Deep Vein Thrombosis : Causes, Complications, and Management

Overview

What is Deep Vein Thrombosis?

Deep Vein Thrombosis (venous thrombosis) is the severe condition of blood clot formation in a vein lying deep inside the body. The blood clot partly or wholly obstructs the blood flow through the veins. A blood clot is a clump of semisolid blood generally formed in response to a cut or an injury. ¹Overview | Researched based study from Sciencedirect.com

Facts

Facts of Deep Vein Thrombosis

• Deep Vein Thrombosis can lead to postphlebitic syndrome or post-thrombotic syndrome(happen after long-term deep vein thrombosis)
• Deep Vein Thrombosis commonly forms in the lower legs and thigh but can also develop in other body parts like the brain, kidney, and intestine.
• The clots are hazardous and can break and travel to the lungs leading to obstruction of blood flow.
• Deep Vein Thrombosis causes lifelong problems such as vein damage
• It also causes swelling, pain and discoloration of the areas nearby a blood clot
• Deep vein thrombosis is treated with medicines to prevent further blood clot¹Facts | Researched based study from Sciencedirect.com

Symptoms

Symptoms of Deep Vein Thrombosis

Symptoms are experienced by only half of the patient population

Generalized Symptoms are

• Pain usually begins in the thigh
• Severe pain in ankle and foot
• Swelling on one side of the ankle, foot and leg
• The affected area is warmer than other body areas
• Reddish, pale or bluish coloration of the affected area
• Veins close to the skin surface appear larger than normal
• Stomach pain when the affected vein is deep inside the abdomen
• Fever in some cases

Upper body Deep Vein Thrombosis symptoms include

• Arm or hand swelling
• Pain in the Shoulder & Neck
• Pain radiates from arm to forearm
• Hand weakness
• Darker skin color than other parts
• Severe headache when the affected vein is in the brain ²Symptoms | Researched based study from Cdc.gov

Risk

Risk factors of Deep Vein Thrombosis

Increased weight

• Excess weight puts pressure on the pelvic veins and legs increased the chance of deep vein thrombosis ³Risk | Researched based study from Nlm.nih.gov

Increased age

• Older age more than 60 years are more prone to deep vein thrombosis ⁴Risk | Researched based study from Ashpublications.org

Decreased movement or inactivity

• It may happen during long-distance flight blood collects in the lower body parts, blood flow slows down and can lead to clot formation .

Vein damage due to injury

• Weakens blood flow which can result in blood clot .

Vein damage during a surgical operation

• Blood vessels can be harmed during surgery can also cause blood clot development .

Vein damage due to infection

• Infections such as tuberculosis and other viral and bacterial infection can lead to deep vein thrombosis.

Pregnancy

• Pregnant has less movement than the normal woman Thus pregnant woman has a higher risk of deep vein thrombosis . ⁵Risk| Researched based study from Nlm.nih.gov

Hereditary history

• Having blood clotting problems in the family increases the likelihood of deep vein thrombosis.

Cancer

• People with lung, brain or stomach cancer who are under chemotherapy (medicines with strong chemicals to treat cancer) treatment has a higher risk of developing deep vein thrombosis ⁶Risk| Researched based study from Cdc.gov .

Certain medications

• Medications such as antidepressants and birth control tablets increase the risk of deep vein thrombosis.

Other health conditions that increase the risk of deep vein thrombosis are

• Heart failure (difficulty of heart muscles to pump adequate blood)
• High blood pressure
• High blood sugar (diabetes)

Diagnosis

Diagnosis of Deep Vein Thrombosis

Venogram

• It is a test to observe the veins of the body .
• A dye is inserted into the troubled vein, and an X-ray is taken to confirm the deep vein thrombosis.
• It allows tracking the obstructed blood flow
• It is only recommended if the ultrasound’s result is not convincing.

