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Deep Vein Thrombosis (DVT)

Definition


Disease: Deep Vein Thrombosis (DVT) Deep Vein Thrombosis (DVT)
Category: Cardiovascular diseases

Disease Definition:

This is a condition that happens when a blood clot (thrombus) forms in one or more of the deep veins in the body, usually the legs. Deep vein thrombosis is a dangerous condition since the blood clot that formed in the vein can break through and move to the lungs. In this case, it is called pulmonary (lung) embolism. It may cause death in some severe cases. However, many cases of deep vein thrombosis vanish by themselves.

 

Not only in deep vein but also in veins that are close to the surface of the skin can blood clots form.  Here, they are called superficial venous thrombosis, phlebitis or thrombophlebitis. Usually, clots that form near the surface of the skin don't travel to the lungs, meaning that they are typically not dangerous.  

 

Although DVT usually doesn't cause any signs or symptoms, but sometimes it may cause leg pain.
Many things can cause DVT, like sitting for long periods of time or inheriting a blood-clotting disorder. A person will need to identify those factors so that they can avoid having serious complications.
 

Work Group:


Symptoms, Causes

Symptoms:

Usually, DVT occurs without symptoms. As a matter of fact 50% of the cases show no remarkable signs.

 

But when signs and symptoms of DVT do show, they include:

 

  • Redness and warmth over the affected area
  • Pain or swelling in the arms or neck, which can occur if a blood clot forms in the arms or neck
  • Swelling in the affected legs, which can include swelling of ankles and feet.
  • Pain in the legs including the ankles and feet, which may start in the calf and feel like cramping.

 

Chest pain accompanied by a pulmonary embolism could be the first sign of deep vein thrombosis. This requires immediate medical help.

 

The warning signs of pulmonary embolism are:

 

  • Coughing up blood
  • Feeling lightheaded or giddy, or fainting
  • A sense of anxiety or nervousness
  • Chest pain or discomfort which usually worsens when the person takes a deep breath or when they cough
  • Unexplained sudden onset of shortness of breath which is the most common symptom.
     

Causes:

When a clot forms in the deep veins of the body, which usually happens in the legs, deep vein thrombosis occurs. Many things can cause blood clots, namely anything that could block blood from circulating or clotting properly.
 

Complications

Complications:

Pulmonary embolism is the primary complication that could happen if someone has DVT. Pulmonary embolism could occur if an artery in the lungs is blocked by a blood clot (thrombus) that travels to the lungs from another part of the body, mainly the legs.

 

A pulmonary embolism could be fatal and thus it’s important to look for the symptoms and seek medical attention if they occur.

 

Some of the symptoms of this condition are:

 

  • Coughing up blood
  • Feeling lightheaded or giddy, or fainting
  • A sense of anxiety or nervousness
  • Chest pain or discomfort which usually worsens when the person takes a deep breath or when they cough
  • Unexplained sudden onset of shortness of breath which is the most common symptom.

 

Postphlebitic syndrome or post-thrombotic syndrome is a common complication that could occur after DVT. This syndrome describes a set of signs the patient may have including swelling of legs (edema), skin discoloration and pain. The syndrome is the result of damage to the veins from the blood clot which reduces blood flow to the affected areas. Symptoms of postphlebitic syndrome might not show till few years after DVT. 

 

Medications like aspirin or diuretics, as well as compression stockings are used in the treatment.
 

Treatments:

The main purpose of the treatment is to prevent blood clots from growing, breaking loose and causing pulmonary embolism. Moreover, treatment prevents DVT from reoccurring.

 

Some of the treatment choices for DVT are:

Compression stockings:

These stockings help in preventing the swelling linked to DVT.  The stockings are worn on the leg from the foot up to the level of the knee. The pressure they cause helps reduce the chances of blood pooling and clotting. These stockings should be worn for a year at least.

Blood thinning medications:

Anticoagulants, which are also called blood thinners, are used to treat DVT when possible. The blood's ability to clot is decreased by these medications. Even though they don’t break up existing blood clots, but they can prevent clots form growing or reduce the risk of developing other clots.

 

The two main forms of heparin are low-molecular weight heparin and unfractionated heparin. Recent research shows that the best option of treatment is the low-molecular weight heparin.  The patient will be injected first with anticoagulant heparin for a few days. After receiving heparin injections, the patient may also receive another anticoagulant in pill form, likely warfarin as a following treatment. The patient may have to keep taking anticoagulants for about three months or longer.

 

Using heparin and warfarin should be monitored closely since both have side effects such as an increased risk of bleeding. However, the patient will be at risk of having more blood clots in case the dose is too low.

 

Pregnant women shouldn't take warfarin. Additionally, to check how long it takes for the blood to clot, the effects of these blood thinning medications could be monitored through periodic blood tests.  

Clotbusters:

If someone has a serious type of DVT or pulmonary embolism, or if other drugs are not working well for them, other medications may be recommended. Thrombolytics is another group of medications that could be used. These drugs, like tissue plasminogen activator (TPA) are given intravenously to break up blood clots. However, they can cause serious bleeding and are typically used only in life-threatening situations.

Filters:

If all medicines fail to thin the patient's blood, a filter might be inserted to a large vein, namely one of the vena cava in the abdomen. They are referred to as “umbrella” because they look like the wire spokes of an umbrella. The filter prevents clots that broke free from inhibiting the patient's lungs.
 

Prognosis:

Not available

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