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What To Know About Deep Vein Thrombosis (DVT)

Deep vein thrombosis (DVT) is when blood clots form, typically in a deep vein in the leg or the pelvis. A pulmonary embolism (PE) can occur if part of a clot breaks off and travels to the lungs. DVT needs urgent medical attention as a PE can be life-threatening.

Deep vein thrombosis (DVT) and pulmonary embolism (PE) are two parts of the disease known as venous thromboembolism.

DVT is a medical urgency. The Centers for Disease Control and Prevention (CDC) say that 10–30% of people who develop DVT in the leg experience fatal complications within a month of diagnosis.

In this article, we define DVT, explain how to recognize it, and ways to treat it.

DVT is blood clotting that develops with deep veins, often in the leg or pelvis.

If the thrombus, or clot, breaks off, doctors call this an embolus. Emboli can make their way to the lung, causing a PE.

Clots may also form in the veins of the arm, such as in people with Paget-Schoetter disease.

According to a 2017 review, DVT is the most common cause of maternal death in the developed world.

DVT is extremely rare in children. According to a 2016 article, the most recent figures suggest that 0.30 in every 100,000 children under 9 years of age, and 0.64 in every 100,000 children aged between 10 and 19 years develop DVT.

Some people may develop DVT without noticing symptoms. However, if symptoms develop, they may resemble the following:

pain in the affected limb that begins in the calf

swelling in the affected limb

a warm feeling in the swollen, painful region of the leg

red or discolored skin

In most people, DVT only develops in one leg. However, on rare occasions, both legs may have DVT.

If a clot dislodges and travels to the lung, the following symptoms may indicate PE:

slow breathing or sudden breathlessness

chest pain, usually more severe while breathing deeply

rapid breaths

a faster heart rate

There are two possible complications:

Pulmonary embolism

PE is the most common complication of DVT and can be life threatening. It happens when a piece of a blood clot becomes dislodged and makes its way through the bloodstream into the lungs.

The clot becomes stuck and disrupts the flow of blood in one of the blood vessels in the lung. In mild PE, an individual may not be aware.

A medium sized clot may cause breathing problems and chest pain. In more severe cases, the lung might collapse. PE can lead to heart failure and can be fatal.

Post-thrombotic syndrome

This is more common among people with recurrent DVT. According to a 2016 review, a person with post-thrombotic syndrome might experience the following symptoms, although they vary between individuals:

a persistent swelling in the calf

a feeling of heaviness in the leg

a pulling sensation in the leg

an excessively tired leg

fluid buildup in the affected leg

redness of the skin

new varicose veins

thickening skin around the area of the DVT

leg ulcers for people with severe post-thrombotic syndrome

Some doctors call this condition post-phlebitic syndrome.

An individual may develop DVT when there is no clear cause. However, according to the National Heart, Lung, and Blood Institute (NHLBI), most people with DVT develop the condition due to one or several risk factors and underlying conditions.

Inactivity

If the human body is inactive for long periods, blood can build up in the lower limbs and pelvic area.

This situation is not a problem for most people. As soon as physical activity levels return to normal, blood flow speeds up. The vein and arteries redistribute blood around the body.

However, prolong inactivity means that blood in the legs may slow a person's blood flow, increasing the risk of clots forming.

A person might be inactive for long periods due to a range of causes, including:

an extended hospital stay

being immobile at home

remaining seated during a long journey, such as a flight

a disability that restricts movement

Injury or surgery

An injury or surgery that damages veins can slow the flow of blood. This increases the risk of blood clots. General anesthetics can also widen the veins, making it more likely that blood pools and clots may form.

While this risk may affect anyone having major surgery, the NHLBI suggest that people receiving knee and hip surgery, particularly, have a high risk of developing DVT.

Genetics

A person may have an inherited disorder that makes blood clots more likely, such as Factor V Leiden thrombophilia.

