Deep Vein Thrombosis, Causes, Diagnosis, Treatment, Prevention, Complications

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Deep Vein Thrombosis, Causes, Diagnosis, Treatment, Prevention, Complications

Deep vein thrombosis (DVT) or deep vein thrombosis is a blood clot in one or more deep veins. In most cases, DVT forms in the veins of the thigh or calf, but it can occur in the veins of other parts of the body.

A blood clot or clot is blood that changes from a liquid form to a rather solid gel through a process called coagulation. When a cut or injury occurs, the blood will clot to make the bleeding stop.

In deep vein thrombosis, there is a blood clot in the deep vein that blocks blood flow. If left unchecked, these blood clots can dislodge and follow the bloodstream, then clog arteries in the lungs. As a result, the patient will have difficulty breathing, even death.

Causes of Deep Vein Thrombosis

Deep vein thrombosis is caused by a disease or condition that prevents blood from flowing or clotting normally. There are three factors that can cause this, namely:

Damage to the veins
Impaired blood flow in the veins
Conditions that make blood clot more easily (hypercoagulability)

Risk factors for deep vein thrombosis

Various diseases or conditions that cause the three factors above can increase the risk of DVT. In other words, a person is more at risk of developing deep vein thrombosis if they have the following conditions or diseases:

Over 60 years old
Have a smoking habit
Using injectable drugs
Taking chemotherapy drugs
Have a genetic disorder that causes the blood to clot more easily, such as Factor V Leiden, nephrotic syndrome, and antiphospholipid syndrome
Taking long trips by car, train, or plane, which keeps your feet from moving much
Undergoing bed rest, being paralyzed, or suffering from an illness that keeps the legs from moving for a long time
Suffering from a heart attack, heart failure, cancer, colitis, being overweight, or obese
Have a history of surgery on veins, such as heart surgery, abdominal surgery, or knee and hip replacement surgery
Have a history of lower body injuries, such as fractures of the femur, leg, or pelvis
Suffering from diseases that interfere with the function of blood vessels, such as vasculitis and varicose veins
Experiencing increased levels of the hormone estrogen, for example due to pregnancy, recently giving birth, and taking birth control pills or estrogen replacement drugs
Have a history of DVT or pulmonary embolism, either in yourself or in the family

Symptoms of Deep Vein Thrombosis

In some cases, DVT has no symptoms at all. However, some of the complaints that usually arise due to DVT can include:

The limbs with DVT feel warm
Pain that gets worse when bending the leg
Swelling in one leg, especially in the calf
Cramps that usually start in the calves, especially at night
Changes in the color of the legs to pale, red, or darker

When to go to the doctor

Immediately see a doctor if you experience the symptoms of DVT mentioned above. If not treated immediately, a DVT blood clot can travel to the lungs and cause the blood vessels in the lungs to become blocked. This condition is known as a pulmonary embolism.

Pulmonary embolism is a medical emergency that must be watched out for, with symptoms such as:

Bleeding cough
The pulse is fast
Shortness of breath or sudden shortness of breath
Chest pain that gets worse when you cough or take a deep breath
Dizziness and feeling like passing out

Deep Vein Thrombosis Diagnosis

To diagnose deep vein thrombosis, the doctor will ask about the patient's symptoms and medical history. Next, the doctor will perform a physical examination of the sore and swollen body part.

After that, the doctor will perform a series of supporting examinations, such as:

blood test

The blood test aims to measure levels of D-dimer, a protein that is formed when blood clots break down in the bloodstream. The higher D-dimer level indicates the possibility of DVT in the patient.

Doppler ultrasound

The purpose of a Doppler ultrasound examination is to see if blood flows normally or is blocked due to a blood clot.

Venography

This examination aims to determine the location of blocked blood flow due to blood clots. Venography is an X-ray examination carried out with the help of injections of contrast dye in the patient's veins.

An MRI scan is done to get an overall picture of the veins. This examination can also detect other disorders that may occur in the organs around the problematic blood vessels.

Deep Vein Thrombosis Treatment

DVT treatment aims to prevent blood clots from getting bigger, prevent pulmonary embolism, and reduce the risk of DVT recurrence. Treatment methods include:

1. Drugs

The drugs given to patients with DVT are anticoagulant drugs, such as heparin and warfarin. This drug works to prevent blood clots from growing and reduce the risk of new blood clots forming.

If the patient's DVT is severe enough or there is a pulmonary embolism, the doctor will prescribe thrombolytic drugs. This drug works by breaking up blood clots quickly.

2. Filter the vena cava

If medication is not effective, the doctor will place a special filter in the main abdominal cavity blood vessel (vena cava). The filter serves to prevent blood clots from entering the lungs and causing pulmonary embolism.

However, keep in mind that installing filters in the long term can actually make the condition worse. Therefore, the filter should be removed after the risk of complications is reduced.

3. Compression stockings

Compression stockings are worn below or above the knee to prevent swelling from DVT. Doctors will advise patients to wear these compression stockings every day, for at least 2 years. The goal is to reduce the risk of new blood clots forming.

4. Thrombectomy

Thrombectomy is performed if the blood clot is large and causes tissue damage. This procedure is done by making small incisions in the blood vessels. After that, the doctor will remove the blood clot, then repair the damaged tissue and blood vessels.

In some cases, the doctor will use a special balloon to keep the blood vessels wide open during the process of removing the blood clot. After that, the balloon will be lifted along with the blood clot.

Complications of Deep Vein Thrombosis

Deep vein thrombosis can cause serious complications, including:

Pulmonary embolism, which is blockage of arteries in the lungs due to blood clots that escape from the legs
Post-thrombotic syndrome (PTS), which is impaired blood flow in the veins due to DVT

Prevention of Deep Vein Thrombosis

Deep vein thrombosis caused by genetic disorders cannot be prevented. However, to prevent DVT due to other conditions or diseases, there are several efforts that can be done, namely:

If you've recently been on bed rest for a long time, move your legs occasionally or walk if you can to keep blood flowing.
If you're on a long commute or your job requires you to sit for long periods of time, do some simple leg movements or get up from your seat occasionally to walk.
If you have recently had surgery, take anticoagulants prescribed by your doctor to reduce the risk of blood clots forming after surgery.
Live a healthy lifestyle, such as not smoking, eating a balanced nutritious diet, maintaining an ideal body weight, and exercising regularly.

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