As the name self explains, it’s a condition when a blood clot inside a vein is formed somewhere deep in the body. Deep vein thrombosis mostly occurs in lower leg or thigh but sometimes in other parts as well. A blood clot is solidified blood that may move places along with blood. This mostly occurs as a complication of an operative procedure.
Symptoms of DVT:
- Swelling in foot, ankle, leg, typically on one side
- Cramping pain in the same leg that begins from your calf
- Severe pain in your foot and ankle
- A warm skin patch
- Affected area skin discoloration to pale or a reddish or bluish color
Symptoms of DVT of the upper limb are usually submissive if at all, they are
- Neck or Shoulder pain
- Swelling of arm or hand
- Blue Discoloration
- Moving pain from arm to forearm
- The weakness of hand muscles
In most cases, it remains undiagnosed until a person has to go to an emergency room for pulmonary embolism. It means the clot has moved from leg to lungs blocking any vital artery. Signs of which are
- Chest Pain getting worse while coughing and inhaling
- High Breath rate
- Blood in cough
- Increased heart rate
Causes of DVT:
- Injury directly to the vessel wall
- Post-Surgery- A vessel may be injured during the surgery forming a blood clot. Resting and not moving manifolds the risk of having DVT.
- Sedentary lifestyle/ Inactivity- Excessive sitting habits result in blood collection in your legs. Gradually a clot may develop.
- Specific Drugs may increase your chances of forming a blood clot.
Risk Factors for DVT:
- Age- 50 and above
- A bone fracture
- Increased weight
- Genetic Disposition
- Venous catheter
- Birth control pills or hormone therapy
- Excessive Smoking
- Sedentary life habits
- Clotting Disorders
- Inflammatory Bowel Disease
- Heart Failure
- Pregnancy- 5-10 times higher risk than the average person. Therefore it is essential for women to get to their feet post-delivery as soon as possible.
- Frequent flyers
Diagnosis of DVT:
- Verbal questions for symptoms
- Physical Exam
- Venogram with due under an X-Ray
- D-dimer test- blood test from factors releasing from a clot
Treatment– It mostly comes as a medical emergency and needs to be handled immediately
- Blood thinners
- Thrombolytic drugs intravenously
- Special clot busters called ‘lyrics’ are administered to dissolve blood clots
- Best Results are achieved when initiated immediately
- A session of 48 min for DVT
- Most effective and commonly used
- Compression Stockings to prevent both swelling and any further development of clots
- Filters in the abdominal vein stop the clot from entering the lungs until drug management dissolves it. These filters then need to be withdrawn.
- Surgical Management- Only in exceptionally large clots
- Thrombectomy- Cut the blood vessel, locate the clot, remove and stitch back. A balloon is inserted into the blood vessel too to keep it inflated as the surgery takes place.
Risk of Surgical Management:
- Damage to vessel
- Excessive bleeding
- Ankle toe movements Move your legs while sitting or lying
- Knee Pulls- While lying pull each knee towards the chest, hold and repeat.
- Draw ankle circles in both directions, both feet
- Include short frequent walks in your routine
- Use a stool to keep your feet on the same level as your body while sitting
- Compression Stockings
- Quit Smoking
- Lose weight
- Take your BP or other medication on time
- Lots of fruits and vegetables
- Lessor no known vegetarian diet
- Less on Vitamin K intake
Age is just one of the factors; anyone at any age can have DVT. Knowing and reading about it is always an asset.
Dr. Tariq Matin, Senior Consultant Interventional Neurology, Narayana Superspeciality Hospital, Gurugram and Dharamshila Narayana Superspeciality Hospital, Delhi