However, even though having this condition increases the risk, only around 10% of people with it go on to develop unusual blood clots, according to Genetics Home Reference.

Pregnancy

As a fetus develops inside the uterus, pressure against a woman's veins in the legs and pelvis increases. A woman has an increased risk of DVT during pregnancy until six weeks after delivering their baby.

Females with some inherited blood disorders, such as hereditary antithrombin disorder, have a higher risk of DVT during pregnancy compared with other women.

Cancer

Some cancers have links to a higher risk of DVT, including late stage colon, pancreatic, and breast cancers.

Cancer therapies and procedures can also increase a person's risk of DVT, including chemotherapy, a central venous catheter, and certain cancer surgeries.

Read more about cancer and its treatments here.

Irritable bowel disease

People with irritable bowel disease (IBD) have a higher risk of DVT. A 2018 study found that the risk may be three to four times higher than that of a person without IBD.

Learn all about IBD here.

Heart problems

Any condition that affects how well the heart moves blood around the body can cause problems with clots and bleeds.

Conditions such as heart attacks or congestive heart failure may increase a person's risk of developing a blood clot.

Find out more about heart disease here.

Hormone-based medications

Females who take hormone-based birth control or are on a course of hormone replacement therapy (HRT) for menopause have a higher risk of DVT than those who do not take these medications.

Discover everything you need to know about HRT here.

Obesity

People with obesity experience more pressure on their blood vessels, especially those in the pelvis and legs.

For this reason, they may have an increased risk of DVT.

Smoking

People who smoke tobacco regularly are more likely to develop DVT than people who have never smoked or have stopped.

People finding it difficult to quit smoking might find these tips helpful here.

Varicose veins

Varicose veins are enlarged and misshapen veins. While they often do not cause health problems, particularly overgrown varicose veins may lead to DVT unless a person receives treatment for them.

Learn more about varicose veins here.

Age

Even though DVT may develop at any age, the risk increases as a person's age advances.

According to the NHLBI, the risk of DVT doubles every 10 years after people reach 40 years of age.

Sex

A person's sex can affect their DVT risk.

Females are more likely than males to experience DVT around childbearing age. However, females have a lower risk after menopause than men do at the same age.

If a person suspects that they may have DVT, they should seek immediate medical attention. The doctor will ask questions about symptoms and medical history before carrying out a physical examination.

A doctor will usually not be able to diagnose DVT through symptoms alone and may recommend tests, including:

D-dimer test: D-dimer is a protein fragment that is present in blood after a blood clot fibrinolysis degrades a blood clot. A test result revealing more than a certain amount of D-dimer indicates a possible blood clot. However, this test may not be reliable in individuals with certain inflammatory conditions and after surgery.

Ultrasound: This type of scan can detect clots in veins, alterations in blood flow, and whether the clot is acute or chronic.

Venogram: A doctor may request this scan if the ultrasound and D-dimer tests do not provide enough information. The doctor injects a dye into a vein in the foot, knee, or groin. X-ray images can track the dye as it moves to reveal the location of a blood clot.

Other imaging scans: MRI and CT scans may highlight the presence of a clot. These scans may identify blood clots while testing for other health conditions.

DVT treatment aims to:

stop the growth of a clot

prevent a clot from becoming an embolism and moving into the lung

reduce the risk that DVT might come back after treatment

minimize the risk of other complications

A doctor may recommend several methods to manage DVT, as follows:

Anticoagulant medications

These are drugs that prevent the clot from growing, as well as reducing the risk of embolism. Two types of anticoagulants support the treatment of DVT: Heparin and warfarin.

Heparin has an immediate effect. For this reason, doctors usually administer it first through a brief course of injections lasting less than a week.

With warfarin, the doctor is likely to recommend a 3–6-month course of oral tablets to prevent recurrence of DVT.

People with recurrent DVT may need to take anticoagulant medication for the rest of their lives.

