Deep Venous Thrombosis- Causes, Risk Factors, diagnosis, treatment and prevention

Deep Venous Thrombosis is formation of blood clot in one or more deep veins of the body particularly  in the legs.   It may cause leg pain usually one sided with swelling and sometimes it is asymptomatic.

Mr. John,50 year old man suddenly started experiencing  left leg pain.When consulted doctor,the doctor diagnosed it as DVT and  said it is an emergency  and should start medicines immediately.

Let's see what is DVT ? Causes , signs and symptoms , treatment and prevention in this blog.

Causes :

• Bed rest for long periods in case of accidents.
• Limited movement, sitting in a place for long time without moving extremities.
• Medical conditions which affect blood like sickle cell anemia, haematologic malignancies.

Who are at Risk :

• Long hours of driving or travel by plane.

Long hours of sitting causes the stasis of blood in the lower extremity and the calf muscle do not contract to help the blood circulate causing risk for thrombosis or clot formation.

• Pregnancy : 

While DVT is not common in pregnancy, the chance of DVT is 5 to 10 times likely than non pregnant woman. Therefore, pregnant woman should avoid sitting in a same place and see that leg movement is there unless in complicated cases like pre- eclampsia where doctor advice complete bed rest and give some guidelines to prevent thrombosis.

• Injury or surgery:

Injury to the veins or surgical procedure enhances the risk of clot formation.

• Birth control pills or hormone 

Birth control or hormone replacement therapies put you in a risk of DVT.

• Smoking

Smoking affects blood clotting and circulation enhancing the risk for clot formation.

• Cancer

Certain forms of cancer involving blood predisposes to formation of blood clots.

• Family history 

Any family history of DVT adds on to the risk of clot formation.

• Age factor

After the age of 60, the risk increases.

Why DVT is an emergency?

The blood clot  can travel and may get lodged anywhere causing problems according  to the place lodged.

Pulmonary embolism:

The blood clot gets lodged in the lungs causing alot of severe symptoms:

• Difficulty  breathing
• Edema
• Tiredness
• Chest pain
• This may even lead to heart failure or loss of lung function.

Signs and Symptoms:

• Leg pain usually one sided leg pain in the calf,foot or whole leg.
• Edema and redness of the affected part.
• warm skin where the clot is present.
• red skin at the back of your leg.

Diagnosis:

Blood test  :

Elevated  D- Dimer is seen. This test shows the broken clot fragments which indicates clot. But this is not reliable test as its elevated in case of injury and surgery. So ultrasound is done to rule out thrombosis.

Ultrasound:

USG leg is done which may reveal the clot. Doppler studies shows how fast the blood is flowing indicating the block by thrombosis.

Treatment:

• Blood thinners medication is given .

• Anticoagulants too is given .

• U may have to take the medicine for a period of 6 months to 1 year.

• Wear compression stockings during the day for a period of at least 2 years. It prevents the blood stasis and formation  of clot.

NOTE : When you are on blood thinning medications , you have to be careful regarding injury. Use soft toothbrush to avoid bleeding from gums. 


Prevention:

''Prevention is better than cure.'' Here are preventive measures:

• People who sit and work for long hours take a break and walk for few minutes  regularly.

• Travelling in plane for long hours. Get up and move frequently.  If that's not  possible then just do some extension of leg and move your leg in sitting position itself.

• Quit smoking as it increases chance of DVT.

• Healthy lifestyle  and diet is important  for proper weight control.
• Exercise regularly especially people who travel by plane often or people  who have to sit and work for long hours.
• Avoid oral contraceptives and follow other methods of family planning.

Conclusion :

Follow healthy lifestyle. Avoid sitting in a place for very long hours and get moving and prevent DVT and its complications. 

Appreciate your sincere comments.

Thank you,

By Divya Lokesh.