Deep vein thrombosis (DVT) is a blood clot in the deep veins of an extremity, most commonly the leg. If not treated properly, a DVT can lead to a pulmonary embolism (PE), in which the blood clot becomes dislodged and moves to the lungs.
A PE can be life-threatening and may require immediate life-saving measures. PE is the third most common cause of death from cardiovascular disease, behind heart attack and stroke. It is important to be aware of what a DVT is, how they are identified, how they are treated, and how to reduce your chance of having one.
What Causes a DVT?
DVT can be caused by various factors, including injury to the extremity, an underlying condition that increases the likelihood of a DVT, increased pressure within the veins, or anything that can slow blood flow within the circulatory system.
The following are factors that increase the risk of a DVT:
- Injury: trauma to a vein as the result of an accident, surgery, or intravenous (IV) drug abuse
- Slowed blood flow: long flights (limited movement to encourage blood flow), general anesthesia, and immobility (bed rest, long-term hospitalization)
- Increased pressure in the veins: obesity or pregnancy
- Increased blood viscosity (thickness): dehydration or thrombocytosis
- Other factors: smoking, aging (however, they can occur at any age), hormonal birth control, cancer, history of DVT
Signs and Symptoms
Some individuals may have symptoms of DVT, while others may not be aware they have one at first. Being aware of these signs and symptoms can help individuals quickly recognize a problem and seek medical attention. Symptoms of a DVT can include:
- Swelling in the extremity
- Pain and tenderness in the leg (this can occur at rest or while moving)
- Redness or discoloration of the skin
- Bulging veins in the leg due to increased pressure
- Warmth at the site
How Does My Healthcare Provider Know If I Have a DVT?
When you notice the signs of a potential DVT, it is important to seek medical attention for further testing to see if you have a DVT. Healthcare providers can do different tests to look for a blood clot. These include but are not limited to a Doppler ultrasound and a D-dimer blood test.
An ultrasound machine uses sound waves to create a visual picture, which can then determine if a blood clot is present. When a blood clot forms in a vein, it releases a substance called D-dimer. Healthcare professionals can use this marker to help determine if a blood clot is the problem by collecting and analyzing a blood sample.
What Is a Pulmonary Embolism?
Those with DVT can be at risk for a very severe medical condition called PE. PE occurs when a blood clot within a deep vein, often in the leg or arm, is dislodged and carried to the lungs. This blood clot, known as an embolism, impairs blood flow within the lungs, causing decreased oxygenation and perfusion, which can ultimately lead to death.
For some individuals, they may not even realize they have had a DVT until they have a PE. Signs and symptoms of PE include:
- Shortness of breath
- Chest pain
- Coughing up blood
- Rapid heartbeat
- Dizziness
- Lightheadedness
Medical help must be received immediately if these symptoms appear. Without medical intervention to restore proper blood flow to the lungs, death can occur quickly.
What Does Treatment Look Like?
When an individual is diagnosed with DVT, the front-line treatment is anticoagulant therapy. Anticoagulant medications are often referred to as blood thinners. These can include a combination of injections and oral medications.
Anticoagulant medications work to thin the blood, thereby reducing clotting. They stop clots from getting bigger and prevent other clots from forming. This includes using medications such as heparin (unfractionated or low molecular weight) or fondaparinux. Both medications are administered subcutaneously, which means the medication is injected under the skin, often in the stomach or fatty tissue on the back side of the arm.
Patients often go home on long-term anticoagulant therapy, such as warfarin, to prevent a clot from reforming. If the clot is severe or circumstances require it, healthcare providers may prescribe clot-busting medications such as alteplase.
It is important to recognize that anticoagulants increase the risk of internal and external bleeding; patients should be aware of any increased bleeding and discuss it with a healthcare professional. Providers should continue to monitor patients and watch for a recurrent clot in the coming months after the initial clot.
Patients are also monitored to ensure their blood is not too thin, which could cause problematic bleeding, and the dose is adjusted as needed.
How Can I Prevent a DVT?
Different preventative actions can decrease the chances of a DVT. For individuals who have recently had surgery or have been hospitalized, it is beneficial to start improving mobility as soon as possible. This can be done by decreasing the time spent in bed and finding opportunities for leg movement. This also applies to those traveling, whether by plane, car, or other transportation that involves sitting for an extended amount of time.
It is beneficial to get up and walk every 1-2 hours while traveling and extend and flex the ankles and legs ten times, approximately every 30 minutes, to improve blood flow. Other ways to improve blood flow in the extremities are to wear compression socks and elevate ones legs. Compression socks help encourage blood to return to the core and prevent stasis or pooling blood.
Taking medication to prevent blood clots as prescribed is also critical to preventing DVTs. This refers to those who may have had a DVT and are being treated, as well as preventing further clots from forming. Healthcare providers will also often prescribe medications such as aspirin after surgery to decrease the chances of blood clots in anticipation of decreased mobility.
Summary
With an increased understanding of DVT, individuals can be more prepared to recognize potential dangers and seek medical attention as needed. It is important to watch for swelling, warmth, tenderness, or discoloration of the extremity.
To decrease the chances of a blood clot forming, avoid extended periods of minimal movement, wear compression socks if applicable, follow any post-surgical guidance to help reduce the risk of DVTs, and take medication as prescribed to prevent clots. Seek medical attention immediately for any concerns, questions, or suspicions of DVT or PE.
About Author:
Rachel Pugmire is a registered nurse and freelance writer. She received her Bachelor of Science in Nursing in 2018, with a minor in gerontology. Her areas of expertise include emergency medicine, pediatrics, and pharmaceutical clinical trials. Medical writing has given her a platform to do what she is passionate about, which is educating patients, their families, and other healthcare professionals.
Rachel is an independent contributor to CEUfast's Nursing Blog Program. Please note that the views, thoughts, and opinions expressed in this blog post are solely of the independent contributor and do not necessarily represent those of CEUfast. This blog post is not medical advice. Always consult with your personal healthcare provider for any health-related questions or concerns.
If you want to learn more about CEUfasts Nursing Blog Program or would like to submit a blog post for consideration, please visit https://ceufast.com/blog/submissions.
