Know about deep vein thrombosis

Deep vein thrombosis is the formation of clots or thrombi in any of the deep veins in the body, generally the legs. It can form without any symptoms at all. Generally the condition is accompanied by pain and swelling in the leg, often only in one. Normally there are chemicals in blood to prevent its clotting inside the body. However, it can develop clots if one is suffering from a group of diseases called thrombophilia and a combination with circumstances.

It is therefore important that people prone for deep vein thrombosis learn to recognize the early symptoms and signs of pulmonary embolism. The clots from these deep veins can break away and get into blood circulation and get carried along and can settle in any blood vessel. The nature of complication depends on the vessel blocked. A common place is the veins of the lungs. This can be life threatening and is imperative that one gets emergency medical attention. The common indications of this emergency are sudden shortness of breath, chest pain or discomfort that worsens on deep breathing, or coughing, rapid pulse, coughing up blood and feeling dizzy or fainting.

It is also important that one should be aware of the risk factors of developing deep vein thrombosis. Some people inherit a disorder that makes the blood to clot easily. This alone seldom causes a deep vein thrombosis but a combination of situations can precipitate blood clotting inside the body itself. Any conditions that slow down the circulation or stagnate are factors one should take care to avoid. These are sitting for hours continuously as in transatlantic flight, driving long distances, prolonged bed rest as in major surgery, paralysis, injuries etc. in short any condition where the calf muscles are not contracting and relaxing. As a matter fact the calf muscles are considered as a supplementary heart. Other risk factors are overweight, pregnancy, birth control pills and hormone replacement treatment, smoking, heart failures, cancer, family history, ages above 60 year and inflammatory bowel syndrome. One may suffer from postphlebitic syndrome, a group of symptoms like persistent leg swelling, leg pain, soreness of the legs and skin discoloration, is due to reduced blood flow to the legs as a result of damages caused by the clots. Prevention any day should be the choice. Ensure calf muscle do contract and relax periodically. If normal activities are not possible raise the heal up keeping the toes on the ground, lower and then lift the toes up keeping the heals on the ground, a sort of rocking the feet. Change life styles by quitting smoking, increase physical exercise and lose weight.

Diagnosis is by taking a detailed history and symptoms to see one’s chances of developing a clot. This is followed by a physical examination to check for extra warmth, swellings and discolorations on the skin. One can even look at deep vein thrombosis (DVT) pictures and make out symptoms. Often these may not give firm idea of a clot. Imaging techniques like ultrasonography, CT scan, MRI and Venography in which an x–ray after injecting an x-ray opaque dye in the ankle or foot is taken. A chemical called D dimer is elevated in all most all patients with deep vein thrombosis and a blood test is done to know this. Less invasive tests are normally resorted to.

Treatment approach has twin objectives of stabilizing the clot so that they neither grow nor break loose causing emergencies like pulmonary embolism. Anticoagulants administered orally or intravenously achieve these objectives very well. Heparin is administered intravenously while medicines like enoxaparin, fondaparinux or dalteparin are injected subcutaneously. They are replaced with tablets like warfarin (needs periodic testing for clotting time) or Dabigatran after a few days. Tablets like Rivaroxaban, Edoxaban Apixaban can be started straight away. One might need to take blood thinners for about three months and it is very important to strictly follow the instruction as too much or too little can create serious side effects. Pregnant women should not take blood thinners without medical advice.

In serious types of deep vein thrombosis like pulmonary embolisms or coronary thrombosis, or medications is not working, certain medicines called clot busters or thrombolysis are given intravenously or directly at clot through a catheter. They are reserved for very serious cases as they can cause very serious hemorrhage. When one cannot take medications a filter is inserted in the main vein the vena cava in the abdomen to prevent them from causing pulmonary embolisms. With medication and strict lifestyle one can lead a normal life with deep vein thrombosis.