid pulse or irregular heartbeat.
• Anxiety or sweating.

Call your doctor now if you have DVT symptoms, including:

• Swelling, warmth, or tenderness in the soft tissues of your leg. Swelling may also appear as a swollen ridge along a blood vessel that you can feel.
• Pain in your leg that gets worse when you stand or walk. This is especially important if there is also swelling or redness in your leg.

Exams and Tests

If your doctor thinks that you have DVT, you probably will have an ultrasound test to measure the blood flow through your veins and help find any clots that might be blocking the flow.

To see if you need an ultrasound, the doctor will do a physical exam. This will include checking your heart and lungs and checking your legs for warmth, swelling, bulging veins, or changes in skin color.

More tests may be used when ultrasound results are unclear. These can include a D-dimer test, MRI, or CT scan. These tests may help diagnose or exclude a blood clot.

If your doctor thinks you might have a pulmonary embolism, he or she may test your lungs.

Learn more

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• Learning About Your CT Scan
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Treatment Overview

The main goals of treatment for DVT are:

• To prevent the blood clot from getting larger.
• To prevent the blood clot from traveling to the lungs (pulmonary embolism).
• To prevent post-thrombotic syndrome. This is a condition that can cause pain, sores, and swelling of the affected leg.
• To prevent blood clots from coming back.

Treatment includes medicine and self-care.

Blood thinners

DVT is usually treated with anticoagulant medicines. These medicines are often called blood thinners, but they don’t actually thin the blood. They prevent blood clots by increasing the time it takes a blood clot to form. They also help prevent existing blood clots from becoming larger.

You might take anticoagulants for at least 3 months. The length of time will vary based on your own health and your risk for a pulmonary embolism.

Other treatments

Other treatments may be used in the hospital for some people. These treatments include thrombolytic medicine, a procedure to remove the blood clot (thrombectomy), and vena cava filters. But these treatments aren’t common. They might be used for people who are at risk for serious problems from DVT.

Self-care

Your doctor may also recommend self-care to relieve symptoms. This care includes:

• Walking several times a day.
• Propping up (elevating) your leg or arm.
• Wearing compression stockings.

Learn more

Self-Care

Home treatment for DVT focuses on:

• Taking anticoagulants (blood thinners) safely.
• Relieving symptoms.

You can do a few things to treat your DVT at home.

• Take anticoagulants safely.

  If you take an anticoagulant medicine, also called a blood thinner, you need to take extra steps to avoid bleeding problems.

  • Prevent falls and injuries.
  • Tell your doctors about all other medicines, supplements, and vitamins that you take.
  • Get regular blood tests, if your doctor tells you to.
• Walk several times a day, if possible.

  Walking can help relieve symptoms like pain and swelling.

• Elevate your leg or arm.

  This also helps with pain and swelling.

• Wear compression stockings if your doctor recommends them.

  Compression stockings are specially fitted stockings. They are tightest at the foot. They get less and less tight farther up on your leg.

Your doctor might suggest that you take a nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen, to relieve pain. Do not take an NSAID unless your doctor tells you that it’s safe for you.

Learn more

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• Fitness: Moving More
• How to Put on Compression Stockings
• Safe Use of Non-Warfarin Blood Thinners
• Warfarin: 5 Things You Can Do to Take It Safely
• Warfarin: Why Taking It Is Worth It

Medicines

Anticoagulant medicines, also called blood thinners, are used to prevent and treat DVT.

These medicines prevent new clots from forming. They also prevent existing clots from getting larger. They don’t get rid of existing clots.

Different types of anticoagulants are used. Talk with your doctor about which medicine is right for you.

If you are in the hospital, you might be given an anticoagulant as a pill, a shot, or in a vein through an I.V. After you go home, you might give yourself shots for a few days. For long-term treatment, you’ll likely take a pill.

You might take anticoagulants for at least 3 months. You may take them for a much longer time, maybe even the rest of your life. The length of time will be based on your health and your risk for a pulmonary embolism.

Learn more

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• How to Give Yourself an Anticoagulant (Blood Thinner) Shot
• Safe Use of Non-Warfarin Blood Thinners
• Warfarin: 5 Things You Can Do to Take It Safely

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How to Diagnose Deep Vein Thrombosis

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How to Diagnose Deep Vein Thrombosis : Deep vein thrombosis is an inflammation of the walls of the veins of the legs, which is accompanied by the formation of blood clots. Primary diagnosis of deep vein thrombosis of the lower extremities will require ultrasound of the veins of the lower extremities and subsequent consultation with a phlebologist. As an additional examination, the doctor may prescribe:

• venography
• rheovasography
• blood test for D-dimer.

