Answers to frequently asked questions about Deep Vein Thrombosis
Can deep vein thrombosis be prevented?
Deep vein thrombosis can effectively happen to anyone, of any age and at any time. It may not necessarily be entirely preventable but risk factors can certainly be kept to an absolute minimum.
Measures which can be taken to achieve this include:
- Lifestyle changes or adjustments: Maintaining healthy blood pressure levels (these should be checked periodically), giving up smoking, losing weight if necessary (or maintaining a healthy weight), getting in regular exercise and healthy eating (balanced nutrition) can go a long way in keeping the body in good health, which promotes better blood flow and normal circulation. Exercise can considerably lower the risk of clotting.
- Make movement a part of everyday habits: Limit or avoid sitting or lying still for long periods of time (longer than 4 consecutive hours) wherever possible, especially following a surgical procedure or extended bed rest. In instances where movement is not possible (e.g. due to injury or when on bedrest), a person can aid circulation by raising and lowering their heels, while keeping toes firmly on the ground, following by toe raises while heels remain on the floor (flex and stretch exercises) or simply pointing and flexing the toes, moving the feet in circular motions, raising and lowering the legs or bending and stretching them.
- Another conscious effort a person can make is to limit how long legs are crossed when sitting for a long time, especially if travelling a long distance (by train, car or aeroplane). It is a good idea to get up occasionally and walk about, which allows better circulation and also lowers the risk of thrombus formation, especially in seniors.
- Travel considerations: Risk for developing DVT is relatively low during travel, but increases past the 4-hour mark. If travelling for extended periods, it is a good idea to get up and move around at least once an hour – stop frequently if driving or take a short walk up and down the aisles of planes, buses or trains. While sitting, a person can flex and stretch their legs and feet, as well as curl and flex the toes to encourage blood flow to the calves. Loose-fitting clothes is also advisable as air pressure changes etc. can alter bodily function and affect circulation or induce swelling. Tight-fitting clothes also restrict blood flow. Consuming plenty of water is also advisable, as is avoiding alcohol and caffeine. This helps to prevent dehydration which can lead to narrowing of the blood vessels, blood thickening, and in turn result in the increased likelihood of clot formation.
- Maintain regular medical check-ups: Periodic check-ups can help to nip a problem in the bud before it becomes serious, and also keep a close eye on how blood flow and overall circulation is functioning. Any abnormalities can be quickly treated. If medications are being used for DVT, a doctor will want to monitor both positive and potentially negative effects. All medication must be taken as directed. Medications used in the treatment of any othermedical health conditions such as diabetes or heart disease will also be carefully managed to maintain optimum health. Women who use oral contraceptives or are undergoing hormone replacement therapy should also talk to their doctors about means of lowering their risk of blood clots. During pregnancy, a woman should also talk to her doctor about reducing her risk factors for clots, particularly as the gestation period progresses into the later trimesters.
- Plan post-op care: If it is possible that a person will be immobile for an extended period of time following a surgical procedure, it is best to discuss measures that can be taken to lower the risk of clots during recovery. Blood thinner medications or compression stockings are some means a doctor may recommend until such time as a person can get up on their own and move around. Simple leg lifts and ankle movements while on bed rest can also help to stimulate blood flow and encourage healthy circulation.
What is the outlook for those with deep vein thrombosis?
In general, treatment for deep vein thrombosis is successful without serious complications and the body can return to normal function. The condition, however, can recur, so precautionary measures to reduce risk as much as possible are advisable. Chronic occurrence of post-phlebitic syndrome can lead to long-term oedema (swelling) or pain which will need to be carefully managed by a treating doctor.
There is a higher risk of a thrombus in the thigh breaking loose and travelling to the lungs (resulting in a PE) than those which occur in the lower leg.
What is upper extremity deep vein thrombosis (UEDVT)?
A form of deep vein thrombosis, UEDVT is characterised by the formation of blood clots in the neck or arms. This form can also lead to complications similar to those of DVT, such as a PE (pulmonary embolism).
Symptoms and signs of UEDVT
- Pain in the neck or shoulder areas, as well as discomfort or pain that travels to the arm or forearm
- Oedema (swelling in the hands and or / arms)
- Skin discolouration (often a bluish colour)
- Weakness of the hand
Like DVT that occurs in the lower extremities, upper extremity deep vein thrombosis can also present no noticeable symptoms until complications occur.
Causes of UEDVT
- Strenuous activity: Such activity can cause damage to the inside coating of a blood vessel (vein, artery, capillary) and increase risk of the formation of a clot. Activities such as rowing, cricket bowling or pitching a baseball are some examples. A clot as a result of strenuous activity is not all that common, but is more often seen in otherwise healthy athletes.
- Medical procedures: Damage to blood vessels which occur during a medical procedure, such as during the insertion of a pacemaker, or a venous catheter (a thin, flexible tube), may slow down blood flow, which in turn increases risk for a thrombus. Those undergoing long-term or chronic catheter treatment (especially above the waist) are at higher risk. UEDVT which occurs as a result of such medical procedures is often referred to as secondary UEDVT (primary UEDVT relates to disorders, abnormalities and deficiencies etc.).
- Trauma / injury: Fractures affecting the ribs, clavicle (or collarbone), humerus (long bone in the arms between the shoulder and the elbow), or injury to the muscle tissues and nearby blood vessels can increase the risk for the formation of blood clots.
- Blood clotting disorders: Genetic abnormalities or deficiencies of certain blood proteins and blood clotting disorders can cause blood to clot more than is necessary, resulting in hypercoagulation. Other medical conditions such as cancer or connective tissue disorders such as lupus, can also lead to hypercoagulation as a side-effect or complication.
- Physical abnormalities: Abnormal muscle insertion (placement of muscle tissues) or an additional rib (known as a cervical rib) which is placed high in the chest are some examples of potential abnormalities that a person may be born with, and which could aggravate nerves or a vein with repetitive motion. This can sometimes lead to the formation of clots. Conditions such as thoracic outlet syndrome (compression of blood vessels) can restrict blood vessels and nerves where they leave the chest area and enter the upper extremities.
Diagnosis and treatment of UEDVT is much as the same as it is for DVT. The outlook, risk factors and complications, are similar too. Effective treatment can ensure that a full recovery is made with little to no lasting (long-term) effects.
What is popliteal vein thrombosis?
A major blood vessel which runs up the back of the knee, carrying blood from the lower leg back to the heart is known as the popliteal vein. Thrombosis can occur in this vein, effectively causing a blockage, and restricting blood circulation in the lower extremities. The result of this type of DVT causes damage to the surrounding tissues and blood vessels. The name merely refers to the specific vein in which the blood clot has formed.
Pain may be noticeable in the lower leg at first and feel like an aching cramp. Swelling will be the next tell-tale sign. Normally, muscle cramp in the legs are not accompanied by swelling. If swelling does occur with a cramping pain, it is best to seek medical treatment for a potential blood clot. Clots which develop in this vein are typically as a result of damage caused by chronic drug / medication use, smoking, persistent inflammation to tissues in the area or a major injury.
Diagnosis and general treatment is typically the same as with any potential thrombosis blood clot. Surgical removal may be necessary, depending on the location of the clot and how severe symptoms are at the time of diagnosis.
Early diagnosis and treatment, as with any blood clot, is essential to prevent serious complications, and reduce the likelihood of long-term damage or consequences.