Deep vein thrombosis Overview

Deep vein thrombosis (DVT) affects the veins of lower limbs, arms and can cause complications like pulmonary embolism (embolism of the lungs), dysfunction of the valves along with mild to severe edema. Deep vein thrombosis of the lower limbs is more common when compared with other forms. A thrombus or a blood clot occurs at the site (veins) from where blood is returned to the heart and life-threatening conditions can occur if the clot is left untreated, as it can dislodge as fragments and can obstruct the blood supply.

Individuals older than 40 years are usually more prone to DVT. Males have a slightly higher risk than females. From ethnic point of view, Asian and Hispanic populations are comparatively at lower risk than others. The incidence of DVT is more prevalent in people who are hospitalized, bed ridden and it is one major cause for morbidity and mortality in such patients, for reasons unknown.

Other risk factors include stroke, sepsis, pregnancy, prolonged period of immobilization, burns, injuries, hormonal changes, chemotherapy, post operative status, increased central venous pressure ,etc to name a few.

Even though, no immediate health risks occur as a result of DVT but the incidence of long-term disability remains high. Accurate diagnosis of DVT cannot be made either by looking at specific symptoms or findings, as some cases may be asymptomatic. Some physical manifestations of the disease can be seen in the form of symptoms which are not specific and can mimic other conditions.

Diagnosis can be confirmed with the help of techniques like venography, ultrasound (most preferred), other imaging techniques like MRI, D-dimer blood test etc. These tests can be used to detect the presence of clots and extent of damage.

Deficiency of some blood coagulation inhibitors, proteins and enzymes can cause changes in the blood vessels, veins causing DVT. Anatomical variations (congenital), some medications can also cause DVT.

Symptoms like pain and discomfort in the calf muscles, edema in the limbs with slight discoloration and blanched appearance can occur. The intensity of the symptoms can vary from one person to another ranging from being mild to severe. Symptoms like breathing difficulty, feeling light-headed or pain in the chest require immediate attention as they are signs of Pulmonary Embolism.

People at risk can make necessary modifications in their lifestyle by including exercise (for improving circulation in lower calf muscles), avoiding smoking and uncontrolled eating, controlling weight and blood pressure etc, so as to stay on the safer side and control the risk factors.

Early diagnosis is the key, followed by suitable treatment so as to prevent severe complications of DVT. First-line treatment options include use of anticoagulants and thrombolytics. Anti-coagulation therapy (use of Warfarin, Heparin) is usually recommended for patients with genetic defects. Aspirin for reducing pain, diuretics to reduce swelling are also prescribed for relief.

Thrombosis at the site of groin can affect the deep veins, so blood thinning therapy should be initiated at the earliest. Abnormal reactions or some side-effects can occur if the person has been previously exposed to blood thinning medications or trauma, undergone surgery etc. The dosage of anticoagulants should be monitored for the same reason. Anticoagulant therapy can be continued for three to six months for complete recovery.