Diseases & Conditions

 

Deep Vein Thrombosis

Diseases & Conditions

 

What is deep vein thrombosis?

 Deep vein thrombosis is a condition that occurs when a blood clot (thrombus) is formed in a deep vein. Deep vein thrombosis usually occurs in a deep leg vein, a larger vein that runs through the muscles of the calf and the thigh.

 Deep vein thrombosis is a life-threatening condition because blood clots in the leg’s vein can travel throughout the body and enter the lungs blocking blood flow and causing pulmonary embolism.

 Deep vein thrombosis is the third most common cardiovascular illness after acute coronary syndrome and stroke.1 The exact incidence of deep vein thrombosis in the Kingdom of Saudi Arabia is unknown. If we assume that the incidence rates are similar to those present in other parts of the world, approximately 25,000 people are affected in the kingdom every year.2

  

What causes deep vein thrombosis?

 Deep vein thrombosis occurs when blood’s clotting system does not function properly. Once a small clot forms in the vein, it can cause an inflammation that may induce the formation of more blood clots. Blood clots can be the result of many conditions that prevent the blood from circulating normally or clotting properly.3

 

 What are the risk factors for deep vein thrombosis?

 Many factors can increase the risk of developing deep vein thrombosis which include:4

  • Family history of blood clot: Some patients inherit disorders from their parents making their blood clots easily.
  • Bed rest or sitting in one position for too long: This will cause slow blood flow in a deep vein due to lack of movement.
  • Injury or surgery to the veins can increase the risk of getting deep vein thrombosis.
  • Pregnancy: Pregnancy and the first six months after giving birth increase the pressure in the veins, which increase the risk of getting deep vein thrombosis.
  • Birth control pills or hormone replacement therapy can increase the ability of the blood to clot.
  • Being overweight or obese increases the pressure in the vein.
  • Smoking
  • Cancer: Certain cancers and cancer treatments could increase the amount of substances that cause the blood to clot.
  • Heart failure
  • Inflammatory bowel disease
  • Older age

 

What are the symptoms of deep vein thrombosis?

 Deep vein thrombosis mainly affects the large veins in the lower leg and thigh, almost always on one side of the body. The clot can block blood flow and cause:5

  • Red skin on the leg
  • Pain in the leg, which often starts in the calf and feels like cramping or soreness
  • Swelling of the leg or along a vein in the leg
  • Skin that feels warm to the touch

 

 How is deep vein thrombosis diagnosed?

 A doctor will diagnose deep vein thrombosis based on medical history, physical examination and different diagnostic tests:6

  • Medical history: Medical history including overall health, medications currently being taken, and any recent surgeries or injuries are investigated by the doctor.
  • Physical examination: The doctor will check signs and symptoms for deep vein thrombosis such as redness of the legs, swelling or warmth.
  • Diagnostic tests:
    • Ultrasound: This is the most common test used to diagnose deep vein thrombosis. It creates images of blood through the arteries and veins in the affected leg.
    • D-dimer test: This test measures a substance in the blood that's released when a blood clot dissolves.
    • Venography: This test consists of an X-ray procedure that creates an image of the veins in the legs.
    • Magnetic resonance imaging (MRI)
    • Computed tomography (CT) scan

 

 How is deep vein thrombosis treated?

 The primary objectives for the treatment of deep venous thrombosis are to prevent pulmonary embolism and to impede the blood from clotting. Deep vein thrombosis treatment options include:7

  • Blood thinners: Anticoagulants are the most common medicines for treating deep vein thrombosis. These medications decrease the blood's ability to clot and they prevent blood clots from breaking loose. They can also impede clots from getting bigger and reduce the risk of developing additional clots.
  • Clotbusters: The medications include thrombolytics which quickly dissolve large blood clots that cause severe symptoms.
  • Filters: Filters may be inserted into a large vein in the abdomen preventing clots that break loose to travel to the lungs and cause pulmonary embolism.
  • Compression stockings: These stockings are worn on the legs and can reduce leg swelling caused by a blood clot.

 

References:

  1. Venous Thromboembolism (Deep Venous Thrombosis & Pulmonary Embolism) (Venous Thromboembolism) http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/cardiology/venous-thromboembolism/ (Accessed January 16, 2016)
  2. Al-Hameed, Fahad, et al. "The Saudi clinical practice guideline for the diagnosis of the first deep venous thrombosis of the lower extremity." Annals of thoracic medicine 10.1 (2015): 3.
  3. Deep Vein Thrombosis (DVT) (Deep Vein Thrombosis (DVT)) http://www.vascularweb.org/vascularhealth/pages/deep-vein-thrombosis-(-dvt-)-.aspx (Accessed January 16, 2016)
  4. Deep vein thrombosis (DVT) (Risk factors) http://www.mayoclinic.org/diseases-conditions/deep-vein-thrombosis/basics/risk-factors/con-20031922 (Accessed January 16, 2016)
  5. Deep venous thrombosis: MedlinePlus Medical Encyclopedia (U.S National Library of Medicine) https://www.nlm.nih.gov/medlineplus/ency/article/000156.htm (Accessed January 16, 2016)
  6. How Is Deep Vein Thrombosis Diagnosed? (- NHLBI, NIH) http://www.nhlbi.nih.gov/health/health-topics/topics/dvt/diagnosis (Accessed January 16, 2016)
  7. Deep vein thrombosis (DVT) (Treatments and drugs) http://www.mayoclinic.org/diseases-conditions/deep-vein-thrombosis/basics/treatment/con-20031922 (Accessed January 16, 2016)