Deep vein thrombosis, commonly referred to as DVT, is a blood clot which forms in the deep veins located in your arms, legs or pelvis that can be dangerous and life threatening.

Arteries have thin muscles within their walls to withstand the pressure of the heart pumping blood to the far reaches of the body.

Veins do not have a significant muscle lining so there is nothing pushing the blood back to the heart except the contraction of muscles in the body through normal movement.

If you are immobile for a long time, the blood-return system may fail resulting in some of the stagnated blood clotting.

A blood clot in the deep venous system of the leg or arm is not in itself dangerous. It becomes potentially life threatening when a piece of it breaks off, travels through the circulation system, enters one of the pulmonary (lung) arteries and becomes lodged there creating a pulmonary embolism.

This can prevent blood flowing properly through the lung, thus decreasing the amount of oxygen absorbed and distributed back to the body.

Symptoms

Common symptoms include pain, swelling, warmth, redness, leg cramps often starting in the calf as well as leg pain that worsens when bending the foot. Other symptoms include bluish or whitish skin discoloration. You may have no symptoms at all. Symptoms of a pulmonary embolism include sudden breathlessness, chest pain that worsens when you cough, feeling lightheaded or dizzy or fainting, a rapid pulse, rapid breathing and coughing up blood. If these occur this should be treated as a medical emergency.Blood clots in the superficial vein system that is closer to the surface of the skin most often occur due to trauma to the vein which causes a small blood clot to form. They are necessary to prevent bleeding if there has been an injury. They are usually harmless. Inflammation of the vein and surrounding skin may result in reddish or dark skin, warmth, tenderness and swelling.

Causes

Blood is meant to flow continuously. If it becomes stagnant, there is a potential for it to clot. The blood in veins constantly forms microscopic clots that are routinely broken down by the body. If the balance of clot formation and clot breakdown is altered, significant clotting may occur.

A blood clot, or thrombus in medical terms, may form if you are immobile for long periods, due for instance to long hours of bed rest or hospitalisation or travelling long distances by air or road.

Other causes include surgery, trauma to the lower leg, pregnancy, obesity, coagulation of the blood faster than usual, birth control or hormone replacement therapy pills, smoking, a genetic or hereditary predisposition to clot formation, an increased number of red blood cells, cancer, trauma to the vein, fracture of the leg or arm, a bruised leg or arm and complications of an invasive surgical procedure.

Treatment and management

The treatment for deep venous thrombosis is anticoagulation or thinning the blood with medication. Your doctor or other health care professional is likely, after three months of treatment, to evaluate your situation and the potential for future blood clot formation. If continued anticoagulation treatment seems indicated, the benefits of preventing possible future blood clots are likely to be weighed up against the risk of bleeding that accompanies the use of blood thinning medications. For those for whom blood thinning medication is contraindicated, an alternative may be to place a filter in the inferior vena cava, which is the major vein that collects blood from both legs. The filter will prevent blood clots, should they arise, from reaching the heart and lungs. However, there is a potential risk of it being the source of a new clot formation.

Treatment for superficial vein blood clots includes warm compresses, leg compression or taking an anti-inflammatory medication such as ibuprofen.

If the superficial vein blood clot occurs near the groin where the superficial and deep systems join together, there is a possibility that the clot could extend into the deep venous system. This might necessitate anticoagulation or blood thinning therapy.

Complications

The main complication of deep vein thrombosis is pulmonary embolism, which occurs when a blood vessel in your lung becomes blocked by a blood clot. This can be life threatening.

Another possible complication is postphlebitic syndrome, which is when the blood clot causes damage to your veins, reducing the blood flow in the affected area and causing leg pain, swelling, skin discolouration and skin sores.

Blood thinning medication may result in bleeding. It is important when taking this medication to have regular blood tests, the results of which may result in your doctor altering the dosage.

Prevention

The main preventative measure is to avoid sitting still for long periods of time. If you have had surgery, it is important to start moving around as soon as possible.

If you are travelling a long distance by car, stop every hour or so and walk around for a bit. If you are making a long trip by air, stand up periodically and walk around. If you can’t, then from time to time raise and lower your heels several times with your toes on the floor and then raise your toes with your heels on the floor. Exercise and manage your weight. Obesity is a risk factor. Don’t smoke, as this increases the risk of DVT as well as the risk of many other illnesses.

The information in this article is provided as a public service by the Cimas iGo Wellness programme, which is designed to promote good health. It is provided for general information only and should not be construed as medical advice. Readers should consult their doctor or clinic on any matter related to their health or the treatment of any health problem. — igo@cimas. co.zw or WhatsApp 0772 161 829 or phone 0242773 0663.