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Deep vein thrombosis (DVT) is a blood clot that usually starts in the deep veins of the legs but can also occur in the veins of the arms, mesentery, or brain. It is one of the venous thromboembolism disorders, accounting for the third leading cause of death from cardiovascular illness after heart attacks and strokes. Deep-vein thrombosis is a critical medical concern that accounts for the majority of pulmonary embolisms. Deep-vein thrombosis is uncommon in children, and the risk increases with age, with the majority occurring in the over-40 age group. The diagnosis of DVT based solely on clinical signs and symptoms is frequently erroneous. DVT symptoms are often nonspecific. Morbidity can only be decreased if diagnosed and treated early on. Obesity, pregnancy, advanced age (over 60), surgery, critical care hospitalisation, dehydration, and malignancy are all documented causes of DVT. Active malignancies and particular medical disorders that raise the risk of venous thromboembolism are classified as persistent risk factors.
Deep vein thrombosis is a disorder in which blood clots (or thrombi) form in deep veins in the legs or elsewhere in the body. Veins are blood vessels that carry blood from the body's tissues back to the heart. Deep veins are found deep within the body, away from the skin's surface.
Clotting is a natural process that helps to stop bleeding, such as after a cut in the skin. A clot may form if the blood flow is too slow, the vein's lining is injured, and an issue in the blood causes it to clot more easily. When a blockage forms in a deep vein, the blood flow slows and the vein swells. If a portion of a clot breaks away and travels via blood channels to the lungs, it is extremely dangerous. This illness, known as pulmonary embolism (PE), may prove lethal.
Nearly one-third of patients with DVT develop PE. To avoid PE, DVT should be detected and treated as soon as possible.
Your doctor may prescribe drugs that prevent blood clots from forming prior to or following surgery. You may also be urged to cease taking certain drugs prior to surgery.
At the hospital, you may be required to wear specialised elastic stockings or inflatable boots. These devices compress the muscles to keep the blood circulating. You might need to keep wearing them until you exit the hospital. Your feet or the foot of your bed might be elevated. You may also be encouraged to get up and stroll around right after the treatment.
Only around half of those with DVT have any signs or symptoms. Signs of DVT in the anklet, calf, or thighs include the following:
The following tests can help your healthcare expert determine if you have DVT or are at elevated risk:
Blood tests: You may be examined for blood diseases that have been linked to an increased risk of DVT.
A Doppler ultrasonography exam involves placing a handheld device over veins and using sound waves to assess blood flow.
Pressure is applied to determine whether the vein reacts normally. This test is most commonly used to confirm a DVT in the legs.
Magnetic resonance imaging (MRI) is a form of imaging examination that can detect clots in the legs or pelvis.
Venogram: This test involves injecting dye into a vein and taking an X-ray. The dye can detect if there is a clot in the vein. Other tests may be performed if the clot is suspected to be in the lungs.
Spiral Computed Tomography (CT): This imaging examination determines whether any clots have travelled to the lungs.
Ventilation/perfusion (V/Q) Scan: This diagnostic examination determines how well air and blood circulate in the lungs. It's used to diagnose PE.
Radiologists assist in guiding minimally invasive procedures such as Thrombolysis (clot dissolution) or Thrombectomy (clot removal) using imaging techniques for precise placement of catheters and devices.
Approximately three out of ten patients who have experienced a DVT or pulmonary embolism will experience another episode within ten years following the first. This is more likely to occur within the first two years, and your risk of developing DVT diminishes with time.
If your initial DVT did not occur as a result of surgery, an accident, or any other significant reason, you are more likely to experience a recurrence. You can lower your risk of developing DVT again by continuing to take any medications prescribed by your doctor and making any lifestyle changes he or she recommends.
Deep vein thrombosis is not a contraindication to physical exercise, either acutely or later on. During the acute period (beginning on day 1), the patient may move around and walk as tolerated; however, excessive exercise is not indicated and may not be tolerated due to pain or oedema.
After roughly a week, patients can gradually increase their level of activity.
Although anticoagulants like heparin and warfarin do not dissolve existing clots, they can prevent them from developing while your body fights them.
This will minimise the immediate symptoms, prevent a significant pulmonary embolism, and lessen the extent of post-thrombotic syndrome (leg oedema, heaviness, and ulceration). Patients will be given heparin (intravenously or subcutaneously) during the acute period before transitioning to warfarin (Coumadin), which is taken orally once daily.
Blood thinner treatment can last three to six months, but depending on your medical history, it may be necessary for the rest of your life. Coumadin has some disadvantages, including its interaction with certain foods (mostly green vegetables) and the necessity for periodic blood tests to ensure that the dosage is appropriate.
Some people with DVT may need to use blood thinners for the rest of their lives. Your doctor will make this decision depending on the likelihood that you will develop another blood clot. When recommending a longer course of blood thinners, they will also assess your risk of bleeding.
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