Deep vein thrombosis (DVT) and Pulmonary Embolism (PE)

Dr Duncan Anderson offers diagnosis, and surgical and nonsurgical treatments for deep vein thrombosis (DVT) and pulmonary embolism (PE).

Deep vein thrombosis occurs when a blood clot forms in a vein deep within the body. It is the result of blood moving too slowly. Most deep vein clots occur in the lower leg, pelvis or thigh. If the vein swells, the condition is called thrombophlebitis.

Almost anyone can develop a DVT. The early warning signs and symptoms of DVT are pain, swelling, feeling of tightness, redness, skin becomes warm to the touch, leg cramps that often start in the calf, leg pain that gets worse when bending the foot, and skin discoloration.

Factors that increase the risk of developing DVT include:

  • Family history of DVT or PE
  • Previously diagnosed episodes of DVT or PE
  • Injury to a vein, often caused by: Fractures, severe muscle injury, or major surgery (particularly involving the abdomen, pelvis, hip, or legs).
  • Immobility - Slow blood flow, often caused by bed confinement (e.g., due to a medical condition or after surgery);
  • Limited movement, as a result of a cast on a leg to help heal an injured bone; Sitting for a long time, especially with crossed legs; or paralysis.
  • Obesity
  • Increased estrogen, often caused by: Birth control pills or hormone replacement therapy sometimes used to ease menopausal symptoms. Pregnancy, for up to 3 months after giving birth
  • Certain chronic medical illnesses, such as: Heart disease, lung disease, cancer and its treatment, inflammatory bowel disease (such as ulcerative colitis or Crohn’s disease).
  • Age - your risk increases as your age increases

Tips for preventing DVT:

  • Avoid immobility - move around as soon as possible after having been confined to bed, as is the case after surgery, illness, or injury. Avoid sitting for long periods of time, such as when traveling for more than four hours. Get up and walk around every few hours.
  • Exercise your legs while you are sitting at your desk or watching TV
  • Wear loose-fitting clothes.
  • If you are at risk, or suspect you are at risk of developing DVT, make use of graduated compression stockings.
  • Use the recommended anticoagulant medication to prevent DVT clots from forming.
  • You can reduce your risk by maintaining a healthy weight, having an active lifestyle, and following doctor’s recommendations based on your individual risk factors.

The danger with deep vein thrombosis is that a blood clot could break loose and cause a life-threatening problem in the lungs, which is called a pulmonary embolism (PE). If the blood supply to the lungs is blocked by a large clot it can be fatal.

Pulmonary Embolism

You can have PE without any symptoms of DVT.
If you have any of the symptoms below, you should seek medical help immediately.

Signs and symptoms of PE can include:

  • Difficulty breathing
  • Faster than normal or irregular heart beat
  • Chest pain or discomfort, which usually worsens with a deep breath or coughing
  • Coughing up blood
  • Very low blood pressure, lightheadedness, or fainting

Diagnosis of DVT and PE

The diagnosis of DVT or PE requires special imaging tests that can only be performed by a doctor. That is why it is important for you to seek medical care if you experience any of the symptoms.

Treatments for DVT and PE

Anticoagulant medications, such as unfractionated heparin, which is injected into a vein, or Warfarin, which is taken orally, are used to prevent and treat DVT. Compression stockings are recommended to prevent DVT and relieve pain and swelling. These might need to be worn for 2 years or more after having DVT. In severe cases, the clot might need to be removed surgically. Immediate medical attention is necessary to treat PE.

In rare cases, when anticoagulants cannot be used or don’t work effectively enough, a filter can be inserted inside the inferior vena cava to capture or trap the embolus before it reaches the lungs. A surgical procedure may also be deemed necessary to remove a clot. The procedures may either be a thrombectomy or an embolectomy. A thrombectomy involves removal of the clot in a patient with DVT. An embolectomy involves the removal of the blockage in the lungs caused by a clot in a patient with PE.

It's interesting to note that DVT does not cause heart attack or stroke as it is not the same type of blood clot that causes blockages to the brain.