A deep vein thrombosis (throm-BO-sis) is a blood clot that forms in a vein
deep in the body. Most deep vein clots occur in the leg or hip veins. They
also can occur in other parts of the body. Blood clots in the veins in the
thigh are usually more serious than blood clots that happen in veins in
your lower leg.
If a clot in a vein breaks off and travels through your bloodstream, it
can lodge in your lung. This is called a
pulmonary embolism (PUL-mo-ner-e EM-bo-lizm), which is a very serious
condition that can cause death.
Blood clots also can occur in veins that are close to the surface of the
skin. These types of blood clots are called superficial venous
thrombosis or phlebitis (fle-BI-tis). Blood clots in
superficial veins cannot travel to the lungs.
Sitting for a long period of time like on a long trips in a car or on an
airplane
Pregnancy, especially the first 6 weeks after giving birth
Being over age 60 (although deep vein thrombosis can occur in any age
group)
Being overweight
Taking birth control pills or hormone therapy, including for
postmenopausal symptoms
Central venous catheters now account for almost 1 in 10 cases.
Your risk for deep vein
clots increases if you have several risk factors at the same time. For
example, a woman with an inherited condition for clotting who also takes
birth control pills has an even higher risk to have a blood clot.
What
Are the Signs and Symptoms of Deep Vein Thrombosis and of Pulmonary
Embolism?
Only about half of the people with deep vein thrombosis have symptoms. The
symptoms may include:
Deep vein thrombosis
Swelling of the leg
Pain
or tenderness in the leg-the pain is usually in one leg and may only be
present when standing or walking
Feeling of increased warmth in the area of the leg that is swollen or
that hurts
Red
or discolored skin.
Pulmonary embolism
Chest pain when you take a deep breath
Shortness of breath.
Some people only find out
they have a deep vein thrombosis after the clot has moved from the leg and
traveled to the lung (pulmonary embolism). It is important to see a doctor
right away if you have symptoms of a pulmonary embolism or deep vein
thrombosis.
Your doctor will obtain a medical history and examine you to determine if
you have deep vein thrombosis.
Duplex ultrasound is the most common test used to diagnose deep
vein clots. It uses sound waves to evaluate the flow of blood in your
veins. A gel is put on the skin of the leg. A handheld device is placed on
the leg and passed back and forth over the affected area. This device
sends sound waves from the leg to an ultrasound machine. A computer then
turns the sounds into a picture. The picture is displayed on a TV screen
where your doctor can see the blood flow in your leg.
Venography may be performed if the Duplex ultrasound does not
provide a clear diagnosis. A venogram is an x-ray used to examine veins. A
dye is injected into a vein and then an x-ray is taken of the leg. The dye
makes the vein visible on the x-ray. If the blood flow in the vein is
slowed, it will show on the x-ray.
Less frequently used tests
Magnetic Resonance Imaging (MRI) shows pictures of organs and
structures inside the body. MRI uses radio waves to make the image. In
many cases, MRI can provide information that would not show up on an
x-ray. This test is being used more frequently to diagnose deep vein
thrombosis.
Computed tomography (CT)
scan is a special type of x-ray that can provide pictures of
structures inside the body. This test is rarely used to diagnose deep
vein thrombosis.
If your doctor suspects
that an inherited disorder could be causing the clots, the doctor may test
for these disorders. This may be important if:
You
have repeated blood clots that cannot be linked to any other cause
You
have a blood clot in a vein at an unusual location, such as a vein from
the liver, kidney, or brain.
Preventing deep vein thrombosis depends on whether you have had a clot
before or if you are at risk for developing a deep vein clot but never had
one.
If you have had a deep vein clot, then you will need to prevent further
clots from developing by:
Taking your medications to prevent or treat blood clots as prescribed by
your doctor
Following up with your doctor for medication changes and blood work.
If you have never had a
deep vein clot, but are in a situation that may increase your risk, be
sure to:
Exercise your lower leg muscles if you will be sitting still for long
periods of time.
Get
out of bed and move around as soon as you are able after having surgery
or being ill. The sooner you move around the less chance you have to
develop a clot.
Take
medications to prevent clots after some types of surgery as directed by
your doctor.
The main goals in treating deep vein thrombosis are to:
Stop
the clot from getting bigger
Prevent the clot from breaking off in your vein and moving to your lungs
Reduce your chance of having another blood clot.
There are several
medications used to treat and/or prevent deep vein thrombosis:
Anticoagulants (sometimes called blood thinners) decrease your
blood's ability to clot. They are used to stop clots from getting bigger
and to prevent a blood clot from forming. Anticoagulants do not break up
blood clots that have already formed. Your body's natural system will
dissolve the clot. Anticoagulants can either come as a pill (warfarin)
or as an injection or shot (heparin).
Heparin and warfarin may be given at the same time. Heparin will act
quickly, while the warfarin will take 2 to 3 days before it starts to
work. Once the warfarin is working, the heparin will be stopped. Pregnant
women cannot take warfarin and will be treated with heparin only.
Treatment for deep vein thrombosis with anticoagulants usually lasts for 3
to 6 months. However, the following situations may change the length of
treatment:
If
your blood clot occurred after a short-term risk like surgery, your
treatment may be shorter
If
you have had clots before, you will need longer treatment
If
you have another illness (like cancer) you are being treated for, you
will take anticoagulants for as long as those risk factors are present.
