Deep Vein Thrombosis

by Maryam Abdul-Jalil and Omar Bhatti

Deep vein thrombosis (DVT) occurs when a blood clot (thrombus) forms in one or more of the deep veins in your body, usually in your legs. Deep vein thrombosis can cause leg pain or swelling, but may occur without any symptoms.

Causes of DVt

  • Surgery that reduces blood flow to a part of your body
  • Major surgery on a hip, knee, leg, calf, abdomen, or chest
  • Orthopedic surgery, such as hip replacement
  • An injury that reduces blood flow to part of your body, such as a broken hip or leg
  • Cancer, even during treatment
  • A previous history of deep vein thrombosis or pulmonary embolism
  • An inherited condition that increases blood clotting
  • Paralysis from a spinal cord injury
  • Current use of hormone therapy, including that used for postmenopausal symptoms, especially in smokers
  • Pregnancy or having recently given birth, especially by C-section
  • Varicose veins, which are swollen, twisted, painful veins
  • A history of heart attack, stroke, or congestive heart failure
  • Inflammatory bowel disease
  • Sitting or inactivity for a long time
  • Long plane flights or long car trips
  • Extra weight
  • Current use of birth control pills or patches
  • Smoking

Symptoms of dvt

  • Pain or tenderness in one or both legs, which may occur only while standing or walking
  • Swelling in one or both legs
  • Warmth in the skin of the affected leg
  • Red or discolored skin in the affected leg
  • Visible surface veins
  • Leg fatigue
  • Many times there are no symptoms!

How is dvt diagnosed?

Your doctor will diagnose deep vein thrombosis (DVT) based on your medical history, a physical exam, and test results. He or she will identify your risk factors and rule out other causes of your symptoms.

When asking about your medical history, your doctor will ask about your overall health, and prescription medicines you're taking, any recent surgeries you have had, whether you have been treated for cancer

For the physical exam, your doctor will check your legs for signs of DVT, such as swelling or redness. Your blood pressure will also be checked as well as your heart and lungs

The most common test for diagnosing deep vein blood clots is an ultrasound and other tests used are an MRI or CT scan


Approximately 1 out 1000 of adults will suffer from DVT. Rates are slightly higher in med than in women.

How Can it be prevented?

  • By maintaining an active healthy lifestyle
  • Maintaining your weight
  • Not smoking
  • Getting your blood pressure checked regularly
  • Discussing alternatives to birth control pills or hormone-replacement therapy to your doctor
  • If you are on an airplane for more than 4 hours, either walk or do leg stretches in your seat. Also stay well-hydrated and avoid alcohol consumption


  • Inheriting a blood-clotting disorder. Some people inherit a disorder that makes their blood clot more easily. This inherited condition may not cause problems unless combined with one or more other risk factors.
  • Prolonged bed rest, such as during a long hospital stay, or paralysis. When your legs remain still for long periods, your calf muscles don't contract to help blood circulate, which can increase the risk of blood clots.
  • Injury or surgery. Injury to your veins or surgery can increase the risk of blood clots.
  • Pregnancy. Pregnancy increases the pressure in the veins in your pelvis and legs. Women with an inherited clotting disorder are especially at risk. The risk of blood clots from pregnancy can continue for up to six weeks after you have your baby.
  • Birth control pills or hormone replacement therapy. Birth control pills (oral contraceptives) and hormone replacement therapy both can increase your blood's ability to clot.
  • Being overweight or obese. Being overweight increases the pressure in the veins in your pelvis and legs.
  • Smoking. Smoking affects blood clotting and circulation, which can increase your risk of DVT.
  • Cancer. Some forms of cancer increase the amount of substances in your blood that cause your blood to clot. Some forms of cancer treatment also increase the risk of blood clots.
  • Heart failure. People with heart failure have a greater risk of DVT and pulmonary embolism. Because people with heart failure already have limited heart and lung function, the symptoms caused by even a small pulmonary embolism are more noticeable.
  • Inflammatory bowel disease. Bowel diseases, such as Crohn's disease or ulcerative colitis, increase the risk of DVT.
  • A personal or family history of deep vein thrombosis or pulmonary embolism (PE). If you or someone in your family has had DVT or PE before, you're more likely to develop DVT.
  • Age. Being over age 60 increases your risk of DVT, though it can occur at any age.
  • Sitting for long periods of time, such as when driving or flying. When your legs remain still for many hours, your calf muscles don't contract, which normally helps blood circulate. Blood clots can form in the calves of your legs if your calf muscles aren't moving for long periods.


