Deep venous thrombosis (DVT)

Overview

Venous disease describes a range of disorders affecting your veins. Venous disease can occur as a result of malfunctioning valves or blood clots in your veins or weakening in your blood vessel walls. Deep venous thrombosis (DVT) is the development of blood clots in a deep vein, meaning a vein in your leg or pelvic area, which can be fatal if left untreated. It mainly affects the large veins in the lower leg and thigh, usually on one side of the body, but also can occur in the deep veins in the arms.

A clot that breaks off and travels through the bloodstream is an embolism. It can lodge in the brain, lungs, heart or other area, causing severe damage. Clots in the thigh are more likely to travel to the lungs, causing a blockage (pulmonary embolus) than are blood clots in other parts of the body.

 

Causes

  • Clots may form when something interferes with the blood flow. They may form because of surgery, obesity, traumatic injury, family history, lying down (bed rest) or sitting for too long (such as on a long plane flight).
  • Bone marrow that produces too many blood cells, thickening the blood more than normal.

Symptoms

Because the clot can block blood flow, it can cause:

  • Changes in skin color (redness)
  • Leg pain
  • Leg swelling (edema)
  • Skin that feels warm to the touch

Severe symptoms can include:

  • Chest pain
  • Coughing up blood
  • Difficulty breathing
  • Fainting

Risk factors

A pacemaker catheter installed through the vein in the groin, or a catheter that stays in a blood vessel for a long time

  • Fractured pelvis or leg
  • Severe injuries or burns
  • Pregnancy or recent childbirth
  • Recent surgery (brain, bone, hip, knee or female pelvic surgery)
  • Heart attack, heart surgery or stroke
  • Cancer
  • Certain autoimmune disorders, such as lupus
  • Smoking
  • Taking estrogen or birth control pills (smoking compounds the risk)

DVT is most common in adults over age 60, but can occur at any age.

 

Diagnosis

Your physician should take your family history and perform a physical exam. If you have a red, swollen or tender leg, your doctor will most likely order a blood test and an ultrasound of the affected area. The blood test will show whether you have a higher chance of blood clotting.

Treatment

Our first approach is often medication with an anticoagulant to slow blood clot formation, without the need for intervention. In more advanced cases, we may recommend thrombolytic therapy, a treatment that involves injecting clot-busting drugs into your blocked vein such as

heparin and warfarin (Coumadin). Other treatments include wearing a pressure (compression) stocking and having a filter placed in your largest vein to prevent blood clots from traveling to your lungs.

DVT often goes away with no problem, but it can recur. Some people may experience long-term pain and swelling in the leg called post-phlebitic syndrome.

 

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