Information From Your Health Care Provider

THROMBOSIS, DEEP VEIN

Basic information

description

A deep vein thrombosis (DVT) is a blood clot (thrombus) that forms inside a deep vein. It may block the blood flow partially or completely, or it could break off and travel to the lung. Deep vein thrombosis often occurs in the lower legs (calves). Less often it occurs in the arm or pelvis. DVTs more often affect adults over age 40 and men more than women.

FREQUENT SIGNS & SYMPTOMS

Sometimes no symptoms occur.
Swelling, tenderness, or pain in the leg, especially the calf muscle.
Warmth or redness of the leg.
Soreness or pain when walking. The soreness does not disappear with rest.
Pain when raising the leg and flexing the foot.

causes

Pooling of blood in the vein, which triggers blood-clotting mechanisms. The pooling may occur after prolonged bed rest, following surgery, or from long-lasting illness, such as heart attack, stroke, or bone fracture.

risk increases with

Persons over 40.
Obesity or smoking.
Estrogen use in birth control pills or for replacement after menopause. More of a risk with smokers.
Surgery and surgery recovery.
Long (usually over 4 hours) auto or airplane trips.
During pregnancy and right after childbirth.
Cancer, heart failure, stroke, and polycythemia.
Bed rest for an extended time.
Fractures.
Intravenous (IV) drug abuse.
Blood disorders that increase the risk of blood clots.

PREVENTIVE MEASURES

Avoid prolonged bed rest if possible. Move legs as often as possible after surgery or during a long illness.
On long auto or airplane trips, exercise your legs at least once every hour. Elevate legs when possible. Drink plenty of fluids. Avoid alcohol.
Stop smoking, especially if you take estrogen.
Wear special compression stockings.

expected outcomes

Usually curable with treatment.

possible complications

Pulmonary embolism (blood clot travels to the lung).
Embolism to another part of the body.
Post-thrombotic syndrome due to vein damage. Blood pools in lower leg, causing swelling and pain in leg.
Excessive bleeding from blood thinning drugs.

diagnosis & treatment

general measures

Your health care provider will do a physical exam of the affected area. Questions will be asked about your symptoms and activities. Medical tests, such as ultrasound, may be done to confirm the diagnosis.
Small clots located in the calf may not need treatment right away. These clots often clear up on their own.
In many cases, hospital care is required for injections of blood thinning drugs and to watch for complications.
A surgical procedure may be done to insert a filtering device ("umbrella") into the vena cava (main vein to the lungs). It will trap clots before they reach the lungs.
Surgery or other procedure may be done to remove a large clot.
Special compression stockings may be prescribed. They help prevent pain, swelling, and complications.

medications

Usually, an intravenous (IV) anticoagulant (blood thinner) drug is prescribed. This stops a clot from growing and prevents new clots. Blood tests will be ongoing to check the anticoagulant level. Oral anticoagulants may be prescribed for 6 months or longer.
Thrombolytic drugs, which dissolve the clots, may be prescribed in more severe cases.

activity

Rest at home as advised by your health care provider. While resting, make it a habit to move leg muscles, bend ankles, and wiggle toes.
Elevate the feet higher than the hips when sitting or when in bed. Place a cushion under the feet or raise the foot of the bed higher.

diet

No special diet.

notify our office if

You or a family member has symptoms of deep vein thrombosis.
The following occur with treatment: any unexpected bleeding, chest pain, coughing up blood, shortness of breath, continued or increased swelling, and pain.