    • Heparin: People with DVT may receive heparin intravenously or by injection in the hospital for several days. You may also continue the injections at home, once or twice daily. Intravenous heparin requires blood testing, but subcutaneous (under the skin) injections of low molecular weight heparin do not.
    • Warfarin: As a DVT treatment, you take warfarin (Coumadin) by pill once a day, beginning while you're still on heparin. Treatment may continue for three to six months or more. While on warfarin, you will need regular blood tests to ensure you have the correct dosage -- too little increases your clot risk, too much increases your risk for bleeding. Warfarin can also interact with other medicines, vitamins, or certain foods rich in vitamin K -- making regular monitoring even more important. If you're pregnant, your doctor will prescribe other types of treatment, because warfarin can cause birth defects.
    • Xarelto: Unlike warfarin, Xarelto does not require monitoring with blood tests. It's also less likely than warfarin to cause serious bleeding. You also do not need to worry about interactions with foods with Xarelto. The downside is that it's much more expensive than warfarin.
    • Pradaxa: Pradaxa is an oral anticoagulant that works by blocking a certain substance (a clotting protein called thrombin) in your blood. This helps to keep blood flowing smoothly in your body.
    • Eliquis: Called a selective Factor Xa inhibitor, this oral anticoagulant has also been approved to prevent strokes in some people. Usually taken twice a day, Eliquis can cause nausea, easy bruising, or minor bleeding (such as nosebleed, bleeding from cuts).
    • Vena cava filter. This is a small metal device that is temporarily inserted to capture blood clots and prevent them from moving to other areas of your body. The filter allows blood to pass through the vein as it normally would.
    • An interventional radiologist or vascular surgeon inserts the filter into the vena cava, which is the main vein going back to the heart from your lower body. To reach this vein, which is in your abdomen, the doctor inserts the filter into a leg, neck, or arm vein. Ask your doctor how long the filter needs to stay in place.
    • Elevation and compression. Elevating the affected leg and using a compression device may help reduce symptoms of DVT, such as swelling and pain. Your doctor may also prescribe graduated compression stockings to reduce the risk of recurrence. You wear this DVT treatment from the arch of your foot to just above or below your knee.
    • Venous thrombectomy. In very rare cases, surgery is required to remove a deep vein clot. This may be true if you have a severe type of DVT that does not respond well to nonsurgical DVT treatment. This is called phlegmasia cerulea dolens.

    Works cited

    "Causes and Risks of Deep Vein Thrombosis, or DVT." WebMD. WebMD, n.d. Web. 13 Mar. 2015. Cushman, Mary.

    "Epidemiology and Risk Factors for Venous Thrombosis." Seminars in Hematology. U.S. National Library of Medicine, n.d. Web. 13 Mar. 2015.

    "How to Prevent Deep Vein Thrombosis (DVT)." WebMD. WebMD, n.d. Web. 13 Mar. 2015.

    "Deep Vein Thrombosis (DVT)." Risk Factors. N.p., n.d. Web. 13 Mar. 2015.

    "Prevention of Deep Vein Thrombosis (DVT

    ) and Pulmonary Embolism - Medical Illustration, Human Anatomy Drawing, Anatomy Illustration." Prevention N.p., n.d. Web. 13 Mar. 2015.

    "Treatment for Deep Vein Thrombosis (DVT)." WebMD. WebMD, n.d. Web. 13 Mar. 2015.

    "Venous Thromboembolism in the Pediatric Population." Venous Thromboembolism in the Pediatric Population. N.p., n.d. Web. 13 Mar. 2015.

    "Vascular and Endovascular Surgery." Deep Vein Thrombosis (DVT) / Thrombophlebitis | Patient Care & Services | at Miller School of Medicine. N.p., n.d. Web. 13 Mar. 2015

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