DVT (Blood Clot in the Legs) Symptoms, Signs, and Treatment Guidelines
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) definition and facts
- What is DVT?
- What does a blood clot in the leg look like?
- What causes DVT?
- Signs and symptoms of DVT
- Signs and symptoms of superficial blood clots
- Who is at risk?
- Which types of doctors treat DVT?
- What tests diagnose the condition?
- What are the treatment guidelines for DVT?
- What is the treatment of superficial blood clots?
- Medications to treat blood clots in the leg
- Warfarin (Coumadin, Jantoven)
- Side effects and risks of anticoagulation therapy
- Does DVT require surgery?
- What are the complications?
- How can blood clots in the legs be prevented?
- Deep Vein Thrombosis and Pulmonary Embolism FAQs
- Find a local Cardiologist in your town
Deep vein thrombosis (DVT) definition and facts
- There are both superficial and deep veins in the limbs or extremities (arms and legs). A blood clot in the deep veins is a concern because it can cause life-threatening complications.
- A blood clot (thrombus) in the deep venous system of the leg becomes dangerous if a piece of the blood clot breaks off or travels through the blood stream, through the heart, and into the pulmonary arteries forming a pulmonary embolism. A person may not have signs or symptoms of a small pulmonary embolism (blood clot in the lungs), but a large embolism can be fatal.
- Risk factors for blood clot formation include immobility, a genetic tendency toward blood clotting, and injury to veins or adjacent tissues occurs.
- Symptoms of DVT or blood clot in the leg include:
- Redness of the leg or arm
- Doctors diagnose the condition is with blood tests, and then is confirmed by ultrasound or other imaging tests.
- Treatment of typically involves taking blood thinning medications (anticoagulants) unless you cannot take them (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
- Cavernous sinus thrombosis
What is DVT?
A deep vein thrombosis, or DVT describes a blood clot (thrombosis) that forms in the deep veins located in the arm or leg. It is important to know the body's anatomy and function to understand why clots form in veins and why they can be dangerous.
- 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. Being mobile causes this blood return system to fail, and the resulting stagnated blood may clot.
- There are two types of veins in the arm or 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 extremity. 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 or arm, in itself, is not dangerous. It becomes potentially life-threatening when a piece of the blood clot breaks off and embolizes, travels through the circulation system through the heart, and enters into one of the pulmonary arteries and becomes lodged. This can prevent blood from flowing properly through the lung and decreasing the amount of oxygen absorbed and distributed back to the body.
- Diagnosis and treatment of a DVT is meant to prevent pulmonary embolism.
- Blood 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.
What does a blood clot in the leg look like?
What causes DVT?
Blood is meant to flow. If it becomes stagnant, there is a potential for it to clot. The blood in veins constantly forms microscopic clots that are routinely broken down by the body. If the balance of clot formation and clot breakdown is altered, significant clotting may occur. A thrombus can form if one or a combination of the following situations.
- Prolonged travel and sitting, such as long airplane flights ("economy class syndrome"), car, or train travel
- Trauma to the lower leg with or without surgery or casting
- Pregnancy, including 6-8 weeks post-partum after delivery of the baby
Coagulation of the blood faster than usual (hypercoaguability)
- Medications such as birth control pills (oral contraceptives), for example, Ortho-Novum, Yaz, Yasmin, Microgestin, Kelnor, and other estrogens
- Genetic or hereditary predisposition to clot formation
- Increased number of red blood cells (Polycythemia)
- Trauma to the vein
- Fracture to the leg or arm
- Bruised leg or arm
- Complication of an invasive procedure of the vein
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