Deep Dive into Deep Vein Thrombosis

Deep Dive into Deep Vein Thrombosis

Deep vein thrombosis (DVT) is a blood clot that occurs in the veins in arms and legs. In this DocTalk video, Jack McCallum, MD, a vascular and endovascular surgeon at Valley discusses symptoms, risks and treatments for DVT. Watch the video or read the transcript below.

Learn more about vascular care at Valley.

0:11 | What is deep vein thrombosis or DVT?
Taking it in pieces, a ‘thrombosis’ is a blood clot, and the deep veins are veins that run deep inside of our arms and legs with the arteries. So, a deep vein thrombosis is a blood clot that occurs in one of those veins. A related condition is called pulmonary embolism, which is when one of these blood clots breaks off, travels through the veins, and gets caught in the lungs. We often talk about DVT and pulmonary embolism together – DVT and PE.

0:43 | What are the symptoms of DVT?
The symptoms of DVT are pain, swelling, and sometimes redness in the involved arm or leg.

0:51 | What causes DVT?
Often, we never know exactly what causes a specific DVT, but we do know that there are things that put people at increased risk of having blood clots. Blood clots start to form when clotting factors and blood cells called platelets are triggered within the blood. Once a clot starts to form, it often snowballs and forms a bigger and bigger clot as time passes, and that sticks to the walls of blood vessels. That’s how we think DVTs start.

1:23 | Who is at risk for having DVT?
There are many things that increase the risk of developing a DVT.

  1. Immobility, such as not moving or walking, like on a long plane ride or having been in the hospital for some period of time.
  2. Damage to the walls of veins, such as happens following a traumatic accident, like a car crash.
  3. Other conditions cause people to develop DVTs, such as certain inherited conditions that make clotting in the blood more likely.
  4. Some types of cancer increase rates of blood clot formation. 
  5. Having COVID-19 increases blood clot formation.
  6. Smoking, pregnancy and obesity all increase the risk for having DVTs.
  7. Having a catheter, such as a central venous catheter (a tube inserted into a central vein to deliver drugs or fluids for medical treatments)  can cause clotting and DVT as well.

2:15 | How is DVT diagnosed?
Since DVTs and the symptoms are common, we often suspect a DVT anytime there’s arm or leg swelling or pain. To confirm the diagnosis, we perform an ultrasound of the veins in the involved arm or leg.

2:32 | How is DVT treated?
Almost all DVTs are treated with anticoagulants, also known as blood thinners. Blood thinners reduce the risk of further clots forming while the body breaks down a clot on its own. The body is always forming and breaking down clots, and blood thinners help break the cycle of clot growth. Rarely, in certain cases, surgery is needed for severe DVTs.

2:57 | What are possible complications of DVT?
The most feared problem of DVT is something called pulmonary embolism, or PE for short. In PE, a piece of clot breaks off from a vein, usually a vein in the pelvis, travels through the veins, and gets caught in the veins in the lungs. This can cause shortness of breath, chest pain and, in severe cases, sudden death. Other problems of DVT include something called post-thrombotic syndrome, in which the veins in the legs stop working well. This can lead to chronic leg swelling, changes in the skin color and texture in the legs, and, in severe cases, wounds that slowly or fail to heal in the skin of the legs.

3:41 | When should you seek treatment for a DVT and who should you see first?
Anytime anyone develops pain and swelling in one of their arms or legs, particularly if it’s just on one side and not on both sides, that’s a big warning sign for DVT. Anytime that happens, you should reach out to your care provider urgently, and if you don’t hear back in about 24 hours, you should probably go to urgent care. There, a provider will check you, and a lot of the time it won’t end up being a DVT. But, because DVTs can be so dangerous, we recommend that you stand up for yourself and get care right away. We understand, and it’s okay to reach out and ask for care urgently in this situation.

4:26 | What can people do to try to prevent DVTs?
One of the best things patients can do to prevent DVTs is to be active. If you’re on a long voyage, such as a long plane flight, I recommend that patients get up and walk around for five minutes every one to two hours. Similarly, if you’re on a long car drive, stop every couple of hours and have a walk around. If you smoke cigarettes, you should stop. Smoking cigarettes increases the risk of DVTs and other health conditions.

If you’re in the hospital, or a family member or loved ones in the hospital, you’ll often see them be given a dose of blood thinners, often as a shot. This helps reduce the risk of getting a blood clot like a DVT while a patient is in the hospital. That’s normal practice and you may see that in your loved one’s care at Valley.

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