Deep Vein Thrombosis (DVT)

What’s the Problem?

Deep Vein Thrombosis (DVT) is a medical condition that occurs when a blood clot forms in a deep vein. These clots usually develop in the lower leg, thigh, or pelvis, but they can also occur in the arm. Some most common symptoms and signs of DVT are recent swelling of the limb, unexplained pain or tenderness, skin that may be warm to the touch, and redness of the skin.

DVT can cause a life-threatening complication called pulmonary embolism (PE). This is when part or all of a clot breaks off and travels through the bloodstream and into the lungs. A blood clot in the lungs can be life threatening.

Who’s at Risk?

The precise number of people affected by DVT/PE is unknown, but estimates range from 300,000 to 900,000 each year in the United States. Among people who have had a DVT, one-half will have long-term complications such as swelling, pain, discoloration, and scaling in the affected limb. Some risk factors for developing DVT include: injury to a vein – often caused by fractures, severe muscle injury, or major surgery; slow blood flow – often caused by confinement to bed, limited movement, sitting for a long time, and recent paralysis; increased estrogen – often caused by birth control pills, hormone replacement therapy, and/or pregnancy (for up to 6 weeks after giving birth); certain chronic medical illnesses such as heart disease, lung disease, cancer and its treatment, and inflammatory bowel disease; previous or family history of DVT or PE; age; obesity; a catheter located in a central vein; and inherited clotting disorders.

Can It Be Prevented?

Yes, DVT may be prevented. If discovered early, it may also be treatable. Some measures can be taken to prevent DVT and PE: maintain a healthy weight, avoid a sedentary lifestyle, and adhere to doctor recommendations. Medication may be used to prevent and treat DVT. Compression stockings are sometime recommended to prevent DVT and relieve pain and swelling. Medicines may be given in cases of severe, life-threatening PE to dissolve the clot and anticoagulants to prevent more clots from forming.

The Bottom Line

• It is important to know about DVT because it can happen to anybody and cause serious illness, disability, and in some cases, death.
• DVT is generally diagnosed using Doppler ultrasound – a test that uses sound waves to check the flow of blood in the veins.
• PE is generally diagnosed using computerized tomography (CT scan) of the lung, a special type of X-ray that can provide pictures of structures inside the body; and/or lung perfusion and ventilation scans (also called V/Q scans), which are tests that show how much blood and air are getting into the lungs.
• Almost anyone can have a DVT. However, certain factors can increase the chance of having this condition, such as: injury to a vein, slow blood flow, increased estrogen (often caused by birth control pills, hormone replacement therapy, or pregnancy), certain chronic medical illnesses (heart disease, lung disease, cancer, and inflammatory bowel disease), previous or family history of DVT or PE, advanced age, obesity, and inherited clotting disorders, etc.
• People can reduce their risk for DVT by maintaining a healthy weight, avoiding a sedentary lifestyle, and adhering to physician recommendations for blood thinners and other prevention strategies.

Case Example

During winter vacation, Sara decides to fly to Japan to visit her sister who is studying abroad at a university there. Several hours into her plane ride, Sara visits the women’s room and all of a sudden, finds herself having trouble breathing. She manages to push the crew button for help before collapsing on the floor. Luckily for her, a doctor who is traveling on the same plane checks Sara’s vitals and notices that she has weak blood pressure and is very likely to be suffering from pulmonary embolism. In order to get Sara to a hospital as soon as possible, the flight makes an emergency detour and lands in Hawaii. Airport paramedics then take Sara to a local hospital for medical treatment.