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What You Need to Know About Deep Vein Thrombosis

Debra Gordon

Last updated: October 28, 2016 3:00 pm

It could start with something as innocuous as a painful, warm, swollen area on your leg. Left unchecked, however, it could lead to organ damage and death.

We’re talking about deep vein thrombosis (DVT), a blood clot that forms within a vein. If that clot breaks off and travels to your lungs, it could block blood flow, preventing oxygenated blood from getting to the rest of your body. This is called a pulmonary embolism.

Blood clots typically form in the legs, either below or above the knee, but may also occur in other parts of your body. The most dangerous ones are those that form in the thighs.

There are numerous causes of DVT, including:

• Inherited conditions, such as clotting factor abnormalities that make your blood “thicker” than normal
• A previous blood clot
• Recent major surgery, particularly orthopedic surgery (think knee and hip replacement)
• A central venous catheter, like that inserted to receive chemotherapy and other drugs
• Lying or sitting for an extended period of time, such as on an airplane
• Cancer
• Pregnancy
• Medications, particularly oral contraceptives and the cancer drugs tamoxifen, thalidomide, and lenalidomide
• Congestive heart failure
• Kidney disease
• Obesity
• Smoking
• Inflammatory bowel disease (Crohn’s disease and ulcerative colitis)

Doctors typically treat DVT with blood thinners, particularly warfarin (Coumadin), which you can take as a pill; or heparin, given as a shot or through an IV. You need to continue the medication for several months. During that time, you’ll need to have regular blood tests to make sure you have the right amount of the drug in your system; too much could lead to bleeding; too little could lead to more clots.

With very serious clots, or if you can’t take warfarin or heparin, your doctor may turn to other approaches, including thrombolytics, which dissolve blood clots; newer oral blood thinners, like Xarelto; or insertion of an inferior vena caval filter, which filters the blood to “catch” the clot much as a strainer filters the water from a pot of spaghetti.

There are several ways to prevent a blood clot:

• Get up and walk around as soon as possible after surgery.
• Move around on long plane and car trips. Also wear loose, comfortable clothing and drink plenty of fluids (not alcohol).
• Take all medication prescribed for a previous blood clot.
• Make sure your surgeon prescribed blood thinners before orthopedic surgery to prevent clots, as well as after.
• Wear compression stockings while traveling if you have a risk of DVT.

Remember, blood clots can be serious. If you develop one, particularly if you have any of the risk factors described above, call your doctor immediately.