Which doctor treats deep vein thrombosis of the lower extremities: If you have symptoms of deep vein thrombosis of the lower extremities, you should first consult a phlebologist.

Deep vein thrombosis is a serious condition that occurs when a blood clot forms in a vein deep inside the body. A thrombus is a blood clot that has turned into a solid state. Deep vein clots usually form in the thigh or lower leg, but they can also develop in other parts of the body. Other names associated with this condition:

• thromboembolism
• post-thrombotic syndrome
• post-phlebitic syndrome.

Although deep vein thrombosis itself is not life-threatening, blood clots can break off and enter the bloodstream. A pulmonary embolism occurs when traveling blood clots become lodged in the blood vessels of the lungs. Since this condition is life-threatening, it is necessary to immediately diagnose and begin treatment.

Symptoms of deep vein thrombosis of the lower extremities

General symptoms:

• swelling of the foot, ankle or leg, usually on one side
• spasmodic pain in the affected leg, which usually begins in the lower leg
• severe unexplained foot and ankle pain
• an area of ​​skin that is warmer to the touch than the surrounding skin
• the skin over the affected area turns pale, becomes reddish or bluish, depending on the skin tone.

The condition is often diagnosed during an examination for a pulmonary embolism (blood clot in the lung). A pulmonary embolism can occur when a deep vein clot travels from an arm or leg to the lung. When an artery in the lung becomes blocked, a life-threatening condition develops that is a medical emergency.

Causes of deep vein thrombosis

A clot is blocking a vein, preventing proper blood circulation in the body. The formation of a clot (thrombus) can occur for several reasons:

• wound. Damage to the wall of a blood vessel can narrow or block blood flow. As a result, a thrombus may form
• operation. Blood vessels can be damaged during surgery, which can lead to the formation of a blood clot. Bed rest or physical inactivity after surgery may also increase the risk of a blood clot
• immobility. If the patient leads a sedentary lifestyle, blood may accumulate in the legs, especially in the lower part. As a result, blood flow in the legs can slow down
• certain medicines. Some medications increase the chance of a blood clot forming.

Risk factors

Deep vein thrombosis most often occurs in patients over 50 years of age. In this case, the disease can develop at any age. Certain conditions that alter the circulation of blood through the veins can increase the risk of blood clots:

• having an injury that damages the veins, such as a broken bone
• being overweight or obese, which puts more pressure on the veins in the legs and pelvis
• family history
• venous catheter
• birth control pills or hormone therapy
• nicotine abuse
• staying in a sitting position for a long time, especially if any other risk factor is involved.

Some diseases may increase the risk of blood clots:

• hereditary bleeding disorders, especially if at least one other risk factor is present
• cancer
• inflammatory bowel disease
• heart failure.

The most common risk for deep vein thrombosis is postoperative when a patient is scheduled for a knee or hip replacement.

Complications

The main complication of deep vein thrombosis is pulmonary embolism, which can develop if a blood clot travels to the lungs and blocks a blood vessel. This can cause serious damage to the lungs and other parts of the body. It is recommended to seek immediate medical attention if signs of a pulmonary embolism appear:

• dizziness
• sweating
• chest pain that is aggravated by coughing or taking a deep breath
• rapid breathing
• hemoptysis
• palpitations.

Deep vein thrombosis during pregnancy

Pregnant women are 5 to 10 times more likely to develop thrombosis because clotting proteins increase and anti-coagulation proteins fall during pregnancy. In addition, increased hormone levels and slower blood flow as the uterus expands and blood flow to the lower extremities is reduced contribute to this risk. The increased risk persists until about 6 weeks postpartum. Caesarean section also increases the risk of thrombosis. Compliance with the following recommendations can reduce the risk of blood clots:

• wearing compression stockings that reduce blood pooling and help maintain blood flow
• any blood thinners, in particular aspirin
• foot and leg exercises to maintain efficient blood flow.

Diagnosis of deep vein thrombosis of the lower extremities

To diagnose deep vein thrombosis, a phlebologist conducts a medical examination, studies the patient’s medical history and prescribes a number of specialized studies.

