DVT - What Is A Deep Vein Thrombosis?
DVT can be painful
Published on March 3, 2014. Mary McShane, All Rights Reserved
A Deep Vein Thrombosis (DVT) is when a blood clot lodges in one of the deep veins of the body, usually the legs. Blood clots that develop in the vein are also called venous thrombosis.
DVT's usually swell and if not treated promptly, a person can develop a pulmonary embolism.
A pulmonary embolism is when the clot breaks out into the bloodstream and then lodges in one of the blood vessels in the lungs, compromising breathing and is a life-threatening event.
Why a blood clot is serious
Causes of Deep Vein Thrombosis (THROMBOSIS)
T - Trauma to the body
H - Hormones increased coagubility
R - RTA (a fracture and injuries of lower limb)
O - Operation (ex: Cholecystectomy)
M - Malignancy ( will cause sluggish blood flow)
B - Blood disorder
O - Orthopedic surgery
S - Serious illness
I - Immobilization (ex: prolonged bed rest)
S - Splenectomy
Is it painful?
When first developing, a DVT can be extremely painful or one can have very little pain at all. Swelling will usually be the first telltale sign with a little ache in the leg. Once discovered, the pain level escalates and medical attention is imperative so that the blood clot does not travel through the body.
People who are in bed, are on ordered bedrest , or who are sitting in one position for long periods (ex: in front of a computer or television) are at the most risk for DVT.
A VTE - venous thromboembolism - is the combination of the DVT and a pulmonary embolism.
Leg warmth, pitting and some swelling are signs of DVT
Symptoms of DVT
- pain, swelling and tenderness in one of your legs (usually your calf)
- a heavy ache in the affected area
- warm skin in the area of the clot
- redness of your skin, particularly at the back of your leg, below the knee
DVT usually (although not always) affects one leg. The pain may be made worse by bending your foot upward towards your knee.
If DVT is not treated, a pulmonary embolism may occur. If you have a pulmonary embolism, you may experience more serious symptoms such as:
- breathlessness, which may come on gradually or suddenly
- chest pain, which may become worse when you breathe in
- sudden collapse
Both DVT and pulmonary embolism are serious conditions that require urgent investigation and treatment.
About Thrombosis: Symptoms and risk factors for deep vein thrombosis (DVT)
Treatment of DVT
Treatment of DVT
The main treatment for DVT is using an anticoagulant, which is a blood thinner, usually heparin. Heparin is injected, usually in hospital while being carefully monitored, followed up at home with coumadin (generic: warfarin), which is a tablet.
An anticoagulant will prevent the clot from growing larger and allow your body to absorb it slowly. It also helps prevent new clots from forming. Regular bloodwork is essential to make sure the medication is working properly and that you are taking the correct dose. Be sure to keep your appointments for blood work and follow ups for the results of the blood work.
In recent years, anticoagulants have been referred to as "clot busters." In an emergency situation, these are always given IV (intravenous). Whenever a paramedic suspects that a patient is having a stroke, even if it turns out the patient isn't having one, the paramedic will deliver one dose. This can be a life-saving; it buys the patient time until he/she can be transported to a hospital. Name brand clot busters are: Lovenox, Coumadin IV, Activase, Warfarin IV and Xarelto
Sometimes a patient needs more immediate and invasive attention where coagulant therapy will take too long (usually about 7 days). In that case, surgery is recommended to remove the clot. A small cut is made in the artery and the surgeon uses instruments to suck out the clot. This option should be considered as a last resort.
Compression stockings (commonly referred to as TED stockings) usually go from your foot up to your knee, but sometimes doctors will order the longer ones which go up to the thigh. Compression stockings will help prevent swelling. This pressure they put on your leg will help reduce the pooling of blood in the veins that cause a clot.
Medical professionals vary on advice, but the general rule of thumb is to wear them for at least one year. They can be a real bugger to get on, and I find coating the leg in baby oil or concentrated hand lotion helps them go on more easily.
Prevention of DVT
- Keeping mobile is paramount to keeping your blood circulating and to prevent clots from forming in the future.
- If you take anticoagulants, such as coumadin or warfarin, make sure you keep taking them because if you stop, you are at risk to develop another blood clot.
- Keep a healthy lifestyle.
- Do not smoke.
- Eat a balanced "low fat" diet of plenty of fruit and vegetables.
- Avoid sitting or laying in one position for too long.
- Get regular exercise.
- If you sit at a computer or at a desk job, just stretching your legs or flexing your feet will help.
- If you go on long car rides, schedule stops every two hours so you can walk around.
- If you are wheelchair bound or otherwise dependent on someone for your mobility, ask someone to do range of motion exercises with you.
While DVT education can best benefit the nursing student or CNA (certified nursing assistant), it never hurts for the patient to be educated as well. A simple adjustment in a daily routine can mean all the difference in the development of a DVT.
The following three videos are the standard of care and show some beneficial exercises for people who are in a sedentary position and not able to move around as much as able bodied people.
Range of Motion Exercises Guidelines
Range of Motion Exercises: Upper Body
Range of Motion Exercises: Leg Abduction and Adduction
© Mary McShane 3/3/2014
© 2014 Mary McShane