Deep vein thrombosis

Question 1

what is a deep vein thrombosis

Answer 1

occurs when a blood clot forms in one or more of the deep veins in the body, usually in the legs
for example the iliofemoral, popliteal, femoral veins

Question 2

what causes DVT

Answer 2

anything that prevents the blood from flowing or properly clotting:
- inactivity: prolonged sitting or bed rest
- injury or surgery
- pregnancy - pressure on the pelvis veins
- hormone therapy or birth control pills
- cancer, certain types of cancers and treatments
- obesity - additional pressure on veins in legs
- inherited conditions - antithrombin, protein C, S deficiencies

think of Virchow’s triad; intravascular vessel wall damage, stasis of flow, and the presence of a hypercoagulable state, can lead to DVT

Question 3

what are the Risk factors of DVT

Answer 3

-Pregnancy, oral contraceptives, old age (older than 60), major surgery, malignancy, obesity, trauma, heart failure.

Question 4

signs and symptoms of DVT

Answer 4

• 50% asymptomatic due to venous collateral channels
• leg swelling, normally unilateral
• leg pain, cramping or soreness that often starts in the calf.
• with high venous pressure, this engorges visible superficial veins
• localised swelling around the clot
• changes in skin colour of the leg, such as red or purple, due to the swelling of blood
• a feeling of warm on the affected leg

Question 5

Complications of DVT = PE

Answer 5

pulmonary embolism - if the blood clot breaks free and gets stuck in a blood vessel in a lung, this blood clot blocks and stops blood flow to an artery in the lung.

symptoms of this would include, shortness of breath, chest pain - the feeling your having a heart attack. And fainting due to drop in Blood pressure (syncope).

Question 6

how is DVT diagnosed and treated

Answer 6

• Doppler ultrasound imaging - most common, modified vein diameter. increased = acute thrombus. decreased = chronic thrombus
• venography - most effective, but invasive/ cost - prohibitive.
• lab results - D-dimers -> rule out DVT.
• Blood thinners (anticoagulants) - mainly for long term e.g. warfarin.
• clot busters (for more serious types of DVT or PE, can cause serious bleeding) NOT GOOD
• filters - normally place in a large vein like the vena cava to allow blood flow
• lifestyle remedies in aim to reduce the chance of aswell treat current DVT. focused on reducing risk factors. E.g. compression stockings, exercises around the calf