The most common side
effect of anticoagulants is bleeding. Blood tests will check how well the
medicine is working. You should call your doctor right away if you are
taking warfarin or heparin and have easy bruising or bleeding.
Thrombolytics are medications given to quickly dissolve the blood
clot. They are used to treat large clots causing severe symptoms. Because
they can cause sudden bleeding, they are only used in life-threatening
situations.
Thrombin inhibitors are new medications that interfere with the
clotting process. They are used in treating some types of clots and for
patients who cannot take heparin.
Vena cava filters are used when you cannot take medications to thin
your blood, or if you are taking blood thinners and continue to develop
clots. The filter can prevent blood clots from moving from the vein in
your legs to the lung (pulmonary embolism). The filter is inserted inside
a large vein called the vena cava. It can catch the clots as they try to
move through the body to the lungs. This treatment will prevent a
pulmonary embolism, but will not stop you from developing more clots.
Your doctor may prescribe graduated compression stockings to reduce
the chronic swelling that can occur in the leg after a blood clot has
developed. The swelling is due to damage to the valves in the leg veins.
Compression stockings are worn on the legs from the arch of the foot to
just above or below the knee. These stockings are tight at the ankle and
become looser as they go up the leg. This causes a gentle compression (or
pressure) up your leg. They have some side effects:
They
can be uncomfortable when worn all day
They
can be hot
They
may be difficult to put on, especially for older adults and overweight
people.
Much of the treatment for
deep vein thrombosis takes place at home. It is important to:
Take
medications correctly.
Have
blood work drawn as directed by your doctor.
Avoid activities that may cause a serious injury.
Talk
to your doctor before taking any other medications, especially
over-the-counter medications.
Ask
your doctor about your diet. Certain foods affect how well your
anticoagulant works.
Frequently Asked Questions About Deep
Vein Thrombosis
If I have mild symptoms of a deep vein thrombosis, can I wait and see
if the clot will go away on its own?
No. Not treating a deep vein thrombosis can cause very serious
complications. If you think you have the symptoms or are unsure if you
have the symptoms, see a doctor right away.
Are there any foods that change the way my medications work?
Yes, foods that contain Vitamin K can change how well warfarin (coumadin)
will work. This vitamin is found in green leafy vegetables and in some
oils like canola and soybean oil. It is best if you eat a well-balanced
healthy diet that doesn't vary. For example, you should not make up for
having no vegetables one week by eating extra helpings of vegetables the
next week.
I hear that alcohol can thin my blood. Can I drink alcohol while taking
anticoagulants?
It is important that you discuss with your doctor what amount of alcohol
is safe for you to drink.
Do I need to restrict my activities while I am being treated for a deep
vein thrombosis?
You should discuss your activities with your doctor. In general, your
activities do not need to be restricted.
Can I take over-the-counter medications while taking anticoagulants
(blood thinners)?
Some over-the-counter medications, such as vitamin K in multivitamins, may
change the way your medications work. Aspirin can also thin your blood.
Taking two medications (even if one is over-the-counter) that thins your
blood may increase your risk for excessive bleeding. Always check with
your health care team before taking any other medications while taking
anticoagulants.
Why do I need to have blood testing?
While you are taking anticoagulants, your doctor will need to carefully
monitor your clotting ability. Blood tests will measure how quickly your
blood clots or if your blood is clotting too slowly. If your lab tests
show that your blood is clotting too slowly or too quickly, your
medications may be changed or adjusted.
Deep
vein thrombosis is a blood clot that forms in a vein deep in the body.
Deep
vein clots in the thigh are more serious then those that happen in your
lower leg. These clots are more likely to travel to the lung.
Many
conditions may increase your risk for deep vein clots. Some of these
conditions alone can increase your risk; when several are combined, your
risk increases further.
Only
about half the people with deep vein clots have symptoms.
Your
doctor will obtain a medical history and examine you to determine if you
have a deep vein clot.
Simple, painless tests can be performed to identify the location of the
clot.
The
main goals in treating deep vein thrombosis are to stop the clot from
getting bigger, to stop the clot from breaking off in your vein and
moving to your lungs, and to decrease your chance of having another deep
vein thrombosis.
Medications are used to treat and/or prevent deep vein thrombosis.
The information contained in materials
published by the National Heart, Lung, and Blood Institute (NHLBI) is in
the public domain. No further permission is required to reproduce or
reprint the information in whole or in part. However, organizations that
reproduce NHLBI publications should cite the National Heart, Lung, and
Blood Institute as a part of the National Institutes of Health and the
U.S. Department of Health and Human Services as the source. This applies
to printed publications as well as documents from the NHLBI Web site.
Organizations may add their own logo or name. We further ask that no
changes be made in the content of the material, and that the material as
well as any NHLBI Internet links should not be used in any direct or
indirect product endorsement or advertising.
Page updated on: 10/08/05
The APS Foundation of
America, Inc. website and forums are independently funded and
maintained by Heidi and Tina. We do not receive any funding from
advertising.
We subscribe to the HONcode principles. Verify
here.
DISCLAIMER: APS
Foundation of America, Inc. website is not intended to replace
standard doctor-patient visits, physical examination, and
medical testing. Information given to members is only an
opinion. All information should be confirmed with your
personal doctor. Always seek the advice of a trained physician
in person before seeking any new treatment regarding your
medical diagnosis or condition. Any information received from APS
Foundation of America, Inc. website is not intended to
diagnose, treat, or cure. This site is for informational
purposes only. If you think you may have a medical
emergency, call your doctor or 911 immediately.
