Deep vein thrombosis is a condition in which a blood clot forms in one or more of the deep veins usually in the legs. A potentially life threatening complication may occur if this clot detaches and travels to the lungs leading to pulmonary embolism.
Etiology:
DVT (Deep vein thrombosis) results from conditions that impair venous return, lead to endothelial injury or dysfunction, or cause hypercoagulability. The conditions leading to DVT and the risk factors include:
- Occult cancer.
- Immobilized patients.
- Adults over the age of 60 years
- Recent history of a major surgery or trauma
- Prolonged sitting like long travels
- Family history of blood clots.
- Pregnancy or delivery in last 6 months
- Obesity
- Fracture of the pelvis or legs.
- Taking oral contraceptives or hormonal replacement therapy.
- Certain autoimmune disorders
- Cigarette smoking.
- Swelling in the affected leg. ( Rarely both legs are involved)
- Changes in skin color
- Pain in the leg
- Warmth and tenderness over the affected part
- Positive Homan’s sign ( Calf discomfort elicited by ankle dorsiflexion with the knee extended)
The two main tests done to diagnose DVT are :
- D-dimer blood test.
- Doppler ultrasound exam of the legs.
Treatment aims to prevent the formation of blood clot.
- Heparin is usually the first line drug which is given through intravenous route.
- Warfarin that can be taken orally can be started along with heparin and continued depending on need.
- Pressure stocking can be given to wear on the legs which helps improve blood flow and reduces the risk of complications from blood clots.
- Sometimes a surgery may be needed to place a filter in the body’s largest vein to prevent the clots form the deep veins to enter the lung circulation.
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