WHAT IS DVT?

As the name suggests it is a thrombus (blood clot) that forms inside one of the deep veins, usually of lower legs (calves) or lower part of the abdomen. It blocks flow of blood either partially or completely. In some instances the clot may break off and travel to the lung.

This is different than clots in superficial veins, which rarely break off. It occasionally affects other veins in the body. Affects all ages, but most common in women (persons) over 50.

SIGNS & SYMPTOMS

• Swelling and pain in the area drained by the vein, usually the ankle, calf or thigh. Swelling in the leg involves everything below the clot, extending to the toes.
• Tenderness and redness of the affected parts.
• Soreness or pain when walking. The soreness does not disappear with rest.
• Pain when raising the leg and flexing the foot (sometimes).
• Fever (sometimes).
• Increased heartbeat (sometimes).

CAUSES

Pooling of blood in the vein, which triggers blood-clotting mechanisms. The pooling may occur after prolonged bed rest following surgery, or from debilitating illness, such as heart attack, stroke or bone fracture.

RISK INCREASES WITH

• Persons over 50.
• Obesity.
• Smoking.
• Use of estrogen in oral contraceptives or for replacement after menopause. This is especially hazardous if estrogen use is combined with smoking.

HOW TO PREVENT

• Avoid prolonged bed rest during illnesses. Start moving the lower limbs as soon as possible after any surgical procedure or during any bed-confining illness.
• On long road or plane trips, exercise your legs at least every 1 or 2 hours.

DIAGNOSTIC MEASURES

• Suggestive symptoms.
• History and examination by a doctor.
• Laboratory studies, including bleeding and clotting time and ultrasound, radioactive fibrinogen and prothrombin time.
• Doppler study of the affected vein

POSSIBLE COMPLICATIONS

Pulmonary embolism, in which the clot breaks away and travels to the lung. The lung's blood supply is blocked, causing affected lung tissue to die.

PROBABLE OUTCOME

Usually curable with anticoagulant treatment, if pulmonary embolism can be avoided.

TREATMENT

GENERAL MEASURES

The following suggestions apply after hospitalization or if the condition can be treated safely at home:

• Wear fitted elastic stockings or wrapped elastic bandages
• Don't cross your legs or ankles while sitting, lying in bed or traveling.
• Elevate the feet higher than the hips when sitting for long periods.
• Elevate the foot end of the bed.

MEDICATION

After hospitalization, your doctor may prescribe anticoagulant drugs (injectable initially and then oral). To minimize the danger of pulmonary embolism, blood tests to monitor the anticoagulant level are mandatory. Oral anticoagulants may be necessary up to 6 months or more.

ACTIVITY

Rest in bed until all signs of inflammation have disappeared. While resting, make it a habit to move leg muscles, bend ankles and wriggle toes.

CONTACT YOUR DOCTOR IMEDIATELY

• If you have symptoms of deep-vein thrombosis.
• The following occurs during treatment:
• Unexpected bleeding anywhere.
• Chest pain.
• Coughing up blood.
• Shortness of breath.
• Continued or increased swelling and pain, despite treatment.