Venous Thrombosis Limb

Venous thrombosis limb, commonly known as deep vein thrombosis or DVT, is a serious condition where a blood clot forms in the deep veins of your body, most often in your leg. Understanding the warning signs and risk factors can help you get the prompt treatment needed to prevent life-threatening complications.

Table of contents

• What is venous thrombosis limb?
• Signs and symptoms you should not ignore
• Causes and risk factors
• Serious complications and dangers
• How doctors diagnose the condition
• Treatment options
• How to prevent venous thrombosis
• Recovery and living with the condition

What is venous thrombosis limb?

Venous thrombosis limb, more commonly called deep vein thrombosis (DVT), occurs when a blood clot (called a thrombus) forms in the deep veins of your body^[1]. While these clots can develop anywhere in your body, they most commonly form in your lower leg, thigh, or pelvis. They can also occur in your arms, particularly if you have a large tube inserted into the vein^[3].

The blood clots form because your veins are injured or because blood is flowing too slowly through them^[5]. These clots may partially or completely block blood flow through the affected vein. Each year, approximately 1 to 3 in every 1,000 adults in the United States develop DVT, and it can occur at any age, though it becomes more common after age 60^[5].

• Leg veins (lower leg, calf, thigh)
• Pelvic veins
• Arm veins

Deep vein thrombosis, DVT, venous thrombosis

Signs and symptoms you should not ignore

Many people with DVT don’t have obvious symptoms. In fact, about half of people with DVT have no symptoms at all, or the symptoms are very mild^[2][5]. When symptoms do appear in the affected leg or arm, they can include:

• Swelling in your leg or arm, which sometimes happens suddenly
• Pain or tenderness, often starting in the calf, which may only occur when walking or standing
• Throbbing pain in one leg (rarely both legs), usually in the calf or thigh^[4]
• Warmth in the area that’s swollen or hurts
• Skin that’s red or discolored (this may be harder to see on brown or black skin)^[4]
• Veins near your skin’s surface that may be larger than normal or hard and sore when you touch them^[1][4]

If you develop any of these symptoms, you should contact your healthcare provider as soon as possible. Don’t wait to see if they go away on their own^[2].

Emergency warning signs: If you have symptoms of DVT along with sudden shortness of breath, chest pain or discomfort that worsens with deep breathing, faster than normal heartbeat, or coughing up blood, call emergency services immediately^[1][3]. These are signs that a blood clot may have traveled to your lungs, causing a life-threatening condition called pulmonary embolism.

Causes and risk factors

Deep vein thrombosis can develop if you have certain medical conditions that affect how your blood clots. It can also happen if you don’t move for a long time, such as during extended travel or when you’re on bed rest after surgery, illness, or an accident^[1].

Certain factors increase your chance of developing DVT. Almost anyone can get DVT, but your risk is higher if you:

• Are over age 60^[4]
• Are overweight or obese
• Smoke or use tobacco products
• Have had DVT before
• Take birth control pills or hormone replacement therapy (HRT)^[4]
• Have cancer or heart failure
• Have varicose veins
• Have a family history of blood clots or an inherited blood clotting disorder
• Are pregnant or have recently had a baby (within the previous 6 weeks)^[4]

Your risk also increases during certain situations, including:

• Being in the hospital or having recently been discharged, especially if you can’t move around much after an operation
• Being confined to bed for long periods
• Having recent surgery, particularly joint replacement or abdominal procedures^[5]
• Taking long journeys (more than 3 hours) by plane, car, or train^[4]
• Being dehydrated
• Having a recent infection^[9]

More than half of all DVTs happen as a result of being in the hospital from a medical illness or following surgery. This is because you’re lying in bed most of the time instead of moving around like you normally would^[5].

Sometimes DVT can happen for no obvious reason. These are called “unprovoked” blood clots^[4][16].

Serious complications and dangers

While DVT itself is not immediately life-threatening, the blood clots have the potential to break free and travel through your bloodstream^[5]. The most serious complication occurs when a part of the clot breaks off and travels through the bloodstream to the lungs, causing a blockage called pulmonary embolism (PE)^[2]. This can be life-threatening and needs treatment right away.

When DVT and pulmonary embolism occur together, the condition is called venous thromboembolism (VTE)^[1]. As many as 600,000 VTE events occur each year in the United States, and up to 300,000 people die each year as a result of DVT and PE^[3][5].

If the clot is small and with appropriate treatment, people can recover from PE. However, there could be some damage to the lungs^[2]. A rare but serious complication called chronic thromboembolic pulmonary hypertension can happen after a PE with a large clot. It can stop blood from reaching the lungs and can be fatal^[2].

Another long-term problem is post-thrombotic syndrome (PTS), which affects one-third to one-half of people who have had a DVT^[2][5]. This happens because of damage the clot does to the valves and inner lining of your veins, leading to blood pooling more than it should. This increases the pressure inside your veins and causes pain and swelling. Symptoms include chronic leg swelling, increased skin discoloration, and in severe cases, leg ulcers known as venous stasis ulcers^[5].

