Deep Vein Thrombosis, DVT - Symptoms, Causes, Types, Complications and Prevention

DVT full form in medical - Deep Vein Thrombosis

A blood clot is called a "thrombus," while several blood clots are called "thrombi". Deep vein thrombosis (DVT) is the occurrence of one or more blood clots in one of the body's principal veins, mostly in the lower limbs (such as, the lower leg or calf).

The clots may completely or partially restrict blood flow in the vein, which may cause some patients to experience pain, swelling, discomfort, discolouration, or redness in the affected area and possibly warm-to-the-touch skin. It can be dangerous if the clot breaks off and travels to the lungs, where it can cause a pulmonary embolism (PE).

Incidence of DVT (Deep Vein Thrombosis)

The lower limb is often impacted by deep vein thrombosis (DVT), with clot development occurring in a deep calf vein and spreading proximally. It is a common venous thromboembolic disorder (VTE) with an annual incidence of over 1.6 per 1000 people.

Distal veins are responsible for 40% of site involvement, followed by popliteal 16%, femoral 20%, common femoral 20%, and iliac veins 4%. Less than 10% of DVTs occur in the upper limbs, and central vein catheters are the primary risk factor.

Venocaval thromboses (clots in the vena cava) are relatively rare and connected to vascular abnormalities, compression, and cancer. 

Types of DVT (Deep Vein Thrombosis)

There are two main types of deep vein thrombosis (DVT), they are as follows::

• Acute DVT (acute deep vein thrombosis)
• Chronic DVT (chronic deep vein thrombosis)

Acute DVT: Acute deep vein thrombosis can develop in men and women of all ages, especially in the legs. It can make walking difficult, swells and hurts the legs. The number of veins injured, and the severity of the symptoms, increase with the size of the blood clot.

Chronic DVT: "Chronic" refers to more than one to two months old clots. The vein becomes scarred when the clot hardens, and it causes the vein to shrink significantly, making it difficult for blood to flow through.

There are also several other types of deep vein thrombosis (DVT), including:

• Travel-Associated DVT: This type of DVT occurs in people who have been sitting for long periods of time, such as on long flights or car rides.
• Postpartum DVT: This type of DVT occurs in women within three months of giving birth.
• Immobilization DVT: This type of DVT occurs in people who are unable to move around much, such as after surgery or a major injury.
• Inherited DVT: This type of DVT is caused by a genetic disorder that makes people more likely to form blood clots. 

Deep Vein Thrombosis - DVT symptoms

DVT disease can be a serious condition, but it is usually treatable with proper medication and regular checkups. These are some of the symptoms of deep vein thrombosis (DVT):

• Throbbing (to beat or pulsate with increased force) pain in the leg
• Occurrence of swelling in one leg (rarely in both legs)
• Warm skin surrounds the painful area
• Red or darkened skin surrounding the painful area (sometimes, it may not be visible in individuals with black or brown skin)
• Swollen veins that are painful to touch

If the patient is experiencing breathlessness (dyspnoea), chest pain along with the above symptoms, then the condition is to be taken as an emergency and needs to consult the doctor immediately. This condition is called pulmonary embolism (PE). 

Pulmonary embolism (PE) is a condition where the portion of a blood clot in DVT passes through the bloodstream to the lungs. People can recover from this condition if the clot is small, and the proper treatment is received.

If a bigger clot dislodges and obstructs the blood from reaching the lungs, it may lead to death finally. Pulmonary embolism (PE) may cause:

• Trouble while breathing
• Arrhythmia (irregular heartbeats)
• Angina (chest pain when taking a deep breath)
• Haemoptysis (coughing up blood)
• Low blood pressure
• Dizziness (light-headedness or fainting) 

Note: One-third of people who get a DVT will suffer long-term health issues called post-thrombotic syndrome (PTS). PTS can lead to oedema, discomfort, skin discolouration or redness, and other problems. It allows the skin more vulnerable to cellulitis, an infection that can enter the circulation and result in sepsis and death.

DVT (blood clot in a vein) typically does not cause a heart attack or stroke. Usually, the body receives oxygen-rich blood from the heart through arteries. Heart attacks and strokes can be brought on by arterial thrombosis, a blood clot in an artery.

Deep Vein Thrombosis - DVT causes

DVT meaning

DVT (Deep Vein Thrombosis) is caused by the prevention or blockage of blood flow in veins due to any of the following risk factors mentioned below, but not limited to:

• Age greater than 60
• Being inactive from spending too much time in bed or sitting motionless while travelling
• Having a catheter for a long time
• Obesity
• Too many blood cells are produced by the bone marrow because of polycythaemia
• Birth or pregnancy during the last six months
• Fractures in the hips, pelvis, or legs followed by recent surgeries
  

Deep Vein Thrombosis - DVT risk factors

DVT (Deep Vein Thrombosis) risk factors are classified as follows:

• General risk factors
• Risk factors associated with coagulation
• Constitutional risk factors
• Potential risk factors

General risk factors

• Reduced blood flow due to immobility because of Operations, General anaesthesia, Bed rests, Stroke or Long flights
• Increased venous blood pressure due to mechanical compression and functional impairment because of Stenosis (narrowing or constriction of the passage), Congenital anomaly (abnormal foetal changes) or Neoplasm (abnormal growth of the tissue) or Pregnancy
• Mechanical injury to the vein due to Peripherally inserted venous catheters, Trauma (injury), Surgery, Previous DVT disease or Intravenous drug abuse
• Increased blood viscosity due to Polycythaemia rubra vera (bone marrow produces too many blood cells), Thrombocytosis (producing too many platelets by the body) or Dehydration
• Anatomic changes in the veins may lead to thrombosis.

Risk factors associated with coagulation

• Genetic deficiencies due to Anticoagulation proteins C and S (glycoproteins responsible for clotting), Deficiency of Antithrombin III (clotting factor) or Factor V Leiden mutation (clotting factor)
• Acquired risks due to Vasculitis (inflammation of blood vessels), Systemic lupus erythematosus (autoimmune inflammatory disease), Altered lupus anticoagulant (immunoglobulins), Inflammatory bowel disease (digestive tract inflammation), Nephrotic syndrome (too much protein excreted by the kidney), Cancer, Sepsis (life-threatening infection), Myocardial infarction (heart attack), Heart failure, Hypertension, Diabetes, Burns, Oral oestrogens, Smoking

Constitutional risk factors: Surgery, Critical care admission, Dehydration, Cancer, Obesity, Pregnancy, Age greater than 60

Potential risk factors: Surgery with general anaesthetics, Hospitalisation, Caesarean section (birth procedure of baby through womb), Hormone replacement therapy, Pregnancy and peripartum period (shortly before or during, or immediately after the birth), Lower extremity injury with limited mobility for more than 72 hours

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