Deep venous thrombosis is a blood clot that forms in a vein deep inside a part of the body. It mainly affects the large veins in the lower leg and thigh.
DVT; Blood clot in the legs; Thromboembolism; Post-phlebitic syndrome; Post-thrombotic syndrome
DVTs are most common in adults over age 60. However, they can occur at any age. When a clot breaks off and moves through the bloodstream, this is called an embolism. An embolism can get stuck in the brain, lungs, heart, or other area, leading to severe damage.
Blood clots may form when something slows or changes the flow of blood in the veins. Risk factors include:
Blood is more likely to clot in someone who has certain problems or disorders, such as:
Sitting for long periods when traveling can increase the risk of DVTs. This is most likely when you also have one or more of the risk factors listed above.
DVT mainly affects the large veins in the lower leg and thigh, almost always on one side of the body. The clot can block blood flow and cause:
Your health care provider will perform a physical exam. The exam may show a red, swollen, or tender leg.
The two tests that are often done first to diagnose a DVT are:
Blood tests may be done to check if you have an increased chance of blood clotting, including:
Your doctor will give you medicine to thin your blood (called an anticoagulant). This will keep more clots from forming or old ones from getting bigger. These drugs cannot dissolve clots you already have.
Heparin is usually the first drug you will receive.
A drug called warfarin (Coumadin) is usually started along with heparin.
When you are taking warfarin, you are more likely to bleed, even from activities you have always done. If you are taking warfarin at home:
Newer blood thinning medicines that are taken by mouth are being developed. Your doctor may recommend one of these for you.
You will be given a pressure stocking to wear on your leg or legs, along with other discharge instructions. A pressure stocking improves blood flow in your legs, and reduces your risk for complications from blood clots. It is important to wear it every day.
In rare cases, you may need surgery if medicines do not work. Surgery may involve:
Many DVTs disappear without a problem, but they can return. Some people may have long-term pain and swelling in the leg called post-phlebitic syndrome.
You may also have pain and changes in skin color. These symptoms can appear right away, or you may not develop them for 1 or more years afterward. Wearing tight (compression) stockings during and after the DVT may help prevent this problem.
Blood clots in the thigh are more likely to break off and travel to the lungs (pulmonary embolus, or PE) than blood clots in the lower leg or other parts of the body.
Call your health care provider if you have symptoms of DVT.
Go to the emergency room or call the local emergency number (such as 911) if you have DVT and you develop:
Wear the pressure stockings your doctor prescribed. They will improve blood flow in your legs and reduce your risk for complications of blood clots.
Moving your legs often during long plane trips, car trips, and other situations in which you are sitting or lying down for long periods of time can also help prevent DVT. People who are at very high risk for blood clots may benefit from heparin shots when they are on a flight that lasts longer than 4 hours.
Do not smoke. If you smoke, quit. Women who are taking birth control pills or estrogen must stop smoking. See: Smoking - tips on how to quit
Ginsberg J. Peripheral venous disease. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 81.
Guyatt GH, Akl EA, Crowther M, et al. Executive Summary: Antithrombotic Therapy and Prevention of Thrombosis. 9th ed. American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141(2 suppl):7s-47s.
Snow V, Qaseem A, Barry P, et al. Management of venous thromboembolism: a clinical practice guideline from the American College of Physicians and the American Academy of Family Physicians. Ann Intern Med. 2007;146(3):204-210.