Understanding blood clots and the associated risks Deep Vein Thrombosis

What is a DVT?

Deep Vein Thrombosis (DVT) is commonly referred to as a blood clot. Chances are you know someone who has had a blood clot or you have had one yourself. A DVT can happen to anyone at any time and affects millions of people worldwide. If left untreated, it may cause serious complications or even death. Wearing Medical Compression Stockings (MCS) and staying active is an important step in reducing your risk of a DVT.

What causes DVT?

What causes a DVT?

Blood clots occur when something slows or changes the blood flow. Blood thickens and clumps together, forming a clot in a deep vein in the body. DVTs most commonly form in the deep veins of the legs behind the knee, in the thigh or in the pelvis.

Symptoms of a DVT

DVTs can go undetected because 50% of the time there are no symptoms at all.

MCS are an important part of acute and long-term DVT management. They alleviate pain, manage swelling, improve mobility and help in the recovery process after a DVT.

Symptoms Include:

  • Pain or tenderness, often starting in the calf
  • Swelling, including the ankle or foot
  • Redness or noticeable discoloration
  • Warmth

DVT Complications

Over time, a DVT can have dangerous effects on your health. These can be both short term and long term, and can sometimes be deadly.

Pulmonary Embolism – a life-threatening complication of DVT

A Pulmonary Embolism (PE) is a life threatening complication of a DVT. Blood clots in a deep vein can break off and travel through the bloodstream. The loose clot is called an embolus and can travel to an artery in the lungs and block blood flow. The condition where a blood clot breaks off and lodges in the lungs is referred to as Venous Thromboembolism (VTE). DVT and PE are collectively referred to as VTE.

 A VTE occurrence is very serious and must be addressed immediately. In fact, it is one of the leading causes of death and disability worldwide.

Since there is a lack of awareness of VTEs, people often mistake PE symptoms with those of a heart attack. A person diagnosed with a DVT, or someone at an increased risk, should contact an emergency professional or go to the nearest hospital immediately if they experience any of these symptoms.

Symptoms Include:

  • Unexplained shortness of breath
  • Rapid breathing
  • Chest pain (may be worse upon deep breath)
  • Rapid heart rate
  • Light headedness or passing out

Post Thrombotic Syndrome (PTS) – a long-term complication of DVT

In addition to the potential short-term complications of a VTE, patients may also develop long-term problems. This condition is known as Post-Thrombotic Syndrome (PTS). PTS develops in up to 50% of patients diagnosed with a DVT and can severely affect a person’s quality of life. Research shows that long-term use of MCS after a DVT may reduce the incidence and severity of PTS.

Symptoms Include:

  • Swelling
  • Chronic leg pain
  • Heaviness
  • Skin Changes
  • Venous leg ulcers
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DVT Risk Factors

Many factors can increase your risk of developing a DVT. The more risk factors you have, the greater your risk. Talk to your doctor about your risks and what you can do to reduce them. The following are common DVT risk factors:

  • COVID-19 – Early evidence suggests that COVID-19 patients may be at an increased risk to develop blood clots. If you are diagnosed with COVID-19, and previously had a blood clot, make sure you tell your healthcare provider immediately.
  • A personal or family history of DVT/PE – If you or someone in your family has had one or both of these, you might be at greater risk of developing a DVT.
  • Age – Being older than 60 increases your risk of DVT, though it can occur at any age.
  • Prolonged sitting – Such as when driving, flying or working at a computer for extended periods without breaks.When your legs remain still for hours, your calf muscles don’t contract, which normally helps blood circulate. Blood clots can form in the calves of your legs if your calf muscles don’t move for long periods of time.
  • Being overweight or obese – Being overweight increases the pressure in the veins in your pelvis and legs.
  • Smoking – Smoking affects blood clotting and circulation, which can increase your risk of DVT.
  • Inheriting a blood-clotting disorder – Some people inherit a disorder that makes their blood clot more easily. This condition on its own might not cause blood clots unless combined with one or more other risk factors.
  • Prolonged bed rest – Such as during a long hospital stay or paralysis. When your legs remain still for long periods, your calf muscles don’t contract to help blood circulate, which can increase the risk of blood clots.
  • Injury/surgery – Injury to your veins or surgery can increase the risk of blood clots.
  • Pregnancy – Pregnancy increases the pressure in the veins in your pelvis and legs. Women with an inherited clotting disorder are especially at risk. The risk of blood clots from pregnancy can continue for up to six weeks after you have your baby.
  • Birth control pills or hormone replacement therapy – Both can increase your blood’s ability to clot.
  • Cancer – Some forms of cancer can increase substances in your blood that cause your blood to clot. Some forms of cancer treatment also increase the risk of blood clots.
  • Heart failure – This increases your risk of DVT and pulmonary embolism. Because people with heart failure have limited heart and lung function, the symptoms caused by even a small PE are more noticeable.
  • Inflammatory bowel disease – Bowel diseases, such as Crohn’s disease or ulcerative colitis, increase the risk of DVT.

DVT Prevention

Minimizing your risk factors helps to minimize your chances of getting a DVT. Talk to your doctor about your options to reduce your risk. A healthy lifestyle, staying active and wearing MCS are important interventions. Walking in combination with wearing MCS propels blood upwards against gravity toward your heart, minimizing your risk.

Here are some things you can do to reduce your risk of a DVT:

  • Keep moving
    • If you’re sitting for a while, don’t cross your legs, which can hamper blood flow.
    • If you’re traveling a long distance by car, stop every hour or so and walk around.
    • If you’re on a plane, stand or walk intermittently. If you can’t do that, exercise your legs while you are sitting. Try tightening and then relaxing your thighs, extending your lower legs and alternating lifting your heels and then toes.
  • Make lifestyle changes – Lose weight and quit smoking.
  • Exercise – Regular exercise lowers your risk of blood clots, which is especially important for people who sit a lot or travel frequently.
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Deep Vein Thromboses treatment

DVT Treatment

  • Anticoagulants – DVT  is most commonly treated with anticoagulants, also called blood thinners. These drugs decrease your blood’s ability to clot. They don’t break up existing blood clots, but can prevent clots from getting bigger and reduce your risk of developing more.
  • Vein Filter – Sometimes a vein filter is inserted into the vena cava, a large vein in your abdomen, to prevent clots that break loose from lodging in your lungs, causing a PE.
  • Thrombolytics – If you have a more serious type of DVT or PE, or if other medications aren’t working, your doctor might prescribe drugs that break up clots quickly, called clot busters or thrombolytics.
  • MCS – MCS  are an important part of DVT prevention and management and can prevent long-term pain, swelling and skin tissue changes associated with DVT.
  • https://www.cdc.gov
  • Kahn SR. The post-thrombotic syndrome: progress and pitfalls. Br J Haematol 2006; 134: 357–365.
  • https://www.mayoclinic.org
  • Partsch H. Compression and deep vein thrombosis. Veins and Lymphatics. 2016 Jun 14.
  • Rabe E, Partsch H, Hafner J, Lattimer C, Mosti G, Neumann M, Urbanek T, Huebner M, Gaillard S, Carpentier P. Indications for medical compression stockings in venous and lymphatic disorders: An evidence-based consensus statement. Phlebology. 2018 Apr;33(3):163-84.
  • https://www.worldthrombosisday.org

What is Deep Vein Thrombosis?