Deep Vein Thrombosis (DVT)

Definition

Deep vein thrombosis (DVT) is a blood clot in the large veins in the leg or pelvis. DVT can be painless or painful, and generally isn't life-threatening if it's quickly treated. Left untreated, DVT can lead to serious health problems if the clot breaks free and travels to the lung artery, creating a pulmonary embolism.

Causes

There are three main causes of DVT: 

• Irritated or inflamed inner vein lining
• Blood that quickly clots
• Slow blood flow through a vein deep in the leg or pelvic area

Risk

• Bed rest (during or after an illness or major medical procedure)
• Patients with cancer or undergoing cancer treatment
• Being confined or unable to walk
• Family history of blood clots
• Obesity (a Body Mass Index of 30 or higher)
• Respiratory or heart failure
• Smoking
• Pregnancy
• Hormone therapy

Symptoms

Many people with DVT have no symptoms.

DVT symptoms include:

• Leg pain or tenderness in calf muscles
• Leg swelling
• Changes in skin color on the leg or foot

Symptoms of a pulmonary embolism include:

• Chest pain
• Shortness of breath
• Rapid pulse
• Cough

Diagnosis

• Ultrasound: Sound waves are used to create an image of the veins and identify the presence of blood clots.
• Blood test: Blood may be drawn to examine for evidence of recent clotting.
• Venogram or phlebogram: This procedure injects a dye into a foot vein to make blood flow visible on an X-ray, which measures blood flow in the veins and look for signs of clots.

Treatment

• Compression stockings and anticlotting (anticoagulant) medications: For less-severe cases, a physician may recommend elevating the leg, wearing compression stockings and taking anticoagulant medicines that prevent additional blood clots from forming.
• Thrombolysis: For more-severe cases, a catheter is inserted and moved to the clot's location. Medication is then applied to the clot to break it up. Following the procedure, you will need to take anticoagulant medication to keep new clots from forming.
• Thrombectomy: Patients who cannot take medications used to break up clots may have a thrombectomy, where the clot is removed through a small groin incision.