Vein and Foot Clinic

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Deep vein thrombosis

Deep vein thrombosis

A blood clot that forms in a vein located deep within the body is known as deep vein thrombosis (DVT). Although it can develop in other deep veins, like those in the arms and pelvis, DVT primarily affects the major veins in the lower leg and thigh. Usually, DVT only affects one side of the body.

Causes

Adults over 60 are most commonly affected with DVT. However, it can happen at any age. An embolism occurs when a clot separates and travels through the bloodstream. Serious harm may result from an embolism that becomes lodged in blood vessels in the heart, brain, lungs, or another location.

When something alters or slows down the blood flow via the veins, blood clots may form.

Among the risk indicators are:

  • A groin vein has been used to insert a pacemaker catheter.
  • Resting in bed or spending too much time in one posture, like while traveling by automobile or plane.
  • Blood clot history in the family
  • Breaks in the legs or pelvis
  • Having given birth in the previous six months
  • Pregnancy
  • Obesity
  • Recently performed surgery (usually on the hip, knee, or pelvis in women)
  • The bone marrow is producing an excessive amount of blood cells, which makes the blood thicker than usual.
  • having a long-term, indwelling catheter in a blood vessel
  • Older than sixty years

Blood clots are more common in people with specific issues or diseases, such as:

  • Cancer
  • Some autoimmune diseases, including lupus
  • Smoking cigarettes
  • Situations that increase the risk of blood clot development
  • Using birth control tablets or estrogens (smoking increases this risk even further)

 

When traveling, extended periods of sitting can raise the risk of DVT. This is more likely to occur if you also possess one or more of the previously mentioned risk factors.

Symptoms

Large veins in the thigh and lower leg, usually on one side of the body, are the primary targets of DVT. The clot may impede blood flow and result in:

  • Skin redness
  • Warm-feeling skin when touched
  • Edema, or swelling, in the arm or leg
  • Tenderness or pain in the arm or leg

Exams and Tests

Your physician will do a physical examination. An exam may reveal a limb that is sore, swollen, or red.

Frequently used tests to identify a DVT include:

  • D-dimer blood test
  • Doppler ultrasonography examination of the problematic area
  • An abdominal or pelvic CT scan

 

To determine whether you have a higher risk of blood clotting, blood tests such as the following may be performed:

  • The Factor V Leiden mutation is checked for by activated protein C resistance.
  • Searching the genome for more mutations, like the prothrombin G20210A mutation
  • Levels of antithrombin III
  • Antiphospholipid antibodies
  • Total blood count (CBC)
  • Anticoagulant for lupus
  • Levels of protein S and C

Treatment

Your doctor will prescribe an anticoagulant, or blood thinner, to you. This will prevent the formation of new clots or the enlargement of existing ones.

Often, heparin will be the first medication you take.

  • You have to stay in the hospital if heparin is administered intravenously (IV). Nonetheless, the majority of patients may receive treatment without hospital stays.
  • You can receive injections of low molecular weight heparin beneath your skin once or twice a day. If you are prescribed this kind of heparin, you might not need to stay in the hospital for as long—or at all.

 

Heparin may be started in conjunction with warfarin (Coumadin or Jantoven), a class of medication that thins blood. Warfarin is ingested orally. It takes a few days to complete the task.

Direct oral anticoagulants (DOAC) are a different family of blood thinners that includes the following:

  • Renzo Abreva (Xarelto)
  • Eliquis (Apixaban)
  • Bradexian (Dabigatran)
  • Edoxaban (Savaysa)

 

These drugs can be used immediately in place of heparin since they function similarly to heparin. The prescription that’s best for you will be determined by your doctor.

It’s likely that you will take a blood thinner for a minimum of three months. Depending on their risk of developing another clot, some patients take it longer—some even for the remainder of their lives.

You have an increased risk of bleeding from blood-thinning medications, even from routine activities. At home, if you take a blood thinner:

  • Take the medication exactly as directed by your healthcare provider.
  • If you miss a dosage, find out from your doctor what to do.
  • Find out from your doctor if you must take oral medications on an empty stomach.
  • As directed by your physician, get blood tests to ensure you are taking the prescribed amount. Those who take warfarin typically require these tests.
  • Find out how to keep an eye out for medication-related issues.

 

Rarely, a procedure could be required in addition to or instead of anticoagulants. These could consist of:

  • putting a filter in the biggest vein in the body to stop blood clots from getting to the lungs
  • Removing a sizable blood clot from the vein or administering medication that breaks up clots.

 

To treat your DVT, adhere to any further advice that you may get.

Outlook (Prognosis)

Although DVT frequently disappears without any issues, it occasionally recurs. The symptoms could start to show up immediately away, or they might take a year or more to manifest. Compression stockings worn both during and after the DVT may help avoid this issue.

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Possible Complications

DVT complications could include:

  • Pulmonary embolism, which has a deadly potential
  • Pain and swelling that is either continuous or sporadic (post-thrombotic or post-phlebitic syndrome)
  • Varicose veins
  • Skin ulcers that don’t heal (less common)
  • Color shifts in the skin

When to Contact a Medical Professional

If you experience DVT symptoms, get in touch with your doctor.

  • Chest pain
  • Sputtered blood
  • Breathing difficulties
  • Fainting
  • Absence of consciousness
  • Additional severe signs and symptoms

Prevention

To prevent DVT:

  • When you are sitting or lying down for extended periods of time, such as when traveling by car or airplane, make sure to frequently move your legs.
  • Take the blood thinners that your doctor has prescribed.
  • Avoid smoking. Blood clots are more common in smokers. See your provider if you require assistance with stopping.