Ultrasound

• It uses sound waves to take pictures of the veins and the arteries
• It examines the blood flow through the veins and arteries

D-dimer test

• D-dimer blood test checks for D-dimer protein in the blood
• D- dimer is the protein fragment made when a clot dissolves in the blood
• High levels of D-dimer protein, along with other symptoms, indicate the clot in the body ⁷Diagnosis| Researched based study from Sciencedirect.com

Treatment

Treating Deep vein thrombosis

Treatment of deep vein thrombosis targets preventing future clots. it involves following measures:

Medicines for Deep vein thrombosis

Anticoagulants (blood-thinning drugs)

Eliquis

• It is used to prevent serious blood clot
• It reduces the risk of repeated deep vein thrombosis

Xarelto

• It reduces the blood clotting ability
• It prevents blood clot

Coumadin

• Prevents new clot formation in the body
• It inhibits vitamin K-dependent clotting factors

Heparin

• It decreases the blood clotting ability
• It prevents the symptoms of blood clot due to specific surgical procedures

Arixtra

• It helps block certain clotting factors in the blood
• It is used to treat severe deep-vein thrombosis

Lovenox

• It reduces the risk of deep vein thrombosis
• It helps to prevent a blood clot in the leg veins in bed rest patients

Thrombolytic drugs

When anticoagulants do not work, then thrombolytic drugs are recommended

• Thrombolytic pills dissolve the blood clot
• It is helpful for people with upper body deep vein thrombosis

Filters

• Filters are recommended for patients who cannot take anticoagulants
• Filters are placed inside large abdominal veins (vena cava). It prevents clots from entering the lungs(pulmonary embolism)
• However, the filters are placed for short durations until the risk of deep vein thrombosis decreases and anticoagulants can be reused.

Compression stockings

• Compression stockings are socks that slightly squeeze the legs.
• It maintains the blood flow and prevents swellings and discomfort .
• It reduces the chance of developing clots .

Thrombectomy (Surgery)

• It is the surgery to remove a blood clot from the vein or artery .
• It is advised only in case of critical situations like huge blood clots or clots causing tissue damage .
• However, the particular risk associated with surgery includes infection, excessive bleeding and blood vessel damage ⁸Treatment| Researched based study from Nlm.nih.gov

Remedies

Home remedies

Following the prescribed medicines along with home remedies can reduce the risk of complications of deep vein thrombosis

Balanced diet

• A well-balanced diet comprising fruits, fibers and vegetables is suitable for people at risk of deep vein thrombosis.

Increasing movement

• Making a habit of taking shorter frequent walks several times a day .

Wearing compression stockings

• People at risk of deep vein thrombosis should wear compression stockings.
• Wearing while travelling for hours in the bus, car etc., could be helpful

Keeping the arm and leg in an elevated position

• Keeping the feet in touch with the ground the whole day can collect blood.
• Legs should be rested in stool to keep it elevated and at the same level as the hip ⁹Remedies| Researched based study from Nlm.nih.gov

Complications

Complication of Deep Vein Thrombosis

Generalized complications

• Difficult breathing
• Excess sweating
• Blood while coughing
• Severe chest pain
• Increased heart rate
• Lightheadedness
• Skin sores

Severe complications of Deep Vein Thrombosis

Postphlebitic syndrome

• The blood clot damages the vein It decreases the blood flow to the affected area
• It causes skin sores, swelling and pain .

Pulmonary embolism

• It is the sudden obstruction of the lung artery .
• It occurs when the clot separates and travels to the lung .
• It blocks the blood flow and may cause death .

Bleeding

• Anticoagulants (blood thinners) are prescribed to treat deep vein thrombosis. It increases the risk of bleeding.
• Hence, it is essential to do blood tests regularly while taking anticoagulants ¹⁰Complications| Researched based study from Sciencedirect.com

Prevention

Prevention of Deep Vein Thrombosis

• Complete cessation of smoking
• Movement of legs on bed rest and surgery
• Regulating one’s weight
• Controlling high blood pressure
• Stretching feet and legs while sitting on a car, bus, or aeroplane for long hours
• Avoiding wearing of the tight fitting clothes that restrict the normal blood flow ¹¹Prevention| Researched based study from Cdc.gov

Takeaway

Key takeaways

• Deep vein thrombosis is a severe disease that can be fatal at times .
• Diagnosis is difficult as only some people experience symptoms .
• It is very crucial to know the risk factors of deep vein thrombosis to prevent oneself from suffering from the disease .
• Moving frequently and maintaining a well-balanced diet are the main ways to prevent deep vein thrombosis .