Deep vein thrombosis (DVT) is the formation of a blood clot, known as a thrombus, in the deep leg veins. Classic symptoms of DVT include swelling, pain, and discoloration in the affected extremity. DVT is a very serious condition that can become life-threating if a large blood clot breaks free from the leg and travels to the heart or lungs, a condition called pulmonary embolism. DVT can also cause permanent damage to the veins of the leg which can lead to chronic leg swelling, pain and skin breakdown, a condition known as post-thrombotic syndrome. In the United States alone, 600,000 new cases of DVT are diagnosed each year and one in every 100 people who develops DVT dies. Recently, DVT has been referred to as "Economy Class Syndrome" because prolonged periods of sitting or inactivity such as long plane flights increase the risk of developing DVT. DVT rates are higher in men, African-Americans and increase substantially with age. It is critical to treat deep venous thrombosis at an early stage to avoid development of further complications, such as pulmonary embolism or recurrent deep venous thrombosis.
Society of Interventional Radiology© 2004, 2009
The deep veins are near the center of the leg and surrounded by powerful muscles that help return blood back to the lungs and heart by squeezing the veins. These muscles contract and squeeze the veins when we walk or exercise. One-way valves prevent the back-flow of blood between the contractions. When the circulation of the blood slows down due to illness, injury or inactivity, blood can accumulate or "pool" which provides an ideal setting for clot formation. Cancer, estrogen medications and certain blood clotting disorders can also increase the risk of DVT.
DVT Risk Factors
- Previous DVT or family history of DVT
- Immobility, such as bed rest or sitting for long periods of time
- Recent surgery
- Above the age of 40
- Hormone therapy or oral contraceptives
- Pregnancy or post-partum
- Previous or current cancer
- Limb trauma and/or orthopedic procedures
- Coagulation abnormalities
- Obesity
DVT Symptoms
- Discoloration of the legs
- Calf or leg pain or tenderness
- Swelling of the leg or lower limb
- Warm skin
- Surface veins become more visible
- Leg fatigue
Pulmonary Embolism
Society of Interventional Radiology© 2004, 2009
Symptoms of pulmonary embolism are frequently nonspecific and can mimic many other cardiopulmonary symptoms including shortness of breath, rapid pulse, sweating, sharp chest pain, bloody sputum (coughing up blood), and fainting. It is estimated that each year more than 600,000 patients suffer a pulmonary embolism resulting in as many as 200,000 deaths annually in the United States. One in every 100 patients who develop DVT dies due to pulmonary embolism. Since the majority of pulmonary embolism are caused by DVT, early detection and treatment of DVT can significantly reduce chances of a fatal embolus.
Symptoms of Pulmonary Embolism
The symptoms are frequently nonspecific and can mimic many other cardiopulmonary events.
- Shortness of breath
- Rapid pulse
- Sweating
- Sharp chest pain
- Bloody sputum (coughing up blood)
- Fainting
Post-Thrombotic Syndrome
Post-thrombotic syndrome is an under-recognized, but relatively common sequela, or aftereffect, of having DVT if treated with blood thinners (anticoagulation) alone, because the clot remains in the leg. Contrary to popular belief, anticoagulants do not actively dissolve the clot, they just prevent new clots from forming. The body will eventually dissolve a clot, but often the vein becomes damaged in the meantime. A significant proportion of these patients develop permanent irreversible damage in the affected leg veins and their valves, resulting in abnormal pooling of blood in the leg, chronic leg pain, fatigue, swelling, and, in extreme cases, severe skin ulcers. While this use to be considered an unusual, long-term sequela, it actually occurs frequently, in as many as 60-70 percent of people, and can develop within two months of developing DVT. There is increasing evidence that clot removal via interventional catheter-directed thrombolysis in selected cases of DVT can improve quality of life and prevent the debilitating sequela of post-thrombotic syndrome.
For more information about DVT, or to schedule an appointment please call (916) 783-8114 (in Roseville) or (916) 732-7777 (in Sacramento)
