Deep vein thrombosis - The silent killer

  • By Dr. T Deepa Porkodi

What Causes Deep Vein Thrombosis?
When you do not use your legs for a long time, as in sitting in a place for too long or being bedridden, the blood gets stagnated in the veins in your legs and calves leading to deep vein thrombosis.

What Exactly Happens In This Condition?
The stagnated blood in the veins causes the veins to bloat up. This leads to swelling of the affected leg. This causes the pain that one feels when you walk or move your legs. The collected blood also forms small clots. Small clots do not usually cause any harm but large clots may travel upwards to the lungs and may cause pulmonary embolism, a fatal condition.

What Are The Symptoms Of Deep Vein Thrombosis?
Deep vein thrombosis may be symptomless for a long time. In fact, a pulmonary embolism may be the first and often last sign of the condition. Swelling and heat in the affected leg around the calf and ankles is the main symptom. There is characteristic dragging pain in the leg when trying to walk or move the leg. The skin over the swelling may turn into a bluish or reddish color.

When Is Deep Vein Thrombosis - A sign Of Emergency?
When you start developing swelling and pain in legs, do consult your doctor to rule out deep vein thrombosis. In case you see any of the following symptoms, rush to the hospital immediately, as you may be developing a potential pulmonary embolism-

  1. Unexplained sudden shortness of breath
  2. Rapid pulse
  3. Feeling lightheaded or fainting
  4. Sweating
  5. Coughing of blood
  6. Feeling of anxiety and nervousness.

I Do Not Sit Around For A Long Time, Will I Still Get Deep Vein Thrombosis?
There are several risk factors for developing the condition. They include:

  1. Inheriting a blood clotting disorder can make you prone to develop DVT quickly. This factor alone may not be that risky unless combined with other risk factors.
  2. Paralysis or a long hospital stay means that you do not get to exercise your calf muscles regularly. This may lead to blood clots and eventually DVT.
  3. Injury to the legs can damage the veins. This may cause DVT.
  4. Surgery needs anesthesia and at times, this anesthesia may cause the veins to dilate. This leads to the blood pooling around and eventually getting clotted.
  5. Pregnancy adds to the pressure on your leg veins. This puts you at a risk to develop DVT. The risk stays for about 6 weeks after you have had your baby. In case you have an inherited blood clotting disorder, you are at even more risk.
  6. Heart Failure causes the heart to lose its effectiveness. It does not pump out the blood well and this leads to stagnation and clotting.
  7. Medical conditions like certain cancers and irritable bowel disease increase the risk of you developing DVT.
  8. Other risk factors include being obese, having a family history of DVT, using oral contraceptive pills, being over 60 years of age, and having had DVT before.

What Complications Deep Vein Thrombosis Cause?
The major concern with DVT is pulmonary embolism. It is a condition that develops when a clot in the leg breaks and travels upstream and reaches the lungs. This clot can block the lung and causes symptoms like shortness of breath, rapid pulse, anxiety, sweating, fainting, and coughing out of blood. If not treated immediately, it may be fatal.
Post-phlebitic or Post-thrombotic syndrome is another complication that includes swelling, discoloration, and pain of the affected leg. This condition develops a few years after DVT has been treated.

How Is DVT Diagnosed?
The doctor will suggest you undergo tests like an ultrasound, venography, and an MRI. Most people with DVT have an elevated level of clot-dissolving substance called D Dimer. A blood test to measure this D Dimer may also be recommended.

What Can I Do To Reduce My Symptoms?
At home, you can keep your leg elevated while resting. This ensures the blood flows in the right direction and does not stagnate. You can also use a warm cloth or a hot water bag to compress the area.

How Is DVT Treated?
When treating DVT, your doctor will have 3 main goals-

  1. Preventing the already formed clots from getting any bigger.
  2. Preventing the already formed clots from breaking off.
  3. Preventing the chances of you developing DVT again.

With this in view, he will prescribe blood thinning medications like heparin, warfarin, etc.

Clot dissolving agents or thrombolytics like Tissue Plasminogen Activators TPAs are used to dissolve the existing clots.

If you are in a condition that doesn’t allow you to take any medicines, a filter is inserted in the inferior vena cava in the abdomen. This filter effectively filters out any loose clot that has broken away and wandered upstream.
Compression stockings are also advised to every patient. These stocking help to keep the swelling under check and also reduce the chances of the blood pooling and clotting.

How Can I Prevent DVT?
Preventing DVT is far easier than treating it.

Start by losing weight if you are obese. Make sure you exercise your legs and calf muscles regularly. If you have developed DVT, keep regular appointments with your doctor. Vitamin K interferes with the action of medicines like warfarin, so keep a check on the amount of vitamin K you consume. Quit vices like smoking and alcohol.