Thrombolysis

People with more severe DVT or PE require immediate medical attention. The doctor or emergency team administers drugs called thrombolytics, or clot busters, that break down clots.

Tissue plasminogen activator (TPA) is an example of a thrombolytic drug.

Excessive bleeding is a side effect of these drugs. As a result, medical teams only administer TPA or similar interventions in emergency situations.

Healthcare professionals administer TPA through a small catheter, or tube, directly into the site of the clot. Patients undergoing catheter-directed thrombolysis will be in the hospital for several days and have intermittent "lysis checks" to make sure the clot is breaking down appropriately.

Inferior vena cava filter

A surgeon inserts a very small device, resembling an umbrella, into the vena cava, which is a large vein. The device catches blood clots and stops them moving into the lungs while allowing blood flow to continue.

Compression stocking

People wear these to help reduce pain, limit swelling, and prevent ulcers from developing. Stockings can also protect the individual from post-thrombotic syndrome.

Someone with DVT will have to wear stockings at all times for at least 24 months.

This is a relatively new technique that surgeons may use to treat a blood clot that occurs with DVT or PE.

The procedure involves using a catheter and a clot-removing device, which may be an aspiration catheter, a retrieval stent, or a pump.

Using imaging techniques for guidance, the surgeon:

inserts the catheter toward the area where the clot is

directs the clot-removing device through the catheter

removes the clot, using aspiration or a stent, and reestablishes blood flow

The authors of a 2019 review conclude that mechanical thrombectomy is safe and effective at treating DVT and reducing the risk of recurrence.

There is no available method for screening people for DVT. However, doctors recommend three ways for people with one or several risk factors, such as recent surgery, to prevent the first occurrence of DVT.

These are:

Regular movement: A doctor might recommend staying highly mobile after surgery to stimulate blood flow and reduce the risk of a clot.

Maintaining pressure on the at-risk area: This can prevent blood pooling and clotting. Medical professionals may recommend wearing compression stockings or a boot that fills with air to increase pressure.

Anticoagulant medication: A doctor may prescribe blood-thinning medication to reduce the risk of clotting before or after surgery.

As smoking and obesity are also key risk factors, it may be advisable to quit smoking and engage in regular physical activity.

According to the American Heart Association (AHA), 150 minutes of moderate-to-high intensity exercise every week is the amount they recommend.

Deep Vein Thrombosis Vs. Varicose Veins: How Do They Differ?

Although varicose veins and deep vein thrombosis (DVT) both affect the veins, these two conditions have different causes, involve different kinds of veins, and have unique symptoms. One is also more serious than the other.

Varicose veins involve the veins near the surface of the skin, whereas deep vein thrombosis involves veins deeper in the limb. Moreover, deep vein thrombosis is a more serious condition, because it involves blood clots that can cause a pulmonary embolism, which can be deadly.

Read on to learn more about these two conditions, including how to tell them apart, and how they are treated.

Varicose veins are swollen veins that typically occur on the legs, but they can occur elsewhere on the body. The affected veins lie just below the surface of the skin.

Varicose veins are caused by weak veins and damaged vein valves, which can cause blood to pool in your veins or flow in the wrong direction.

Symptoms may include bulging, raised, blue veins that can be itchy and sometimes painful.

Risk factors

Certain factors can increase your risk of varicose veins, including:

pregnancy

having overweight or obesity

advanced age

standing for long periods of time

a sedentary lifestyle

frequent constipation

having a family history of varicose veins

Can varicose veins lead to complications?

Varicose veins are usually not a cause for concern, but they can also cause discomfort, such as achy, itchy legs, and fatigue in the legs.

In rare cases, they can lead to more serious complications, such as venus ulcers (ulcers in the veins).

Although varicose veins are not the same as deep vein thrombosis, people who have varicose veins are at increased risk of developing deep vein thrombosis.

