A comprehensive list of today's common ailments and health conditions.
By Angela Young
Most commonly affecting leg veins, deep vein thrombosis or DVT, as it is typically abbreviated, is characterized by the formation of a blood clot in a deep vein. Complications from deep vein thrombosis can be life threatening and it is considered to be a medical emergency. The most serious risk associated with deep vein thrombosis is pulmonary embolism, where the clot dislodges and then travels to the lungs.
When deep vein thrombosis occurs in a lower extremity, there is a 3% chance of the patient dying from a pulmonary embolism. Generally developing in the calf veins and proceeding in the direction of the flow of the vein, deep vein thrombosis is in most cases above or below the popliteal vein. In rare cases the deep vein thrombosis extends into the inferior vena cava or lilac veins.
Though it is possible for DVT to occur without any symptoms, in most cases the area of the thrombus (blood clot) will be quite painful, red, swollen and in some cases the outer veins may be engorged.
There are numerous conditions that can contribute to deep vein thrombosis, but three mechanisms must be in place for an individual to be affected. They include damage to the wall of the blood vessels, a decreased flow of blood and an increased tendency of blood clotting.
Many medical conditions including cancer, infection, medical trauma, stroke and heart failure can lead to deep vein thrombosis. The two largest risk factors for deep vein thrombosis are hospitalization and surgery, while smoking and immobilization such as when on a long flight also have been cited as factors. Estrogen-containing hormonal contraception, intravenous drug use and a history of miscarriage are also factors that can contribute to deep vein thrombosis.
Hereditary risk factors can also play a significant role in the diagnoses of deep vein thrombosis. These include mutations in factor V and prothrombin genes, as well as deficiencies in the anticoagulation factors antithrombin, protein S and protein C.
To diagnose deep vein thrombosis, generally a D-dimers blood test is used, along with a Doppler ultrasound of the veins in question. In some cases, additional testing is required.
Other blood tests that are generally performed after a low D-dimer test result include a complete blood count, liver enzymes, primary coagulation studies and renal function and electrolytes.
Though home treatment is an option in some cases, most patients suffering from deep vein thrombosis will require hospitalization, as most will have additional risk factors that will require more monitoring than home care can provide.
Deep vein thrombosis is typically treated by breaking down the clot with thrombolytic agents. Patients are then given anticoagulants to prevent the formation of new clots and pulmonary embolism.
For patients that cannot undergo anticoagulant treatment, an inferior vena cava filter can also be used to reduce the occurrence of pulmonary embolism. However, this treatment is viewed only as a temporary measure to prevent the more life threatening pulmonary embolism.
For medical and surgical inpatients, prevention is key and most hospitals will use a combination of anticoagulants, thromboembolic deterrent stockings, and intermittent pneumatic compression devices to prevent deep vein thrombosis from occurring. For travelers, as well as those patients susceptible to deep vein thrombosis, compression stockings and regular walking are often recommended to prevent it.
Deep vein thrombosis affects 1 in 1000 people annually with an estimated 350,000 to 600,000 Americans suffering each year from it.
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