Deep vein thrombosis (DVT) is a condition where a blood clot forms in the deep veins, usually in the legs or pelvis. Sometimes, the clot can break off and travel to the lungs, causing a pulmonary embolism (PE), which can be life-threatening.
If you are experiencing swelling, pain in the legs, or sudden shortness of breath, you can get personalised advice from licensed doctors through Hope Plus. This premium service helps you get timely care and avoid complications.
Key Takeaways
- DVT occurs when clots form in deep veins, often in the legs or pelvis.
- Pulmonary embolism happens when a clot dislodges and blocks blood flow in the lungs.
- Risk factors include prolonged immobility, surgery, certain medications, pregnancy, and inherited clotting conditions.
- Early treatment and preventive measures, including blood thinners and mobilisation, are essential.
Causes
- Venous stasis: slowing of blood flow in veins.
- Increased blood clotting: inherited or acquired conditions that make blood more likely to clot.
- Endothelial injury: damage to vein walls from trauma or surgery.
Risk Factors
- Prolonged bed rest, immobility, or limb paralysis
- Heart failure or recent heart attack
- Trauma or vein injury, including from intravenous cannulas
- Use of oral contraceptives, pregnancy, or postpartum period
- Cancer or certain chemotherapy treatments
- Long-distance travel by air
- Inherited clotting disorders
Symptoms
- Pain, swelling, warmth, or tenderness in the calf, thigh, or groin
- Pulmonary embolism may cause sudden shortness of breath, chest pain, rapid heart rate, or low blood pressure
- Up to 50% of DVT cases may show no obvious symptoms
Investigations
- Compression ultrasound with or without Doppler to detect clots in veins
- Chest CT angiogram if pulmonary embolism is suspected
- Additional tests may include blood D-dimer, ECG, chest X-ray, and echocardiogram
Treatment
- Enoxaparin (low molecular weight heparin) 1 mg/kg every 12 hours for at least 5 days is prescribed and administered by a healthcare provider
- Warfarin 5 mg orally in the evening is started on the same day as enoxaparin. Maintenance doses of 2.5–7.5 mg daily are adjusted based on INR 2–3
- If enoxaparin is unavailable, unfractionated heparin is prescribed with dose adjustments monitored by APTT
- Rivaroxaban: 15 mg orally twice daily for 3 weeks, then 20 mg daily; patients take the drug at the same time each day. Not used in pregnancy or breastfeeding
- Apixaban: 10 mg twice daily for 7 days, then 5 mg twice daily; also not used in pregnancy or breastfeeding
- All anticoagulants are monitored for bleeding complications, and patients are encouraged to start moving as soon as safely possible
Prevention
- Early mobilisation after illness, surgery, or travel
- Prophylactic enoxaparin 40 mg SC daily for acutely ill patients or those with prolonged hospitalisation
Prompt recognition and treatment of DVT and PE are essential for reducing complications, protecting your lungs, and improving recovery.