• Ultrasound of the vessels of the lower extremities. This is the most commonly used method for diagnosing deep vein thrombosis. The study uses sound waves to take pictures of the arteries and veins to examine blood flow. If a blood clot is present, interrupted blood flow will be detected.
• Venogram. If the ultrasound is inconclusive, the doctor may order a venogram. During this test, a contrast agent is injected into a vein. Then an x-ray of the area being examined is taken. The contrast agent makes the vein more visible, so interrupted blood flow will be easily detected.
• D-dimer blood test. The assay measures the presence of a substance that is released when a blood clot ruptures. If levels are high and the patient has risk factors for deep vein thrombosis, then a blood clot is likely present in the body. A blood test for D-dimer can also be an indicator of other factors, such as pulmonary embolism, stroke, pregnancy, or infection, so more testing may be needed to make a diagnosis.

Prophylaxis for deep vein thrombosis of the lower extremities

The patient can reduce the risk of deep vein thrombosis by making several lifestyle changes:

• blood pressure control
• smoking cessation
• moderate weight maintenance

Walking after bed rest can also prevent blood clots. If the patient is to undergo surgery, then a course of special drugs that thin the blood is preliminarily prescribed.

Diet and deep vein thrombosis of the lower extremities

A nutritious and balanced diet is important in preventing deep vein thrombosis in the legs, as well as helping to avoid life-threatening complications. In addition, a healthier lifestyle includes many of the changes that are needed to prevent blood clots in the first place. This includes being physically active, not smoking, and maintaining a moderate weight. A diet high in fiber, fruits, and vegetables is considered recommended for patients at risk of deep vein thrombosis. Certain vitamins and minerals may counteract the effects of thrombosis medications. For example, large amounts of vitamin K can reduce the ability of warfarin to thin the blood and prevent blood clots.

The best specialists in St. Petersburg with a rating of 4.5+

Prokopets Anna Igorevna

Specialization: Phlebologist, Vascular surgeon

Medical experience: since 2014

Where does the reception: LDC Svetlana, Institute of Traumatology and Orthopedics. Wreden

Kanina Larisa Yaroslavovna

Specialization: Phlebologist

Medical experience: from 1986 years old

Where does the reception: LDC Svetlana, Blagodatnaya clinic, MC Via-Medica

Sabelnikov Vladimir Vasilyevich

Specialization: Phlebologist, Vascular surgeon

Medical experience: since 1978

Where does the reception: LDC Svetlana, Institute of Traumatology and Orthopedics. Wreden

Plokhov Valery Borisovich

Specialization: Mammologist, Phlebologist, Surgeon, Proctologist

Medical experience: since 2002

Where does the reception: LDC Svetlana

Ostrovsky Vitaly Sergeevich

Specialization: Ultrasound doctor, Phlebologist, Surgeon, Proctologist

Medical experience: since 2010

Where does the reception: MC Baltmed Ozerki

Toshchev Alexey Andreevich

Specialization: Ultrasound doctor, Phlebologist, Vascular surgeon

Medical experience: since 2015

Where does the appointment: MC Medpomoshch 24 Zanevsky, Laser Doctor Gorokhovaya, SMT Moscow, My Clinic Gorokhovaya, Sports Clinic

Gamzatov Temirlan Khizrievich

Specialization: Phlebologist, Surgeon

Medical experience: since 2006

Where does the reception: MC March, FGBUZ Clinical Hospital No. 122 named after. L. G. Sokolova

Bondarenko Pavel Borisovich

Specialization: Phlebologist

Medical experience: since 2014

Where does the reception: MC Energy of Health

Pikhanova Zhanna Maksudovna

Specialization: Phlebologist, Surgeon

Medical experience: since 2011

Where does the appointment: Long Vita MC, QClinic Clinic, Reaclinic on Antonova-Ovseenko, Reaclinic on Vosstaniya

Shishkin Andrey Andreevich

Specialization: Oncologist, Phlebologist, Proctologist

Medical experience: since 2011

Where does the appointment: SM-Clinic on Danube, SM-Clinic on Malaya Balkanskaya

Kabirov Alexander Vitalievich

Specialization: Phlebologist

Medical experience: since 1990

Where does the reception: SM-Clinic on Vyborgsky

Ermolin Ivan Evgenievich

Specialization: Ultrasound doctor, Phlebologist

Medical experience: since 2018

Where does the reception: SM-Clinic on Udarnikov, MEDICA on Badaeva, Coris Trauma Center, Koris Ambulance

Andozhskaya Julia Sergeevna

Specialization: Ultrasound doctor, Phlebologist

Medical experience: since 1988

Where does the reception: SM-Clinic on the Danube, Center for Israeli Medicine Sunclinic

