Section Head of Vascular Medicine in the Robert and Suzanne Tomsich Department of Cardiovascular Medicine
Specialties: Thrombolytic therapy, atheromatous embolization, hypercoagulable disorders, venous disorders, sclerotherapy, peripheral arterial disease, pulmonary artery disease, unusual vascular disorders
Hello. I’m Dr. John R. Bartholomew. I am the Section Head of Vascular Medicine at the Miller Family Heart & Vascular Institute. Today, I’d like to talk to you about deep vein thrombosis, or DVT – what it is and how it is treated.
What is deep vein thrombosis (DVT)?
Deep vein thrombosis is a blood clot that develops in a vein deep in the body. The clot may partially or completely block blood flow through the vein. Most DVTs occur in the lower leg, thigh or pelvis, although they also can occur in other parts of the body including the arm, brain, intestines, liver or kidney.
DVT itself is not life-threatening. But, the danger of DVT is that the blood clot has the potential to break free and travel through the bloodstream, where it can become lodged in the blood vessels of the lung. This is a condition known as a pulmonary embolism. This can be life threatening, so prompt diagnosis and treatment is critical.
What are symptoms of DVT?
Not everyone with DVT will experience symptoms. But, symptoms sometimes experienced include swelling of the leg or arm, leg or arm pain or tenderness – sometimes present only when standing or walking, a feeling of increased warmth in the area of the leg or arm that is swollen or that hurts, redness or discoloration of the skin and enlargement of the superficial veins in the affected leg or arm.
Some people only find out they have DVT after the clot has moved from the leg or arm and traveled to the lung.
Who is at risk for DVT?
Several factors can increase your risk of developing DVT. These include being over age 40; being overweight; sitting for a long period of time on car, truck, bus, train or airplane trips; bed rest or hospitalization; limited blood flow in a deep vein due to injury, surgery or immobilization; cancer and some of its treatments; having an inherited condition that increases the risk of blood clotting; being pregnant and up to six weeks postpartum; taking birth control pills or hormone therapy. However, it is important to note that almost half of all patients with DVT have no identifiable risk factors.
How is DVT diagnosed?
DVT is diagnosed through a thorough history and exam, which can include several diagnostic tests. These may include an ultrasound to evaluate blood flow and detect the location of clots, occasionally a more invasive test known as venography or imaging scans such as MRI or CT scans.
Depending on the severity of your condition, you may be admitted to the hospital for treatment or be treated on an outpatient basis.
What is treatment for DVT?
Treatment includes medications – such as blood thinners – compression stockings, elevation of the affected leg, as well as more invasive diagnostic procedures using medications that dissolve clots if they are extensive. These include: intravenous or catheter-directed thrombolytic therapy, a nonsurgical treatment using clot-dissolving medications; angioplasty, a nonsurgical procedure to widen the vein after the clot has been dissolved, using a stent – or small metal mesh tube – to keep the vein expanded. A device known as a vena cava filter may also be used if you cannot take medications to thin your blood. These small filters are placed into one of the largest veins in your body and catch clots from the legs as they move toward your lungs.
The main goals of DVT treatment are to stop clots from getting bigger, preventing clots from breaking off and moving to your lungs, reducing your risk of future blood clots, and preventing long-term complications, such as chronic leg swelling, increased pressure, discoloration of the skin and leg ulcers.
If you have had a DVT, you will need to prevent additional clots by taking your medication and having follow-up appointments with your doctor for continued monitoring.
How can you prevent DVT?
If you have never had a deep vein clot, but are at risk, there are several steps you can take. These include exercising your lower leg muscles if you are sitting still for long periods of time, getting out of bed as soon as you can after being ill or having surgery, taking medications or using compression garments after surgery as directed by your doctor, as well as regular follow up.
At Cleveland Clinic, we are committed to preventing DVT in our hospital and have launched a new initiative to assess all inpatients for their risk of developing a DVT. This is critical because the incidence of hospital-acquired DVT is 10-20 percent among medical patients and 15-40 percent among surgical patients not receiving appropriate prophylaxis (or preventive measures). Furthermore, this is important because patients with hospital-acquired DVT and pulmonary embolisms often show no symptoms.
If you have symptoms of a pulmonary embolism or DVT, it is important to notify your doctor immediately or go to the emergency room. Do not wait to see if the symptoms will “go away.” It is absolutely critical to seek treatment right away to prevent serious complications.
For More Information
If you need more information or would like to make an appointment with a specialist, contact us, chat online with a nurse, or call the Miller Family Heart & Vascular Institute Resource and Information Nurse at 216.445.9288 or toll-free at 866.289.6911. We would be happy to help you.
This information is provided by Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition.
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