Deep vein thrombosis (DVT) happens when a clot forms in a deep vein, putting you at risk of a pulmonary embolism, which is a clot that travels to your lungs and makes it hard to breathe. A pulmonary embolism can be life threatening.

Slowed blood flow in your veins, damage to a vein, or other factors that cause blood clots to form can cause DVT.

Symptoms

DVT symptoms are typically experienced in the lower half of the body, such as the pelvis, thighs, and legs. Roughly 50% of people with DVT do not have any symptoms. If you have symptoms, they may include:

leg swelling

reddened skin (rash-like appearance) in the area of the clot

pain or tenderness in the area of the blood clot

skin that's warm and tender to the touch in the area of the blood clot

Because DVT can lead to serious complications, it's important to get immediate medical attention if you notice these symptoms.

Risk factors

Certain factors can increase your risk of DVT, including:

Share on PinterestSymptoms of deep vein thrombosis (DVT) can include swelling, redness, and pain in the area of the blood clot. It's important to seek immediate medical attention if you have these symptoms.Photo credit: MedSci/Alamy Stock Photo Can deep vein thrombosis lead to complications?

DVT can lead to a pulmonary embolism, a serious and potentially deadly condition. With a pulmonary embolism, the clot in your vein travels to your lungs, which causes a blockage. A large clot can prevent blood from reaching your lungs, resulting in restricted blood flow and decreased oxygen levels in your blood.

DVT can also lead to a long-term condition called post-thrombotic syndrome (PTS), where damaged veins cause pain, swelling, and sometimes disability.

Complications from DVT are the third most common cause of cardiovascular deaths, after strokes and heart attacks.

Varicose veins affect the veins just under your skin, while DVT affects deeper veins. As such, with varicose veins, you're likely to see bulging, bluish veins on your legs and other affected areas.

With DVT, you are more likely to experience swelling, skin that's warm to the touch, and redness of the affected leg or area, rather than bulging veins.

Both varicose veins and DVT can cause discomfort, such as pain and tenderness, most often in the legs. But with varicose veins, you're more likely to also experience itching, which is not a symptom of DVT.

Varicose veins usually cause visual symptoms, but DVT doesn't cause any symptoms about half the time.

The other major difference between these two conditions is that DVT can cause a pulmonary embolism. This is not the case with varicose veins. Symptoms to watch for include shortness of breath, dizziness, a racing heartbeat, and a cough that may include blood.

While one of the treatment options for both varicose veins and DVT may be compression stockings, the other treatments for these two conditions are quite different. Here's what to know.

Treatment for varicose veins

Sometimes varicose veins don't need to be treated at all. Treatment will depend on your symptoms and their severity. Treatments may include:

compression stockings

pain relief

increased physical activity

less time spent standing

surgery to remove large or serious varicose veins

minimally invasive procedures, such as sclerotherapy, radiofrequency, or laser ablation

Treatment for deep vein thrombosis

If you're diagnosed with DVT, you need prompt treatment. This may include:

blood thinning medication

thrombolytic medication, to break up clots

surgical removal of the clot

compression therapy, such as compression stockings

It's easy to confuse varicose veins and deep vein thrombosis (DVT) as they both involve vein-related issues. But these two conditions have different causes, involve different kinds of veins, and have unique symptoms.

If you have varicose veins, you may notice bulging blue veins, usually on your legs. DVT can cause leg swelling, pain, and reddening of the skin. One of the most important differences between these two conditions is that DVT can lead to a pulmonary embolism, a serious and potentially life threatening complication.

Varicose veins don't always need treatment, but treatment is vital for DVT. If you have any symptoms of DVT, get immediate medical attention.

Deep Vein Thrombosis

Deep vein thrombosis or DVT is a blood clot that forms in a deep vein, most commonly in your leg or pelvis. The condition is usually linked to immobility, such as in patients lying in hospital beds for long periods after surgery or in long-haul airline passengers. It may lead to severe health complications like pulmonary embolism.

