Deep Vein Thrombosis

Deep vein thrombosis (DVT) is a condition in which blood clot (thrombus) is formed within deep veins in your body. The blood clot occurs when the blood thickens or clumps together. It commonly affects the large veins in the lower leg and thigh although it can affect any part of the body.

Several factors such as sitting for a long time while travelling, inherited blood disorders, prolonged hospital stay or bed rest, injury to the veins from surgery, certain cancers, pregnancy, smoking, obesity, heart failure and hormone replacement therapy may increase the chance of developing DVT.

Deep vein thrombosis can lead to pulmonary embolism, a condition where the blood clot breaks off from the vein and travel through the bloodstream to the lungs and blocks the blood flow. The mobile clots are called an embolus. Pulmonary embolism is a very serious condition and can be fatal if left untreated.

Another condition known as Post-Phlebitic Syndrome may develop. This is characterised by long term swelling of the leg (oedema), skin discoloration and pain in the leg. These symptoms may be observed immediately or may develop after some years.

In many cases, a DVT may not cause noticeable symptoms (silent DVT).   Signs and symptoms associated with a DVT include;

• Pain
• Swelling in the affected leg including ankle and foot
• Increased warmth over the affected area and changes in your skin colour
• Sudden difficulty in breathing, chest pain or discomfort, dizziness, sweating, coughing blood and nervousness: this may indicate pulmonary embolism

Your doctor will perform a physical examination to check for the areas of swelling, tenderness or skin discoloration. Other tests such as a D-dimer blood test, ultrasound of the legs, and CT or MRI scan that provides pictures of your veins may be ordered.

There are several treatment options available to treat DVT and they include:

• Medications: Anti-coagulants also called blood thinners that decrease the blood's ability to clot may be prescribed. These medications do not dissolve the existing clots, but helps in preventing the clot from becoming larger. Clot busters or thrombolytic treatments are used to dissolve the clots and are prescribed only in life-threatening situations
  
  
• Compression stocking: Compression stockings are usually worn to reduce the symptoms associated with blood clot including swelling and pain.. The stocking creates graduated pressure along the leg that improves the blood flow. Stockings also reduce the risk of developing further blood clots. These stockings should be worn until a proper assessment of venous function which is usually performed prior to completion of the initial medication treatment regime
  
  
• Mobility: Once the risk of pulmonary embolism has been assessed and risk minimised, walking becomes a key component of the treatment regime to improve resolution of the clot in the leg and, decrease symptoms

Surgery: Removal of a blood clot is very rarely required however in some cases, placement of a stent or supportive tube within a chronically narrowed vein may be rarely needed if the prescribed medications do not work.

Placement of Filter: A filter is placed in the large vein in the abdomen to prevent the blood clots that break loose from traveling to the lungs.

If you are at a risk of developing DVT, you can help prevent the condition by

• Regular checkups
• Taking the prescribed medications
• Wearing compression stockings
• Exercising: Stretching or moving your leg when you are travelling for more than four hours or when sitting for a long time
• Modifying your life style such as losing weight, quitting smoking, and controlling your blood pressure