Deep Vein Thrombosis - DVT

What is a Deep Vein Thrombosis (DVT)?

A Deep Vein Thrombosis (DVT) is a blood clot that has formed in one of the Deep Veins. A DVT usually occurs in a larger vein that runs through the muscles of the calf and the thigh. It can cause pain and swelling in the leg and may lead to complications such as Pulmonary Embolism (PE). This is when a piece of blood clot breaks off into the bloodstream and blocks one of the blood vessels in the Lungs.

DVT and Pulmonary Embolism are known collectively as Venous Thromboembolism (VTE).

What causes a DVT?

A DVT can occur for no reason however, there are certain risks that can increase the risk of developing a DVT. These are:

* Inactivity - Not moving around i.e In Hospital

* Blood Vessel Damage

* Medical and Genetic Conditions

* Pregnancy

* Contraceptive Pill and Hormone Replacement Therapy (HRT)

* Other Causes - Obesity, Smoking, Dehydration

Symptoms of a DVT

In some cases of Deep Vein Thrombosis (DVT) there may be no symptoms at all but possible symptoms can include:

• Pain, Swelling and Tenderness in one of your legs (Usually the Calf)
• A Heavy Ache in the affected area
• Warm Skin in the area of the clot
• Redness of your skin, particularly at the back of your leg below the knee

A DVT usually affects one leg but there have been cases of bilateral DVTs.

Complications of a DVT

If a DVT is not treated, a Pulmonary Embolism (PE) which is a blood clot that has come away from its original site and become lodged in one of the Lungs may occur. If you have a Pulmonary Embolism (PE) you may experience more serious symptoms such as:

• Breathlessness which may come on gradually or suddenly
• Chest Pain which may become worse when you breathe in
• Sudden Collapse

Both DVT and Pulmonary Embolism (PE) are serious conditions that require URGENT investigation and treatment.

Diagnosis of a DVT

If you suspect that you have a DVT then you need to seek Medical Professional attention. You will need to have a specialised blood test called a D Dimer and an Ultrasound Scan. If both of these fail to detect a DVT then you should have a Venogram however, a Venous Duplex Ultrasound Scan from the onset will tell you specifically if you have a DVT or not.

Treatment for a DVT

If you have a Deep Vein Thrombosis (DVT) you will need to take an Anticoagulant.

Anticoagulation

Anticoagulant medicines prevent a blood clot from getting bigger. They can also help stop part of the blood clot from breaking off and becoming lodged in another part of your bloodstream (Embolism).

Although they are often referred to as "blood-thinning" medicines, Anticoagulants do not actually thin the blood. They alter chemicals within it which prevents clots forming so easily.

Two different types of Anticoagulants are used to treat DVT:

• Heparin
• Warfarin

Heparin is usually prescribed first because it works immediately to prevent further clotting. After this initial treatment you may also need to take Warfarin to prevent another blood clot forming.

Your GP or Hospital Consultant will prescribe the Anticoagulant required for you.

Compression Stockings

Compression Stockings help prevent calf pain and swelling and lower the risk of ulcers developing after having a DVT. They can also help prevent Post Thrombotic Syndrome which is damage to the tissue of the calf caused by the increase in Venous Pressure that occurs when a vein is blocked by a clot and blood is diverted to the outer veins.

After having a DVT, stockings should be worn every day for at least two years because symptoms of Post Thrombotic Syndrome may develop several months, or even years, after having DVT.

Compression Stockings should be fitted professionally. They need to be worn all day but can be taken off before going to bed or in the evening while you rest with your leg raised.

Raising your Leg

As well as wearing Compression Stockings you might be advised to raise your leg whenever you are resting. This helps to relieve the pressure in the veins of the calf and stops blood and fluid pooling in the calf itself.

When raising your leg make sure that your foot is higher than your hip. This will help the returning blood flow from your calf. Putting a cushion underneath your leg while you are lying down should help raise your leg above the level of your hip. You can also slightly raise the end of your bed to ensure that your foot and calf are slightly higher than your hip.

Prevention of a DVT

* Smoking and Diet

* Mobilising

* Compression Stockings

* Anticoagulant