When you hear someone talking about a DVT or Deep Venous Thrombosis, even if you don’t fully understand the process of the condition, it makes you a little nervous! DVT’s, in the eyes of the general public, and in the eyes of medical professionals, are not something to “mess around with.” The seriousness of the condition, if caught early can quickly be diluted, but if a DVT is not detected or progresses beyond its initial stages, complications become real threats!
To take a step back for a minute, lets talk specifically about what a DVT is, and what it means in terms of presenting symptoms. The vasculature in the leg, and in the remainder of the body for that matter has two main systems. There is an arterial system that is responsible for brining blood from the heart out to the body providing oxygen and nutrients to the tissues allowing them to thrive. There is also a venous system, which is responsible for carrying deoxygenated blood from the body’s tissues back up to the heart and lungs for re-oxygenation and recirculation. For all you engineers out there, it’s a closed-circuit system!
Specifically in the lower extremities, the venous system, that which is responsible for carrying blood back up to the heart, is divided into a superficial (meaning close to the skin’s surface) and a deep (meaning hiding within the musculature of the leg) system. All blood within the superficial system is funneled into the deep system before it can be returned to the heart. A Deep Venous Thrombosis is a clot or a blockage in the deep venous system of the leg, meaning blood from both the superficial and deep systems of the affected leg can not properly return to the heart, as all blood must return through the deep veins.
When a blockage occurs (DVT), the patient may feel no symptoms at all, but more than likely the patient will notice pain, redness, increased temperature to touch, and swelling all within the affected leg. These symptoms, in addition to some of the associated risk factors for a DVT should raise immediate suspicion and requires immediate medical attention.
Speaking of risk factors, there are categories of patients who are more likely to suffer a DVT than others, and although it is rare to develop a DVT in the absence of such risk factors it is possible.
Here are a few common risk factors for the development of a DVT:
1. Stasis – periods of immobilization of the lower extremities such as casting after an injury or surgery, or long periods where the legs are stationary such as long airplane rides.
2. Hypercoagulability – some individuals are more prone to clotting than others secondary to genetically inherited disorders called thrombophilias.
3. Damage to vessel walls – injury to the venous system directly from any traumatic injury or recent surgery can be a predisposing factor
4. Heart Conditions – such as atrial fibrillation, congestive heart failure and past history of a myocardial infarction (heart attack).
5. Obesity – carrying extra weight tends to induce an increase in pressure on the deep venous system predisposing the vessel walls to damage, and thus increasing the risk of DVT
6. Tobacco Use – smoking can also induce damage on the vessel walls in addition to affecting the bloods ability to remain fluid and free-flowing.
7. Estrogen Use – a side effect of virtually any oral contraceptive available for women is development of a DVT.
8. Past history of a DVT – those patients with a previous DVT history have a much higher predilection to developing a DVT again.
To reiterate, if you suspect a DVT with or without associated risk factors, you should seek immediate medical attention. If you had presented to your Podiatrist office and a DVT was suspected during your visit, you would immediately be referred to the emergency room, so if you are at home, start with the emergency room first.
Next week we will discuss what to expect upon your arrival to the emergency room with suspicion of a DVT so that a diagnosis can be made or excluded. In addition we will discuss treatment options so as to prevent progression of a DVT into a more serious complication: Pulmonary Embolism.
