Deep Vein Thrombosis (DVT)

 

What is Deep Vein Thrombosis?

Veins are the blood vessels that transport blood from various body parts to the heart.

A serious medical condition in which a blood clot is formed in a vein deeply inside body is called Deep vein thrombosis (DVT). A blood clot i.e. athicket of blood that mostly is in a jelly like state is formed in the veins. It is normally observed that DVT occurs in the thigh or lower leg area, however Deep Vein Thrombosis can happen in any other areas of human bod.

Sometimes condition of Deep Vein Thrombosis is also sometimes referred as PostThrombotic Syndrome, Post Phlebitic Syndrome & Thromboembolism though the former two are conditions which are outcome of prolonged existence of DVT.

Sometimes the clot so identified as DVT breaks free, and flow to other vital organs in the body. Incidence wherein clots are observed to block flow to lungs is called pulmonary embolism and is considered life threatening.

 

What causes Deep Vein Thrombosis? / Who is at risk?

There is no single factor identified to be the cause of DVT. DVT as condition is observed to be developed due to various factors or combination thereof. Some of the factors which are known to be the cause of DVT or which increase the probability of a person developing Deep vein Thrombosis are listed below:

  • Heredity: It is observed that people with a family history of Deep Vein Thrombosis have significant high chances of developing DVT themselves.
  • Weight: People who are overweight or obese tend to develop DVT as more pressure is exerted on veins in legs and pelvis.
  • Any injury resulting in damage to veins may lead to onset of clot formation in the deep veins i.e. DVT as any major injury may affect the inner lining of any deep vein leading to clots.
  • Medical conditions/ illnesses like heart disease, lung diseases, bowel inflammation disease, cancer also highly risk the chance of clot formations in veins.
  • Pregnancy/ Hormonal therapy/ Consumption of birth control pills: All these may lead to increase in level of “Estrogen” in female body and which may assist in easy clot formation.
  • Long Bed Rest or Seated for a long time: Non-movement of muscles for a longer duration sometimes lead to pooling of blood in lower legs and if combined with any other factors mentioned it greatly assists in development of Deep vein Thrombosis.

While development of DVT is more probable with increase in age, existence of any of the above factors may lead to onset of Deep vein Thrombosis at younger age.

What are the major Symptoms of Deep Vein Thrombosis?Why is DVT Dangerous?

DVT is difficult medical condition to identify as many patients (50%) may not display any symptoms. Also, the symptoms are more generic and are shared among various medical conditions. Patients may not be aware of DVT till they experience a serious life-threatening medical incidence like pulmonary embolism. Some of the common symptoms are:

  • Leg or foot swelling (sometimes only in one leg)
  • Pain, cramp or tenderness in the leg (usually in calf region)
  • Warmer skin that feels warmer than the surrounding skin
  • Reddish or Discoloured skin over the pain area

While the above symptoms may appear generic and one may not feel the need of medical evaluation, it is to be remembered that DVT leads to lethal incidences like Pulmonary Embolism hence shouldn’t be ignored.
Patients experiencing above symptoms are advised for medical treatment, below are listed some symptoms which a patient having life-threatening incidence of Pulmonary Embolism may experience and hence should be immediately evaluated by qualified medical professionals.

  • Shortness of Breath
  • Rapid Breathing with Chest Pain
  • Light headedness
  • Rapid Heartbeat
  • Excessive Sweating
  • Coughing with bloody sputum

How Deep Vein Thrombosis (DVT) is Diagnosed?

Primary evaluation of DVT is done by conducting a physical evaluation by medical professional. Clinical confirmation of DVT is done by performing some of the below mentioned tests as required by the medical doctor.

  • Ultrasound:With the help of medical device, sound waves are used to identify the existence and development of blood clots.Many a times a series of ultrasounds are required over period to determine growth and development blood clots. This is the most preferable primary test for DVT.
  • Venography: Under this X-Ray is taken of dye induced veins to identify the clot formation.
  • MRI/ CT:These tests provide visual images of veins and reveal if any clot formation has happened.
  • Blood test: While the above radiology tests confirms presence of clots, blood tests are done to obtain corroborative confirmations for DVT like higher levels of a substance called D dimer.

Treatment of Deep Vein Thrombosis

1. Medication – Anti Coagulants (Blood Thinners):

Primary treatment and the only non-interventional treatment option for patients, under this method patients are given medications which prevent any future clot formation and hence prevent any spread of DVT.

Though primary treatment, it should be noted that this may not be best suitable for existing clots and your doctor may suggest following interventional procedures to reduce risks and prevent any incidence.

2. CatheterDirected Thrombolysis (Clot Busting):

CatheterDirected Thrombolysis is the most preferred and effective treatment option for existing blood clots. It is usually recommended when patient is identified with multiple grown clots at the time of diagnosis or the doctor needs to ensure prevention of any untoward incidence which may not be avoided with medications.

It is small interventional procedure under which an X-ray is used as guide and an interventional radiologist will put a thin tube (catheter) in patient’s vein. The catheter is than used to administer the drug directly in the blood clot which dissolves it.

If the vein is narrow, it may be widened by conducting a balloon angioplasty to prevent future blockages.

3. Filters:

This treatment option is adopted generally when due to certain medical condition Catheter Directed Thrombolysis can not be done for the patient. Specifically designed to prevent incidences like Pulmonary Embolism, under this procedure a device is inserted into the main vein (Vena cava) which takes back blood from lower body to heart.

This device filters blood clots and stops them from moving to parts of your body where they can become dangerous.

4. Venous thrombectomy. In exceptional and rarest of cases, there may be a need to cut out the deep vein blood clot.

Treatment option most suitable for any patient depends on multiple factors and should be decided by a specialist like interventional radiologist.

How to Prevent Deep Vein Thrombosis (DVT)/ Precautions along treatment

While nothing much can be done to change the heredity, risk of developing Deep Vein Thrombosis can be greatly reduced by adopting a healthy and active lifestyle.

  • Regular exercise
  • No Smoking
  • Keeping optimum weight and BMI under check
  • Moving feet around at regular intervals during long travels and avoiding long sittings
  • Adhering to medications as prescribed by doctor
  • Keeping blood pressure and control
  • Keeping doctor informed of any DVT issue in the family
  • Compression stockings are recommended to prevent swelling and reduce chances of developing clots.

The above if adopted can significantly reduce the onset of Deep Vein Thrombosis.

Difference between DVT and Varicose Veins and Peripheral Artery Disease

Deep Vein Thrombosis refers to a medical condition wherein the blood clot forms in the deep vein and whereas in Varicose vein the blood flow is obstructed just beneath the surface of the skin in the veins due to improper functioning of valves inside the vein.

Also, the clots formed due to varicose veins do not usually break out and travel to vital organ like lung, while there is high chance of this potentially fatal condition happening in case of DVT. In DVT when such incident occurs it is called Pulmonary Embolism.

Peripheral Artery Disease is a condition in which arteries become hard and narrow due to plaque formation. With time and build up of plaque blood flow to arms and legs get obstructed and reduced. Such condition when happens in veins and not arteries it is called Peripheral Vascular Disease (PVD) and it can cause Deep Vein Thrombosis.

It is to be also noted that while Varicose Vein & Peripheral Artery Disease may not be considered as fatal medical condition, these conditions if unchecked may lead to serious outcomes like amputation of limbs and development of conditions like Deep Vein Thrombosis which is a life-threatening medical condition.

Also, one should observe that these medical conditions may exhibit similar/ same symptoms and hence one should seek guidance of medical professional for proper diagnosis and medical treatment.