Baranov Vladimir Sergeevich

Specialization: Phlebologist, Surgeon

Medical experience: since 2005

Where does the appointment: SM-Clinic on Danube, SM-Clinic on Malaya Balkanskaya

Volkov Anton Maksimovich

Specialization: Phlebologist, Surgeon

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Where does the reception: SM-Clinic on Udarnikov, SM-Clinic on Vyborgsky

Kuzmin Evgeny Vitalievich

Specialization: Phlebologist

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Chernyakov Ilya Sergeevich

Specialization: Ultrasound doctor, Phlebologist

Medical experience: since 2010

Where does the reception: SM-Clinic on Danube

Author: Fedorov Oleg Nikolaevich

Specialization: Ultrasound doctor, Oncologist, Phlebologist, Surgeon

Where does the reception: Primary Oncology Department of the Central District of St. Petersburg 9000 3

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Literature

1. Barkagan Z.S. Diagnosis and controlled therapy of hemostasis disorders. /Barkagan Z.S., Momot A.P.//. M. Newdiamed. – 2001. – p. 296.
2. Bokarev I.N. Modern achievements and problems of antithrombotic therapy. /Bokarev I.N.//. Therapist, arch. 1993. -vol.65. – No. 10. – With. 101-105.
3. Leontiev S.G. Conservative therapy for acute thrombosis of the inferior vena cava system. /Leontiev S.G., Kapranov S.A., An E.S. and etc.//. The third annual session of the NTSSSH them. A.N. Bakulev. May 23-25. – 1999. – p. 65.
4. Chazov E.I. In book. Anticoagulants and fibrinolytic agents. / Chazov E.I., Lakin K.M.//. M. 1977.
5. Panchenko E.P. Antithrombotic drugs. /Panchenko E.P.//. Klin, pharmakol. ter. 1997. – 3. – p. 38.

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causes, symptoms, signs, complications, diagnosis (tests), treatment, prevention

Thrombosis is a pathological condition in which blood clots begin to form inside the vessels, called blood clots. This leads to disruption of blood flow inside the vessels and causes death. A blood clot that circulates freely throughout the vascular system of the bloodstream is called an embolus.

When a thrombus begins to block the lumen of the vessel by 75% or more, the flow of blood, and therefore oxygen and other substances necessary for life, entering the tissues, is greatly reduced. This leads to the appearance of symptoms of hypoxia, and decay products accumulate in the cells, since they are not removed from them by the bloodstream. If the vessel is blocked by more than 90% begins oxygen starvation of tissues and cell death.

Venous thrombosis affects not only the lower extremities, although it is most often manifested here. It can be localized in almost any vessel – the upper limbs, chest, brain, neck. The veins located on the surface are more often affected, and the deep venous system is affected very rarely.

Causes of development

All causes of thrombosis can be divided into three large groups.

In the first case, the appearance of blood clots is influenced by hypercoagulability or thrombophilia. Most often, this condition is the result of a genetic defect or appears on the background of an autoimmune disease. Recent studies have shown that neutrophils play a huge role in the formation of deep blood clots, which for one reason or another become more active, and blood begins to clot right in the veins.

The second reason is damage to the vessel wall. In this case, the body always tries to repair the “hole” as quickly as possible, including protective factors. At the same time, normally, the inner surface of all vessels is always smooth, but pathological conditions can make it rough. Then the platelets cling to the roughness, accumulate and form a blood clot in this place.

The third cause is blood stasis. This condition develops with prolonged sitting or heart failure.

Provoking factors for the development of thrombosis of the lower extremities and its other varieties are:

• abnormal structure of veins;
• varicose veins;
• obesity of varying degrees;
• prolonged bed rest;
• passive lifestyle;
• oncology;
• pregnancy;
• infectious diseases;
• trauma and surgery;
• smoking;
• taking drugs that are aimed at increasing blood clotting.

The risk of pathology increases several times during flights and trips that last more than 4 hours.

Classification

Today, doctors divide thrombosis into two large groups – venous and arterial. Each of them is also divided into several options.

Deep vein thrombosis is a condition that can affect a specific group of blood vessels. These are the portal, renal, jugular, inferior vena cava, as well as the veins of the shoulder and the venous sinus of the brain.

Arterial thrombosis usually results from the appearance of atherosclerotic plaques on the vessel wall. This is what leads to strokes and heart attacks.

Hemorrhoidal thrombosis, which is a complication of hemorrhoids, requires special attention. It develops due to circulatory disorders in this area and the formation of a large blood clot in the plexuses of the rectum.

