Healthy Living/Blood Clots






       
Click to enlarge picture 
Alternative names   
DVT; Blood clot in the legs 
Definition   
Deep venous thrombosis is a condition where there is a blood clot in a deep vein (a vein that accompanies an artery).  
Causes, incidence, and risk factors   
Deep venous thrombosis (DVT) affects mainly the veins in the lower leg and the thigh. It involves the formation of a clot (thrombus) in the larger veins of the area. This thrombus may interfere with circulation of the area, and it may break off and travel through the blood stream (embolize). The embolus thus created can lodge in the brain, lungs, heart, or other area, causing severe damage to that organ.

Risks include prolonged sitting, bedrest or immobilization (such as on long plane or car trips), recent surgery or trauma (especially hip, knee or gynecological surgery), fractures, childbirth within the last 6 months and the use of medications such as estrogen and birth control pills. Risks also include a history of polycythemia vera, malignant tumor, and inherited or acquired hypercoagulability (changes in the levels of blood clotting factors making the blood more likely to clot).
Deep venous thrombosis is more commonly seen in adults over age 60 but can occur in any age group.
 Symptoms   
leg pain in one leg only
leg tenderness in one leg only
swelling (edema) of only one leg
increased warmth of one leg
changes in skin color of one leg, redness
 Signs and tests   
An examination may reveal a red, swollen, or tender leg.

The presence of deep venous thrombosis may be seen on:
venography of the legs
Doppler ultrasound exam of an extremity
plethysmography of the legs
D-dimer blood test
Many of the inherited and acquired causes of hypercoagulability (clotting tendency) can be detected by blood tests:
antithrombin III, protein C, protein S
Factor V Leyden
Prothrombin 20210a mutation
DIC screening
lupus anticoagulant and anticardiolipin antibodies
 Treatment   
Treatment of DVT is intended to prevent the development of a pulmonary embolus and to prevent recurrent DVT.
For years the standard treatment has been an anticoagulant medication called heparin which was given through the vein. This results in relatively immediate anticoagulation and treatment of the clot. Along with heparin an oral medication called warfarin is given. Because warfarin usually takes several days to reach effectiveness (until it reaches a therapeutic level), the heparin is continued until the warfarin is therapeutic for at least 24 hours. The warfarin is usually continued for approximately six months though there is some debate about the optimal duration of therapy. In almost all circumstances warfarin should not be initiated until heparin has been started.
Because heparin is given as a continuous intravenous infusion, it requires hospitalization. However, newer forms of heparin, known as low molecular weight heparin (usually enoxaparin) can be used in some circumstances. This heparin can be given by injection once or twice a day and thus can shorten or eliminate the need for hospitalization.
Warfarin causes an increase in a blood clotting time known as the PT. The PT is monitored to determine if the blood is sufficiently anticoagulated. A measurement known as the INR standardizes PT measurements between labs. For most patients warfarin is adjusted to keep the INR between 2 and 3.
 Expectations (prognosis)   
Most DVT's disappear without difficulty, however there is a risk of recurrence. Some patients may develop some chronic pain and swelling in the leg known as post phlebitic syndrome. Pulmonary embolus is uncommon when DVT's are treated properly but can occur and can be life threatening.  
Complications   
pulmonary embolus
post-phlebitic syndrome
 Calling your health care provider   
Call your health care provider if symptoms suggestive of DVT occur.

Go to the emergency room or call the local emergency number (such as 911) if chest pain, difficulty breathing, fainting, loss of consciousness, or other severe symptoms occur in a person with a DVT.  
Prevention   
Anticoagulants may be prescribed as a preventive measure for high risk people or people undergoing high risk surgical procedures. Minimize immobility of the legs (ambulate frequently during long plane trips, car trips, etc).


For more information visit
MedlinePlus Trusted Health Information for You




 
This picture shows a red and swollen thigh and leg caused by a blood clot (thrombus) in the deep veins in the groin (ileofemoral veins) which prevents normal return of blood from the leg to the heart.
BACK




Venous blood clot
 
BACK
Deep venous thrombosis (DVT) affects mainly the veins in the lower leg and the thigh. It involves the formation of a clot (thrombus) in the larger veins of the area.
blood clots, spinal cord injury 
Veins carry blood from the extremities to the heart and lungs, where the blood is oxygenated. As the blood returns to the heart from the lungs, the arteries carry the oxygen-rich blood out to the extremities.
Deep veins
 
Veins carry blood from the extremities to the heart and lungs, where the blood is oxygenated. As the blood returns to the heart from the lungs, the arteries carry the oxygen-rich blood out to the extremities.
BACK