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Deep Vein Thrombosis
WHAT YOU NEED TO KNOW:
What is a deep vein thrombosis (DVT)?
A DVT is a blood clot that forms in a deep vein of the body. The deep veins in the legs, thighs, and hips are the most common sites for DVT. A DVT can also occur in a deep vein within your arms. The clot prevents the normal flow of blood in the vein. The blood backs up and causes pain and swelling. The DVT can break into smaller pieces and travel to your lungs and cause a blockage called a pulmonary embolism (PE). A PE can become life-threatening.
What increases my risk for a DVT?
After you have a DVT, your risk for another increases. A DVT can happen to anyone, but any of the following may increase your risk:
- A family history of blood clots
- Limited activity caused by bed rest, a leg cast, or sitting for long periods
- Injury to a deep vein, or surgery
- A blood disorder that makes your blood clot faster than normal, such as factor V Leiden mutation
- Age older than 60 years
- Hormone replacement therapy
- Birth control pills, especially in women who smoke or are older than 35 years
- Pregnancy, and for 6 weeks after childbirth
- Cancer or heart failure
- A catheter placed in a large vein
- Smoking cigarettes
- Obesity or varicose veins
What are the signs and symptoms of a DVT?
- Warmth, pain, or tenderness
How is a DVT diagnosed?
- A D-dimer blood test may be done to check for signs of a blood clot.
- An ultrasound uses sound waves to show pictures on a monitor. An ultrasound may be done to show a clot in your vein.
- Contrast venography is an x-ray of a vein. Contrast liquid is used to make the vein easier to see on the x-ray. Tell a healthcare provider if you have ever had an allergic reaction to contrast liquid.
How is a DVT treated?
- Blood thinners help prevent blood clots. Examples of blood thinners include heparin and warfarin. Clots can cause strokes, heart attacks, and death. The following are general safety guidelines to follow while you are taking a blood thinner:
- Watch for bleeding and bruising while you take blood thinners. Watch for bleeding from your gums or nose. Watch for blood in your urine and bowel movements. Use a soft washcloth on your skin, and a soft toothbrush to brush your teeth. This can keep your skin and gums from bleeding. If you shave, use an electric shaver. Do not play contact sports.
- Tell your dentist and other healthcare providers that you take anticoagulants. Wear a bracelet or necklace that says you take this medicine.
- Do not start or stop any medicines unless your healthcare provider tells you to. Many medicines cannot be used with blood thinners.
- Tell your healthcare provider right away if you forget to take the medicine, or if you take too much.
- Warfarin is a blood thinner that you may need to take. The following are things you should be aware of if you take warfarin:
- Foods and medicines can affect the amount of warfarin in your blood. Do not make major changes to your diet while you take warfarin. Warfarin works best when you eat about the same amount of vitamin K every day. Vitamin K is found in green leafy vegetables and certain other foods. Ask for more information about what to eat when you are taking warfarin.
- You will need to see your healthcare provider for follow-up visits when you are on warfarin. You will need regular blood tests. These tests are used to decide how much medicine you need.
- A vena cava filter may be placed inside your vena cava to treat your DVT. The vena cava is a large vein that brings blood from your lower body up to your heart. The filter may help trap pieces of a blood clot and prevent them from going into your lungs.
- Surgery called a thrombectomy may be done to remove the clot. A procedure called thrombolysis may instead be done to inject a clot buster that helps break the clot apart.
What can I do to manage a DVT?
- Wear pressure stockings as directed. The stockings put pressure on your legs. This improves blood flow and helps prevent clots. Wear the stockings during the day. Do not wear them when you sleep.
- Elevate your legs above the level of your heart. Elevate your legs when you sit or lie down, as often as you can. This will help decrease swelling and pain. Prop your legs on pillows or blankets to keep them elevated comfortably.
What can I do to prevent a DVT?
- Exercise regularly to help increase your blood flow. Walking is a good low-impact exercise. Talk to your healthcare provider about the best exercise plan for you.
- Change your body position or move around often. Move and stretch in your seat several times each hour if you travel by car or work at a desk. In an airplane, get up and walk every hour. Move your legs by tightening and releasing your leg muscles while sitting. You can move your legs while sitting by raising and lowering your heels. Keep your toes on the floor while you do this. You can also raise and lower your toes while keeping your heels on the floor.
- Maintain a healthy weight. Ask your healthcare provider how much you should weigh. Ask him or her to help you create a weight loss plan if you are overweight.
- Do not smoke. Nicotine and other chemicals in cigarettes and cigars can damage blood vessels and make it more difficult to manage your DVT. Ask your healthcare provider for information if you currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your healthcare provider before you use these products.
- Ask about birth control if you are a woman who takes the pill. A birth control pill increases the risk for PE in certain women. The risk is higher if you are also older than 35, smoke cigarettes, or have a blood clotting disorder. Talk to your healthcare provider about other ways to prevent pregnancy, such as a cervical cap or intrauterine device (IUD).
Call your local emergency number (911 in the US) if:
- You feel lightheaded, short of breath, and have chest pain.
- You cough up blood.
When should I call my doctor?
- Your arm or leg feels warm, tender, and painful. It may look swollen and red.
- You have questions or concerns about your condition or care.
Care AgreementYou have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.
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