Deep Vein Thrombosis (DVT) is the result of blood clotting whilst it is still inside the blood vessel. In the majority of cases, painful swelling in the leg will be experienced as a ‘warning sign’ however, this is not always the case and, in some instances, no obvious symptoms will be presented.
Despite the fact that many people could be at risk of developing DVT, there is still much uncertainty as to how to prevent the condition from occurring, and a general lack of awareness around the importance of speaking medical treatment if you think you are suffering from the condition.
Here, to help provide some clarity on the condition, leading vascular specialist Professor Mark Whiteley of The Whiteley Clinic, shares the ten key things everyone should know:
DVT CAN OCCUR FOR NO APPARENT REASON
Professor Whiteley says: “Although there are some recognised risk factors for DVT, the condition can also effect people for no apparent reason. If there is a clear reason why DVT has occurred, we call it "provoked" DVT. If there is no known reason for DVT then we call it an "unprovoked" case.
Studies have shown that over 80% of hospital patients will experience a minor DVT. One in 12 people who fly long haul, over 7 hours, will also experience a minor case. However, in most cases these cases will resolve themselves and will not cause the individual any lasting problems. In fact, many people may not even know they’ve had a problem.
However, we must be careful not to trivialise DVT as some individuals will experience much more serious symptoms - such as aching/pain and swelling, clots to the lung (called pulmonary embolism) , and/or scarring of the deep vein with long-term deterioration of the leg post thrombotic syndrome (PTS).”
DVT PRESENTS A NUMBER OF SYMPTOMS
Professor Whiteley says: “Although in some cases there will be no symptoms associated with DVT, in others there will be some distinct warning signs. These can include: pain/swelling/tenderness in the leg (usually in the calf), a heavy aching feeling, warm skin around the affected area, or a redness to the skin. If anyone is concerned that they may be experiencing any of these symptoms, and they become breathless or experience chest pain, then they should seek medical attention immediately.”
PREGNANCY INCREASES YOUR RISK OF A DVT
Professor Whiteley says: “Pregnancy can increase the risks of DVT, particularly at the time of delivery. A normal adult has approximately 5L of blood. However, pregnant women increase their blood volume to 7L at the end of pregnancy. This is because women lose blood whilst giving birth and so the body produces more to keep at a safe level. Not only do women have extra blood, their body also adapts to clot blood quicker after they have given birth to stop haemorrhages.
Unfortunately, the downside of this is that it increases the risk of DVT. If a woman is pregnant and has varicose veins, then the risk is increased even more so.
COMPRESSION STOCKINGS ARE KEY FOR PREVENTION
Professor Whiteley says: “Wear properly measured and fitted graduated compression stockings if you are ever in a position where you cannot move easily such as on a long flight, long car journey, long coach journey etc.
VARICOSE VEINS ARE A SERIOUS FACTOR
Professor Whiteley says: “One of the most important things to talk about in relation to DVT, is varicose veins. Varicose veins occur when the flow of blood within a vein changes. Blood can fall backwards down your veins with gravity if the valves are not working properly – stretching the vein walls as a result. With the flow of blood changing, and the vein wall changing, this is serious potential for clots forming in the veins.
When a clot forms in a varicose vein, it is called "phlebitis". Since 2012, it has been known that everyone with phlebitis should have a duplex scan for the following reason. If the clot is small and in a varicose vein a long way from the deep veins, then it can be treated safely with aspirin and support stockings. However, if it is within 5 cm of a deep vein, there is a risk of it causing a clot on the lung (pulmonary embolism). Of course, having varicose veins treated properly by the new endovenous techniques will stop the risks of phlebitis and any other associated problems.”
POOR LIFESTYLE CAN INCREASE YOUR RISK
Professor Whiteley says: “Other known factors for developing DVT are malignancy, immobility, major surgery, dehydration, smoking (particularly if combined with oral contraceptive pill) and a family history of getting DVTs (called thrombophilia).”
A SLOW BLOOD FLOW IS CRITICAL
Professor Whiteley says: “In short, a DVT is a clot in the deep vein. Clots form because of one or more of three main reasons - changes in the composition of the blood, changes in the flow of blood, or changes in the vein wall. Any one of these, or combination of these, can increase the risk of a deep vein thrombosis.”
DVT CAN BE FATAL
Professor Whiteley says: “Deep vein thrombosis (DVT) is a diagnosis that will cause huge concern for many patients. However, as with many medical conditions, DVT can affect people in different ways. DVTs can be tiny, and of no significance, or can be huge and can be life threatening. Of course between these two extremes, there is also a whole scale. A duplex ultrasound scan will be able to diagnose a DVT and also assess how severe it is.
The risks associated with DVT are reduced both in the short term (clots to the lung) and in the long term (post thrombotic syndrome-swollen and discoloured leg with or without leg ulceration) if the DVT is diagnosed early and treated aggressively with anticoagulation.”
If DVT is not treated, around one in 10 people will develop a pulmonary embolism. This is a serious condition which can cause chest pain, sudden collapse and/or either gradual or sudden breathlessness.
EXERCISE IS KEY FOR RECOVERY
Professor Whiteley says: “People undergoing major surgery nowadays get blood thinners and support stockings to try and reduce the risk of DVT. Physiotherapists also try to mobilise patient as soon as possible after such operations. Many Surgeons today also prefer local anaesthetic procedures so that their patients can "walk in, walk out", and keep mobile. This new "ambulatory" surgery performed in local anaesthetic clinics dramatically reduces risks of deep vein thrombosis.
Anything that increases the flow of blood in the veins will reduce the risk of clots, and therefore reduce the risk of DVT. Exercise and movement, particularly walking, is so important. Compression stockings, particularly if properly fitted, have been shown to reduce the risk of DVT but this is markedly enhanced by movement of walking. Those who cannot walk or move often require anticoagulation injections or tablets.”
THERE ARE MANY WAYS TO PREVENT A DVT
Professor Whiteley says: “Keep hydrated, keep active and mobile - particularly through lots of walking. Treat varicose veins as quickly as possible with an endovenous technique, under local anaesthetic, to reduce risk of DVTs occurring.”
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