How doctors diagnose the condition

To diagnose DVT, your healthcare provider will do a physical exam and ask questions about your symptoms. The provider will check your legs for swelling, tenderness, or changes in skin color^[8].

If a doctor thinks you have DVT, you should be referred to a hospital within 24 hours for testing^[4]. The tests you have depend on whether your provider thinks you are at low or high risk of DVT. Common diagnostic tests include:

D-dimer blood test: This test measures a type of protein produced by blood clots. Almost all people with severe DVT have increased blood levels of D-dimer. This test often can help rule out DVT^[8].

Duplex ultrasound: This is the standard test for diagnosing DVT. This non-invasive test uses sound waves to create pictures of how blood flows through the veins. For the test, a care provider gently moves a small hand-held device over the skin. The scan shows whether blood is flowing normally through the vein^[4][8]. Additional ultrasounds may be done over several days to check for new blood clots or to see if an existing one is growing.

Venography: This test uses X-rays and dye to create a picture of the veins. The dye is injected into a large vein and helps blood vessels show up more clearly on X-rays. You may also have an X-ray of the vein (venogram) where you’ll be injected with a dye to show where the blood clot is^[4][8].

MRI scan: This test may be done to diagnose DVT in veins of the belly or other areas^[8].

You may have an injection of a blood-thinning medicine called heparin while you’re waiting for an ultrasound scan to see if you have DVT^[4].

Treatment options

The primary goals for treating DVT are to prevent the clot from getting bigger, stop the clot from breaking loose and traveling to the lungs, and reduce the chances of another DVT^[8].

The main treatments include:

Blood thinners (anticoagulants): These medicines help prevent blood clots from getting bigger and reduce the risk of developing more clots. You’ll probably need to take these for at least 3 months^[4][8]. Common types include heparin injections and oral medicines such as warfarin or rivaroxaban. If you take warfarin, you’ll need to watch what you eat, as vitamin K (found in foods like kale, spinach, and Brussels sprouts) can affect how the drug works^[4].

Compression stockings: Your doctor might recommend special tight-fitting socks that keep a certain amount of pressure on your leg. This can help with blood flow after DVT and may help prevent post-thrombotic syndrome^[5].

Surgery or procedures: In some cases, surgery may be needed to remove blood clots or stop them from forming^[4][8]. An inferior vena cava filter may be placed in patients who cannot take blood thinners because of a high bleeding risk^[9].

If you get a DVT when you’re pregnant, you’ll have injections for the rest of the pregnancy and until your baby is 6 weeks old^[4].

How to prevent venous thrombosis

There are many things you can do to lower your chance of getting DVT:

Stay active: Walk regularly and avoid sitting still for long periods. Don’t sit still for more than 2 hours at a time—get up and move around every hour or so^[4]. Taking regular walks can help boost your blood flow^[5].

Maintain a healthy weight: Being overweight or obese increases your risk^[4].

Stay hydrated: Drink plenty of fluids to avoid dehydration. DVT is more likely if you’re dehydrated^[4].

Don’t smoke: Smoking increases your risk of blood clots^[4].

Don’t drink lots of alcohol: Excessive alcohol consumption can increase your risk^[4].

Avoid crossing your legs: When you sit down, don’t cross your legs, as that position can affect your circulation^[4].

When traveling long distances: If you’re traveling for 3 hours or more by plane, train, or car, take breaks often to stretch your legs. On a plane, try to move around the cabin once an hour. While in your seat, flex your ankles and move your toes up and down to keep blood flowing. Wear loose clothing and drink plenty of water while avoiding alcohol^[4].

If you’re in the hospital: If you go into hospital, your healthcare team should check if there’s a higher chance you’ll get DVT. You may be given treatment to prevent it, such as medicine or compression stockings. You can help protect yourself by staying active and walking around if you can, or by moving your toes and ankles in circles if you have to stay in bed^[4].

Recovery and living with the condition

After you leave the hospital, there are things you can do to help you recover from DVT:

• Walk regularly to boost your blood flow and help you feel better^[4][5]
• Keep your affected leg raised when you’re sitting^[4]
• Delay any flights or long journeys until at least 2 weeks after you start taking blood-thinning medicine^[4]
• Wear compression stockings as directed by your doctor

Be patient with your recovery. You may need to take medicine for a few months and wear compression stockings for up to two years^[5].

If you’ve had a blood clot before, your chances of another one are higher^[1]. Watch for signs of a new DVT, such as new or worse pain, pressure, or cramping in your calf. It’s sometimes normal for the affected limb to stay slightly swollen after treatment^[5].

Let all your doctors know if you’ve had a blood clot of any kind. If you take blood thinners, tell your dentist when you make your appointment and follow any instructions they give you^[5]. You should also be careful with activities that might cause bleeding or injury, as blood-thinning medicines can make you more likely to bleed from small injuries^[5].