Signs of Deep venous thrombosis (DVT, venous blood clot)

Description

A blood clot embedded in one of the major deep veins of the legs, arms or pelvis. The clot blocks blood flow through these veins preventing blood form being brought back to the heart. Smoking, birth control pills, prolonged sitting, cancer, bed rest, giving birth, intravenous catheters, and recent fractures increases the risk of DVT. If the blood clot breaks away it can travel through the heart and lodge in the pulmonary artery causing a life threatening disease named pulmonary embolus. Some patients have have hypercoagulable disorders that cause them to make more blood clots. The most common hypercoagulable states are factor V Leiden, protein C deficiency, protein S deficiency, and antithrombin III deficiency.

Symptoms

Leg pain, leg swelling, groin pain, leg tenderness, leg discoloration, arm pain, arm swelling, arm discoloration.

Tests

A history and physical exam will be performed. A d-dimer, a blood test, can be used to rule out a deep vein thrombosis (DVT). A noninvasive vascular assessment (NIVA) is done to diagnose the DVT. Blood tests to look for a disorder called "hypercoagulable state" may be done.

Standard Workup

D-Dimer

Treatment

Anticoagulants are given usually initially given as a shot (enoxaparin) and orally (warfarin). The anticoagulant effects of the warfarin are measured and when adequate the enoxaparin is discontinued. At times intravenous heparin is used instead of enoxaparin. Large blood clots may be removed from the vein either surgically or with medication delivered directly into the affected vein. For additional information contact the National Heart, Lung and Blood Institute Health Information Center at: http://www.nhlbi.nih.gov or call (301)592-8573.