Everything you need to know about deep vein thrombosis (DVT)

Blood Clot

When an individual is diagnosed with a blood clot, fear is one of the first emotions that run through the mind. Let’s be frank… the word “blood clot” sounds frightening. A quick search on Dr. Google returns over 7 million results and trying to figure out which information is correct is mind-boggling! This is the first part of a series of blog posts that will very simply describe what a deep vein thrombosis (DVT) is, the signs and symptoms of DVT, and its diagnosis and treatment.

Location, Location, Location

First and foremost, it is important to understand where a blood clot is located since not all blood clots are the same. Many people confuse veins and arteries and do not really understand the difference between the two types of blood vessels. Arteries carry oxygen-rich blood away from the heart to the various parts of the body (i.e. arms, legs, brain). Veins, on the other hand, drain the body and carry oxygen-poor blood back to the heart and lungs. Blood clots that occur in arteries can lead to life-threatening conditions such as a stroke, heart attack, or loss of blood supply to an organ. Blood clots that occur in veins, on the other hand, are generally not life threatening unless they travel to the lungs.

What is DVT?

There are two sets of veins in the arms and legs: the superficial veins and the deep veins. When one develops a blood clot in a superficial vein in the arm or leg, this is known as a superficial thrombophlebitis. Varicose veins, spider veins, or the veins that you see on the surface of your hands are examples of superficial veins. Superficial thrombophlebitis usually heals by itself but may require a warm compress, pain medication (e.g. ibuprofen/Advil), and in rare cases blood thinning medication.

When a blood clot develops in the deep veins of an arm or leg, this is known as a deep vein thrombosis or DVT (click here for link to video). Deep veins are deep within the body and cannot be seen like superficial veins. DVT is a very serious condition that must be treated immediately. If ignored, a DVT can break up into pieces and travel to the lungs causing a pulmonary embolism or PE (click here for link to video).  A PE can lead to death (sometimes sudden death) but if diagnosed early can be treated with blood thinning medicine.

Hopefully you now have a better understanding of what DVT is, why only certain blood clots are called DVT, and why it’s important to seek treatment immediately if you are having symptoms of DVT. I will discuss the signs and symptoms of DVT in my next blog post.

10 Signs that you may have TREATABLE venous insufficiency

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  1. Lower extremity swelling – This may worsen as the day progresses and improves by morning.
  2. Leg fatigue, pain and heaviness – This worsens when you are on your feet and improves when the legs are elevated
  3. Cramps or charley horse, especially at night
  4. Restless legs
  5. Flaking or itching skin on the legs
  6. Skin discoloration or hard leathery skin, especially near the lower legs and ankles
  7. Varicose veins
  8. Multiple bouts of superficial thrombophlebitis (SVT) – This presents as a painful, red, and palpable cord that runs along the medial thigh or back of the leg. It is tender to the touch and generally treated with warm compresses, anti-inflammatory medications, and in some cases, blood thinning medication.
  9. Venous ulcers
  10. Any of the above along with a history of a blood clot or DVT

 

Deepak Sudheendra, MD, FSIR, RPVI

Why is venous disease ignored?

For the millions of people worldwide suffering from venous disease, it is not uncommon for their cries of help to go ignored. Consider that there are about 250 million cases of peripheral arterial disease (PAD) worldwide. The incidence of venous disease is estimated to be 5-6x the number of arterial cases which tops over the 1 billion mark! If venous disease affects so many people, than why is it largely ignored by the medical community?  

In my opinion, education of both patients and physicians seems to be the main reason that venous disease is not taken seriously.  As a physician, I can honestly say that I did not learn anything about venous disease in medical school. It was not discussed! Imagine every medical student in the country going off to practice medicine with little to no knowledge of venous disease!

While the medical community is partly to blame for the management of venous disease, patients must also assume some responsibility for their venous health. Many patients do not understand the importance of the symptoms of chronic venous insufficiency (CVI) or DVT. Many patients believe that CVI symptoms are just a normal part of aging or are purely a cosmetic problem and as a result do not seek medical help or even mention it to their doctors. 

The third party that has ignored venous disease are the biomedical companies.  In terms of vascular disease, their focus has predominantly been on PAD. However this too is starting to change as many companies are now becoming aware of the magnitude of patients suffering from untreated venous disease.  

With increasing education and public outreach, my hope is that more patients will be treated for venous disease in the years to come. 

Deepak Sudheendra, MD, FSIR, RPVI