Deep Vein Thrombosis
(DVT, Blood Clot in the Legs)
Benjamin Wedro, MD, FACEP, FAAEM
Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
- Deep vein thrombosis (DVT) facts
- Introduction to deep vein thrombosis (DVT)
- What are the causes of deep vein thrombosis (DVT)?
- What are the symptoms of deep vein thrombosis (DVT)?
- When should I seek medical care for deep vein thrombosis (DVT)?
- How is deep vein thrombosis diagnosed (DVT)?
- What is the treatment for deep vein thrombosis (DVT)?
- Deep vein thrombosis (DVT) medications
- Surgery for deep vein thrombosis (DVT)
- What are the complications of deep vein thrombosis (DVT)?
- Can deep vein thrombosis (DVT) be prevented?
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Deep vein thrombosis (DVT) facts
- There are both superficial and deep veins in the limbs or extremities (for example, hands, legs and feet). A blood clot in the deep veins is a concern because it can be dangerous.
- A blood clot (thrombus) in the deep venous system of the leg becomes dangerous when a piece of the blood clot breaks off (embolus, plural = emboli), travels downstream through the heart into the pulmonary circulation system, and becomes lodged in the lung.
- A tendency to form blood clots can occur when people are immobile, have a blood tendency toward clotting, or have injury to veins or their adjacent tissues.
- Symptoms of deep vein thrombosis include:
- tenderness, and
- redness of the leg or arm.
- The diagnosis of DVT can be suggested by blood tests and confirmed by ultrasound or other imaging tests.
- Treatment of DVT typically involves blood thinning medications (anticoagulants) unless they cannot be used in a patient (contraindicated). In that situation, an inferior vena cava filter is potentially considered.
- Complications of DVT include pulmonary embolism (PE) and post-phlebitic syndrome.
- There are other types of thrombosis such as:
- cerebral venous thrombosis (CVT),
- portal vein thrombosis, and
- cavernous sinus thrombosis.
Introduction to deep vein thrombosis (DVT)
Arteries have thin muscles within their walls to be able to withstand the pressure of the heart pumping blood to the far reaches of the body. Veins don't have a significant muscle lining, and there is nothing pumping blood back to the heart except physiology. Blood returns to the heart because the body's large muscles squeeze the veins as they contract in their normal activity of moving the body. The normal activities of moving the body returns the blood back to the heart.
There are two types of veins in the leg; superficial veins and deep veins. Superficial veins lie just below the skin and are easily seen on the surface. Deep veins, as their name implies, are located deep within the muscles of the leg. Blood flows from the superficial veins into the deep venous system through small perforator veins. Superficial and perforator veins have one-way valves within them that allow blood to flow only in the direction of the heart when the veins are squeezed.
A blood clot (thrombus) in the deep venous system of the leg is not dangerous in itself. The situation becomes life-threatening when a piece of the blood clot breaks off (embolus, pleural=emboli), travels downstream through the heart into the pulmonary circulation system, and becomes lodged in the lung. Diagnosis and treatment of a deep venous thrombosis (DVT) is meant to prevent pulmonary embolism.
Clots in the superficial veins do not pose a danger of causing pulmonary emboli because the perforator vein valves act as a sieve to prevent clots from entering the deep venous system. They are usually not at risk of causing pulmonary embolism.
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