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Alternative Names Return to top
DVT; Blood clot in the legs; ThromboembolismDefinition Return to top
Deep venous thrombosis is a condition in which a blood clot forms in a vein that is deep inside the body.
Causes Return to top
Deep venous thrombosis (DVT) mainly affects the veins in the lower leg and thigh. A clot (thrombus) forms in the larger veins of the area. This clot can interfere with blood flow, and it may break off and travel through the bloodstream (embolize). The traveling blood clot (embolus) can lodge in the brain, lungs, heart, or other area, severely damaging that organ.
Risks for DVT include prolonged sitting (such as on long plane or car trips) or bedrest. It also may be caused by recent surgery (especially hip, knee, or female reproductive organ surgery), fractures, childbirth within the last 6 months, and the use of medications such as estrogen and birth control pills.
Risks also include overproduction of red blood cells in bone marrow (polycythemia vera), cancerous (malignant) tumor, and having a condition in which the blood is more likely to clot (hypercoagulability).
Deep venous thrombosis is most common in adults over age 60, but it can occur in any age group.
Symptoms Return to top
Exams and Tests Return to top
An exam may show a red, swollen, or tender leg.
The presence of deep venous thrombosis may be seen on:
Treatment Return to top
DVT treatment helps prevent a pulmonary embolus from forming and helps prevent another DVT.
For years, the standard treatment has been a medication called heparin to stop blood clots from forming (anticoagulant). It results in quick anticoagulation, and it prevents the clot from growing.
If heparin is given continuously through a vein (IV), it requires a hospital stay. However, newer forms of heparin known as low molecular-weight heparin can sometimes be used. These forms include:
Heparin can be given by injection once or twice a day to shorten or avoid the need for a hospital stay.
A person with DVT also may get an oral medication called warfarin with the heparin. Warfarin usually takes several days to fully work. Heparin is continued until the warfarin has been fully effective for at least 24 hours. People will take warfarin for about 6 months. Usually warfarin is started after heparin.
Warfarin causes an increase in the time it takes blood to clot, known as prothrombin time (PT). A system called the International Normalized Ratio (INR) is used to report the ability of the blood to clot properly. Doctors will adjust warfarin to keep the INR between 2 and 3.
Rarely, surgery may be performed when medications fail:
Outlook (Prognosis) Return to top
Many DVT's disappear without a problem, but they can recur. Some people may have chronic pain and swelling in the leg, known as post phlebitic syndrome.
A pulmonary embolus, a blood clot that breaks free in the leg and travel to the lungs is called, can occur and can be life threatening. Rapid treatment of DVT helps prevent this problem.
Possible Complications Return to top
When to Contact a Medical Professional Return to top
Call your health care provider if you have DVT-like symptoms.
Go to the emergency room or call the local emergency number (such as 911) if you have DVT and you develop chest pain, difficulty breathing, fainting, loss of consciousness, or other severe symptoms.
Prevention Return to top
Doctors may prescribe anticoagulants to help prevent DVT in high-risk people or those who are undergoing high-risk surgery. Wearing compression stockings on the legs also helps prevent DVT in high-risk patients.
To help prevent DVT, move your legs often during long plane trips, car trips, and other situations in which you are sitting or lying down for long periods of time.
Update Date: 4/7/2008 Updated by: A.D.A.M. Editorial Team: David Zieve, MD, MHA, Greg Juhn, MTPW, David R. Eltz, Kelli A. Stacy, ELS. Previously reviewed by Rita Nanda, MD, Department of Medicine, Section of Hematology/Oncology, University of Chicago Medical Center, Chicago, IL. Review provided by VeriMed Healthcare Network (4/27/2007).
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Page last updated: 02 September 2008 |