Causes

There are many reasons that cause deep vein thrombosis. These are –

Being inactive for a long time: This happens in case of recent surgeries, prolonged illness, injury or long-distance journey) there is an increased chance of a blood clot formation due to less flow of blood to other parts of body.

Damage of a blood vessel: If the wall of a blood vessel or lining of a vein is damaged, it may become narrowed leading to the formation of a blood clot.

Symptoms

DVT may cause no symptoms at all. However, some people might experience swelling, redness and pain in the affected area. Apart from these, other symptoms that can prove fatal if ignored for a long time include –

If a clot becomes dislodged and passes through the blood vessels, it can reach the lungs and cause a life-threatening blockage in it known as a pulmonary embolism. Risk Factors

Some of the common factors that increase your risk of deep vein thrombosis are –

DVT is one of the major complications that can occur after a hip replacement surgery.

According to a research, for every hour spent sitting the risk of a blood clot increases by 10 percent.

Another study says that overweight and obese middle-aged women are more likely to develop potentially fatal blood clots within leg veins than their normal weight counterparts.

Patients diagnosed with sleep apnoea, a snoring-related condition, are three times as likely to develop a deep vein thrombosis as non-snorers.

Several cases have been registered where women have suffered from DVT after having a contraceptive pill.

If you suffer from any condition that causes your blood to clot more easily than normal such as cancer, thrombophilia and Hughes syndrome, your risk of suffering from DVT increases.

Other factors such as being overweight or obese, suffering from dehydration or any disease that restricts mobility (especially as you age) puts you at an increased risk of DVT.

Diagnosis

Some of the diagnostic tests used to detect DVT are -

Ultrasound: The detection of blood clot in your veins can be diagnosed with the help of an ultrasound scan. A Doppler ultrasound (a special type of ultrasound) detects the flow of blood through a blood vessel.

D-dimer blood test: It is a blood test that shows broken fragments of blot clots dispersed in the bloodstream. This test is not always accurate and hence, needs to be substantiated with additional tests like an ultrasound or MRI scan.

Venography: If an ultrasound and D-dimer blood test are not successful to detect blood clot in the body, venegraphy is recommended. This method involves injection of a special dye into a vein (mostly your foot vein and an X-ray is taken. If you have a blood clot, there is a gap around that particular area as the dye is unable to flow round it.

MRI: MRI or Magnetic Resonance Imaging is another imaging test used to obtain detailed images of the veins and thus, check for a blood clot. Here are few things you should know about MRI.

Treatment

The treatment options for DVT include:

Warm compresses: Apply warm compresses to the affected area to treat pain, swelling and inflammation. In addition to this, compression stockings are also widely used that should be fitted with professional help and reviewed every three to six months.

Pain killers: Your doctor might recommend painkiller medications to relieve pain caused due to blood clot. However, the dosage is dependent on the severity of the pain.

Anticoagulants: An anticoagulant is a substance that prevents coagulation (clotting) of blood. Anticoagulants, such as heparin or warfarin, are a type of blood thinners that work on chemical reactions in the body to increase clotting time.

Surgery: In rare cases, deep vein thrombosis requires surgery to remove blood clot thereby aiding in the normal flow of the blood to other parts of the body.

Complications

If left untreated, deep vein thrombosis may lead to –

Pulmonary embolism: It occurs when the blood clot travels through the bloodstream to the lungs and blocks passage of air, which can be fatal. Although the consequences are dependent on the size of the clot, breathing difficulties and chest pain might turn into severe health complications such as heart or lung failure.

Post-thrombotic syndrome: If the blood clot is present in the calf then there is an increased pressure in the calf tissue. This causes swelling, rashes, ulcers and pain in the calf and is known as post-thrombotic syndrome.

Prevention

There are few simple yet effective tips to prevent deep vein thrombosis in people at an increased risk of suffering from the condition. These include -

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