Venous Thrombosis

NAME ALTERNATIVE: 

Blood clot in the legs; DVT; DVT 

DEFINITION: 

It is a condition in which a blood clot forms in a vein deep inside the body.

Causes, incidence, and risk factors: 

Deep vein thrombosis (DVT) affects mainly the veins in the lower leg and thigh. A clot (thrombus) forms in the larger veins of the area. This thrombus may interfere with blood flow and can break off and travel through the bloodstream (embolize). The blood clot (embolus) can lodge in the brain, lungs, heart, or other area, causing severe damage to that organ.
Some of the risks for deep vein thrombosis include prolonged sitting (eg prolonged travel by plane or car) or bed rest. It can also be caused by surgery (especially hip, knee, or female reproductive organs), fractures, have given birth in the last 6 months and the use of medications such as estrogen and birth control pills.
Other risks include excessive production of red blood cells in the bone marrow (polycythemia vera), cancerous (malignant) and having a condition in which it is more likely that the blood (hypercoagulability) clot.
Deep vein thrombosis is more common in adults over 60, but can occur in any age group.

SYMPTOMS: 

Leg pain in one
Tenderness in one leg
Swelling (edema) of one leg
Increased warmth in one leg
Changes in color of the skin on a leg (redness)

TREATMENT: 

Treating DVT helps prevent the formation of a pulmonary embolus and prevent another DVT.
For years, the standard treatment has been a blood thinner called heparin, which is administered through the vein and prevents clotting (anticoagulant). It results in rapid anticoagulation is the clot. A person with deep vein thrombosis can also take an oral medication called warfarin with heparin.
Warfarin usually takes several days to fully work. Heparin is continued until the warfarin has been fully effective for at least 24 hours. People take warfarin for about six months and it usually starts after heparin.
Because the heparin was continuously administered through a vein (IV), requiring hospitalization; however, sometimes, you can use new forms of heparin, known as low molecular weight heparin (usually a drug called enoxaparin). This heparin can be administered by injection once or twice daily to shorten or eliminate the need for hospitalization.
Warfarin causes an increase in clotting time, known as prothrombin time (PT). A system called the International Normalized Ratio (INR, for its acronym in English) in order to report the ability of the blood to clot properly used. Doctors adjust warfarin to maintain the INR between 2 and 3.

PROGNOSIS: 

Most DVTs disappear without a problem, but may recur. Some patients may develop a chronic pain and swelling in the leg, known as postphlebitic syndrome. Pulmonary embolus is uncommon DVT when treated properly, but can occur and can be life threatening.