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Upper Extremity Vs. Lower Extremity DVT
Deep vein thrombosis (DVT) is a blood clot that forms in a blood vessel inside your body, far away from your skin, that carries blood toward your heart. This mainly happens in your legs and pelvis. That's called lower extremity DVT. It can also happen in your arms, though not nearly as often. That's upper extremity DVT.
DVT in both the upper and lower body can happen to almost anyone at any age and for many reasons. For example, your vein could have been damaged by an injury or operation. Half of blood clots happen after surgery or being in the hospital.
Blood can pool and is more likely to clot when you have to stay in bed or sit still for a long time, like on a plane or car trip. This mostly causes lower extremity DVT.
Some things only cause DVT in your upper body. The most common is having a device in your arm or chest like a catheter (sometimes called a central line), pacemaker, or defibrillator.
Cancer raises your chance of upper extremity DVT, too. Some cancer medicines also go in through a central line.
Upper extremity DVT can happen in people who have a condition called Paget-Schroetter syndrome (PSS). Typically, young athletes get PSS in the arm they use most for sports like baseball, swimming, or tennis. When you do the same motion over and over, the veins in your neck and shoulder get squeezed. This can trigger a clot.
You're much more likely to get a blood clot in your leg than your arm. Still, upper extremity DVT is happening more often. That may be because more people are getting central lines and pacemakers.
Your chance of getting a clot is higher when you:
They're usually the same, regardless of where DVT is in your body. But symptoms happen only about half the time.
It's important to catch and treat DVT before it causes more problems. The biggest danger is much more likely to happen with lower extremity DVT. The clot could break away from the wall of the vein and travel through your blood to your lungs. Then it's called a pulmonary embolism (PE).
A small clot may damage your lungs. A large clot can be deadly.
You can have PE without any symptoms of DVT. Get medical help right away if:
Other health problems can look a lot like DVT. A torn muscle, a skin infection, or a clot in a vein right under your skin (thrombophlebitis) could cause the same symptoms. Your doctor may do tests to find out what's going on.
Duplex ultrasound is the main way to check for upper and lower extremity DVT. It lets your doctor see inside your body without X-rays. Instead, it uses sound waves to create images. The images can show places where your blood flow slows or stops. Ultrasound gives fast results and doesn't hurt or have side effects.
To get a better view of an upper extremity clot or rule out other problems, your doctor might use CT and MRI imaging tests.
D-dimer is a blood test that looks for a protein left over when your body breaks down clots. A negative test usually means you don't have DVT.
Small clots sometimes dissolve on their own, especially ones below your knee. Big clots that don't move or go away are more serious.
The most common treatment for both upper and lower extremity DVT is a blood thinner medicine. These drugs are also called anticoagulants.
A blood thinner doesn't really thin your blood. But it can keep a clot you have from growing and can stop new clots from forming. You'll probably take it for at least 3 months, though that can vary.
If you have a very large clot that hurts a lot and is causing swelling, your doctor may suggest a medicine to break it up. Clot busters aren't used that often because they can cause more serious side effects than blood thinners.
How Do I Recognise A Deep Vein Thrombosis?
One in nine of us will develop a deep vein thrombosis during our lifetime. This in itself is not life threatening, however if it breaks away and travels to the lung it can result in a pulmonary embolism, which can be fatal.
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There are three main risk factors for DVT: sticky blood, vein damage and immobility. Sticky blood can be caused by illness, old age, pregnancy and medication while vein damage can result from trauma such as surgery.
The Red Flag symptoms of a DVT, when combined with one or more of the risk factors above, are:
DVT has long been associated with air travel; however being in hospital is the one factor which actually accounts for the highest number of cases. As we lead more sedentary lives, experts have also coined a new term: 'e-thrombosis'. This identifies the growing number of DVT cases in which long periods of sitting at a computer without getting up has been the prime cause.
The symptoms can sometimes be hard to spot, however there are easy guidelines we can follow in order to significantly reduce our chance of developing one in the first place.
Whatever our daily routine, it is important to ensure we stand up regularly. Evidence has shown that sitting for 90 minutes can reduce the blood flow in the legs by half. Instead, it is recommended we get up every half an hour to an hour, stimulating the muscles and pumping blood around the body. This prevents it from pooling and staying in the same place.
At the same time, stay hydrated, and make sure your seat is comfortable and appropriate for your height. If you are at a particularly high risk however, a course of "blood thinning" medications may be necessary to prevent fatal clots.
Taking these preventative measures will reduce your risk, and recognising when to seek treatment could ultimately save your life.
Deep Vein Thrombosis
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Deep vein thrombosis (DVT) is a blood clot (thrombus) in a deep vein, usually in the legs. These clots require medical care right away.
These clots are dangerous because they can break loose, travel through the bloodstream to the lungs, and block blood flow in the lungs (pulmonary embolism). Pulmonary embolism is often life-threatening. DVT can also lead to long-lasting problems. It may damage the vein and cause the leg to ache, swell, and change color.
Clots can also form in superficial veins. Blood clots with inflammation in superficial veins (called superficial thrombophlebitis or phlebitis) rarely cause serious problems.
Blood clots most often form in the calf and thigh veins, and less often in the arm veins or pelvic veins. Diagnosis and treatment of DVT in other parts of the body are similar.
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