Deep Vein Thrombosis

Overview

A deep vein thrombosis (DVT) is a blood clot in certain veins, usually in the legs, pelvis, or arms. Blood clots in these veins need to be treated because they can get bigger, break loose, and travel through the bloodstream to the lungs. A blood clot in a lung can be life-threatening.

The doctor may have given you a blood thinner (anticoagulant). A blood thinner can stop the blood clot from growing larger and prevent new clots from forming. You will need to take a blood thinner for at least 3 months.

The doctor has checked you carefully, but problems can develop later. If you notice any problems or new symptoms, get medical treatment right away.

Symptoms

What are the symptoms of deep vein thrombosis (DVT)?

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.

Complications & Comorbidities

What problems can happen when you have deep vein thrombosis (DVT)?

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.

Causes

What causes deep vein thrombosis (DVT)?

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.

Prevention

How can you prevent deep vein thrombosis (DVT)?

  • 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.

Diagnosis

How is deep vein thrombosis (DVT) 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.

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.

Treatment

How is deep vein thrombosis (DVT) treated?

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.

When to Call

Deep vein thrombosis: When to call

Call 911 anytime you think you may need emergency care. For example, call if:

  • You passed out (lost consciousness).
  • You have symptoms of a blood clot in your lung (called a pulmonary embolism). These include:
    • Sudden chest pain.
    • Trouble breathing.
    • Coughing up blood.

Call your doctor now or seek immediate medical care if:

  • You have new or worse trouble breathing.
  • You are dizzy or lightheaded, or you feel like you may faint.
  • You have symptoms of a blood clot in your arm or leg. These may include:
    • Pain in the arm, calf, back of the knee, thigh, or groin.
    • Redness and swelling in the arm, leg, or groin.

Watch closely for changes in your health, and be sure to contact your doctor if:

  • You do not get better as expected.

Self-Care

Caring for yourself when you have deep vein thrombosis (DVT)

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.

Copyrighted material adapted with permission from Healthwise, Incorporated. This information does not replace the advice of a doctor.

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