Deep vein thrombosis (DVT) is the development of blood clot (thrombus) within deep veins. Thrombosis is the formation of abnormal mass (blood clots) from blood components within the vascular system when it occurs within deep veins it is known as DVT. Blood clots are formed in both extremities but usually, they are formed in deep leg veins (femoral veins, calf veins) or the deep veins of the thigh which blocks blood circulation through these veins.
DVT is a threatening condition that can cause death or preventable morbidity. DVT/PE kills more people than AIDS, breast cancer, water drowning, and Motor vehicle accidents per year. DVT/PE kills approximately 100,000 Americans per year. It’s a preventable Death in most cases.
Deep vein thrombosis in leg:
DVT usually occurs in deep leg veins, a large vein that passes through calf and thigh muscles.
CAUSES OF DVT IN LEG:
- Damage to a blood vessel of the lower body due to any reason such as fracture, severe muscle injury or surgery.
- Prolonged sitting or immobility (bed rest after surgery or illness).
- Heart attack or heart failure.
- Pregnancy or recent childbirth. (Clotting risk is also higher during pregnancy and for up to 6 weeks after giving birth because of increased estrogen)
- Estrogen therapy or birth control pills (Estrogen in birth control pills or hormone therapy makes blood more likely to clot.)
- Thrombophilia (a genetic condition where your blood has an increased tendency of blood clotting that increases the risk of thrombus formation)
- Antiphospholipid syndrome (Antiphospholipid syndrome (APS), sometimes known as Hughes syndrome, is an autoimmune condition that causes thickening of the circulating blood, blood platelets clump together that results in the formation of blood clots)
- Advanced age.
- Any medical conditions that affect the vein.
SIGNS AND SYMPTOMS OF DVT IN LEG:
- Pain or tenderness in the leg which you may feel only when walking or standing.
- Erythema (Redness of a specific area) particularly at the back of leg below the knee.
- Warm skin in the area of clot.
- Worsening leg pain when bending the foot.
- Charley horse (leg cramps occurs especially at night).
- Bluish or whitish discoloration of the skin.
DIAGNOSIS OF DVT IN LEG
- Medical history: Medical history may include overall health conditions of a person, any specific or genetic disease, any prescribed medicines or any recent injury or surgery.
- Physical examination: Physical examination of DVT in leg includes checking for physical signs of DVT such as swelling, tenderness or discoloration of the skin of specific area.
- Ultrasound: The most common test for diagnosis of Deep vein thrombosis is ultrasound. A Duplex ultrasound is used to detect DVT in the leg. Duplex ultrasound is a combination of a traditional ultrasound and Doppler ultrasound. A Traditional ultrasound uses sound waves that are bounced off internal tissues and make echoes. The patterns of these echoes from an image, which is then shown on the screen of the ultrasound machine. Doppler ultrasound is used to detect any abnormalities in blood flow. Sound waves are bounced off the blood within a vein. Flowing blood changes, the sound waves by the “Doppler effect.” The ultrasound machine can identify these changes and verify whether blood within a vein is flowing normally. An absence of blood flow confirms the presence of a blood clot.
- Venography, MRI and CT scanning: If the ultrasound report does not provide a clear diagnosis and there are signs and symptoms of DVT, Venography method is used to detect a blood clot. Contrast dye (usually an iodine dye) dye is injected into the vein, and an X-ray is done. The dye makes the vein visible on X-ray which shows blood flow. If blood flow is slow it indicates the presence of a blood clot. As venography can be painful and invasive it is now replaced by MR venography or CT scanning.
- D-Dimer test: Almost all people who develop severe deep vein thrombosis have a raised level of a substance called D-Dimer in blood. This test measures D-Dimer substance in the blood. If the test shows high levels of the substance, it indicates deep vein thrombosis.
TREATMENT OF DVT IN LEG
Anticoagulants (Blood thinners) are the most common drugs used to treat DVT.
- These drugs can be taken as pills or can be injected. These drugs do not break up existing clots but prevent existing clots from getting bigger or the formation of new blood clots. Heparin and warfarin are 2 types of anticoagulants that are used to treat DVT. Heparin is usually prescribed first because it works immediately to prevent further clotting. After this initial treatment, you may also need to take warfarin to prevent another blood clot forming.
- Thrombolytic drugs (Clot busters): If a patient has severe DVT, or if other medications aren’t working, then the doctor may prescribe drugs that break up clots quickly, called clot busters.
These drugs are given intravenously.
- MedShoola SCD Pump and Compression stockings: SCD pump and Compression stocking are used to prevent DVT and PE. It should not be used if a patient already has been diagnosed with DVT/PE. It is contraindicated if someone has an acute blood clot in the legs since it can cause the clot to break off and travel to the lungs.
- Inferior Vena Cava Filters: They are small devices that are placed into a large vein (The Vena Cava). The filter trap blood clots. Blood clots in the veins of the legs and pelvis usually travel to the lungs where they may cause a pulmonary embolism or blockage. IVC filters help lower the risk of pulmonary embolism by trapping large clots and preventing them from reaching the heart and lungs.