Deep Vein Thrombosis
Last reviewed by Dr.Mary on October 2nd, 2017.
What is Deep Vein Thrombosis?
Deep vein thrombosis or also known as thrombophlebitis is the formation of blood clots in the deep veins. Thrombus means blood clots. The clotting formations are commonly located at the thighs and lower legs. A very unwanted complication of thrombosis is dislodgement resulting to emboli (free-moving blood clots). This can be a life-threatening condition that can lead to pulmonary embolism, heart failure or cerebrovascular disease (in layman’s term; stroke).
Deep Vein Thrombosis Symptoms
The cardinal sign for this condition is called Homan sign. We can identify this while dorsiflexing the patient’s foot (bending the foot towards the head) while the patient lies flat on a bed or even surface and he/she complains of calf pain. When you gently palpate the area affected, you would feel the area warm, swelled up and the patient would complain of tenderness. In most cases, the lower leg and calf are affected. But there are instances that blood stasis can occur in the upper extremities if there is an underlying cause present.
Deep Vein Thrombosis Causes
This condition is triggered by a triad of causes, the so-called Virchow’s Triad (proprietor: Rudolf Virchow, many medical terms where coined to his name for his many contributions he has given to public health):
Hypercoagulability of blood
There is increased viscosity of the blood. This may be brought about a condition called polycythemia vera or the intake of oral contraceptives. Patients with indwelling venous catheters are not excused for this phenomenon. Polycythemia vera is a condition wherein there is an abnormal increase in number of red blood cells produced by the bone marrow. Most cases would also suggest the increase in other blood components such as the white blood cells and the platelets. This can only be identified when laboratory exams are done or when manifestations present themselves. It may develop through years and may be asymptomatic at the early stage. This should be treated immediately once diagnosed for it can be life threatening. Birth control pills usually brings along adverse effects. Long-term use of this can predispose you to blood clot formation. Clotting factors of the blood are presumptively increased by estrogen. Women taking contraceptive pills should avoid cigarette smoking and taking blood coagulants. These would just contribute to the possibility of deep vein thrombosis and its life threatening complications.
Blood vessel wall damage
From injury, trauma and surgery. In the event of a venous injury, the normal immune response would be increase of circulating blood components. There would be hypercoagulability of the blood in the area, thus resulting to a thrombus.
Decreased venous return or venous stasis
Precipitated by prolonged standing and cross-legged sitting. Immobility such as those bedridden patients is at high risk in deep vein thrombosis. Postoperative patients are also a candidate for thrombosis formation. Because of the absence of muscle exercise, inadequate blood flow may become a result. Leading to pain and swelling of the affected area. This has been caused by the marked high pressure flow from the venous system.
Deep Vein Thrombosis Treatment
Seeking treatment when acute symptoms have been identified can save you from any complication. Especially if chest pain and difficulty in breathing presents abruptly are concerning manifestations. In order to be treated, diagnosis should be done. Diagnostic exams are made especially to patients at most risk for deep vein thrombosis formation. Consult the doctor to have you treated in time, just in case. Persons, who are in great risk for thrombus formation such as smokers, birth control pills taker and has polycythemia vera should consult their family doctor to seek for preventive measures and treatments.
Treatment for blood clots is accorded to the symptoms presented by the client. In relieving pain, application of warm compress and anti-inflammatory drugs are prescribed. Steroids are commonly given to clients to disrupt inflammation. Anticoagulants or blood thinners are the most useful medication for DVT. But take note, this form of drug are only quite useful if the clot has not existed in a long time. It is impossible to dissolve a blood clot through this medication. Anticoagulants only prevent further clotting and worsening of the patient’s condition. We have warfarin and heparin used as blood thinners. Heparin is usually given for immediate use, while warfarin is for maintenance use. But these drugs also have a side effect which is bleeding, inevitable when you are taking such drugs. One should avoid eating green leafy vegetables rich in Vitamin K if you are taking either heparin or warfarin. Anti-thrombin or thrombolytic is a drug that dissolves a clot. This type of drug is used in cases of large clots that can severely affect a person. Take note, one should be alert for adverse bleeding reaction after taking these drugs.
Deep Vein Thrombosis Prevention
Upon knowing the causes of thrombus formation, we have a vivid idea on how to prevent such condition.
First, when travelling abroad or if you anticipate a long journey, one should wear compression stockings, called Jobst compression stockings. These stockings should be knee-up high to the thighs. This would improve circulation and this prevents thrombus formations.
One way for preventing too is to take blood thinners. Those at risk for thrombi formation are readily prescribed with these. Postoperative patients are also given with this kind of remedy for preventive purposes.
To quit smoking is a very good way to start. Avoiding this kind of habit prevents you from further complications too.
Do not massage the affected areas; this can result to thrombi dislodgement. It is advisable too to increase water intake. This can be of assistance in preventing further clotting.
Pregnant clients are in due risk too after giving birth. The tendency after giving birth is prolonged bed rest, especially after a cesarean section. It is highly advised to pregnant women and postpartum clients not make self immobile in a long period of time.
Another intervention to prevent thrombosis formation is to raise the legs. By doing this, the patient’s blood circulation especially from the lower legs will be smooth. Proper venous return is facilitated by this action. We are also taking off the pressure from the patient’s legs when performing this. A little assistance is also needed if patients are fairly incapable.