If the veins that supply blood to the intestines are affected, then such thrombosis is called mesenteric. Here it is important to help the person quickly, as the condition is life-threatening and can cause death.

Symptoms and signs

Acute thrombosis is a life-threatening condition that requires immediate medical attention. However, most often patients go to the doctor with thrombosis of the veins of the lower extremities, which also has certain symptoms.

The main symptoms of thrombosis are heaviness in the legs, pain and cramps. These complaints appear as a result of stagnation of blood or tissue hypoxia. The pain can have a different character: pulsating, cramping, spreading along the affected vein. When you press the calf muscle, the pain noticeably intensifies and becomes unbearable when you try to walk or make movements in the ankle area. More often, the pathology covers one limb.

Another important sign of thrombosis is edema. The leg greatly increases in size, and this is especially noticeable at the level of the lower leg and below. In the place of edema, the skin becomes hot to the touch, and due to the lack of oxygen supply and blood flow, a bluish cadaveric hue appears. The skin also looks taut and shiny.

As for arterial thrombosis in the legs, its main manifestations are skin pallor, which turns into a bluish tint, pain at night and at complete rest, sleep disturbance, numbness of the limb, absence of peripheral pulse.

Complications

Of particular danger are incompletely attached blood clots, which are freely located in the lumen of the vessel. They are also called floating. It is they who most often cause blockage of the vessel and, together with the blood flow, are delivered to the heart or to the brain.

The most dangerous complication is pulmonary embolism. At this time, there is a blockage of the vessels that carry blood to or from the lungs. The incidence of these complications increases with age. Without adequate and rapid treatment, patients die in the first hours and even minutes after the onset of PE.

The formation of blood clots is of particular danger in people with obesity, when using oral contraceptives, the presence of diseases associated with increased blood clotting, as well as those leading a sedentary lifestyle.

Thrombosis of the hemorrhoid in the absence of treatment can cause necrosis of the epithelium or mucosa, which is located above the affected area. At the site of necrotic tissue changes, infected wounds often appear, which then become ulcers, and it is very difficult to cure them. And finally, another formidable complication is severe bleeding, which can be stopped only after surgery.

Diagnosis

Correct and adequate diagnosis of thrombosis includes a number of measures. It all starts with an examination by a therapist, who then sends the patient for further treatment to a phlebologist, as well as for a consultation with a cardiologist, neurologist, pulmonologist and other doctors.

A number of tests must be carried out according to the purpose:

• complete blood count + ESR + leukocyte formula;
• D-dimer blood test, which helps detect bleeding disorders;
• analysis for prothrombin (according to Quick) and INR;
• determination of fibrinogen;
• determination of the level of C-reactive protein;
• homocysteine.

If necessary, a urine test is taken, the blood type and Rh factor are determined, and an analysis is made for a coagulogram. Other tests for thrombosis are done as needed and depending on complaints.

Instrumental methods help determine the exact location of the thrombus, its size, the speed of movement through the bloodstream, and many other factors. The gold standard is duplex scanning not only of veins, but also of arteries, as well as ultrasonic triplex scanning. Other methods include chest X-ray, ECG, ultrasound of the abdominal organs.

Additional methods of patient examination include FGS, MRI, abdominal aortography, vein phlebography, CT.

Treatment

Treatment of the disease with damage to the superficial and deep veins differs markedly.

Superficial lesions are treated on an outpatient basis – the patient takes antiplatelet agents that help prevent thrombosis, NSAIDs for severe pain, heparin ointments and gels are used topically, and compression stockings are also required.

Deep vein thrombosis is treated in a hospital setting. Anticoagulant therapy is carried out, the duration of admission is decided only by the doctor. Surgical treatment is performed based on the location of the thrombus.

Prophylaxis

How to reduce the risk of thrombosis? The most important thing is to start leading an active lifestyle, get rid of obesity and undergo all the necessary examinations to detect the disease at an early stage. You need to take at least 10,000 steps a day. And in the case of a long journey by car, you should stop every hour and be sure to take a walk to avoid stagnation of blood in the pelvic area. It is also recommended to play sports three times a week, go to the gym or fitness.

Primary prevention includes drinking at least 2 liters of water per day, especially during the summer, to help reduce the risk of blood clots. Quitting smoking and drinking helps prevent deep vein thrombosis in the brain and lungs.

Prevention of secondary thrombosis will help prevent secondary thrombus formation and blockage of the vein.