Ask the Geriatrician: Deep Vein Thrombosis
Ask the Expert
Andrew Dentino, MD, AGSF, FACP, FAPA
Chief, Division of Geriatric and Palliative Medicine
Texas Tech University Health Science School of Medicine
Deep Venous Thrombosis (DVT) is a blood clot, or thrombus, in a major vein that may partially or completely block the flow of blood. The clot often occurs in the legs or pelvis, in areas where blood flow is slow, or in an injured blood vessel. DVT can be life-threatening should pieces of the clot break away and travel to the lungs. This is called pulmonary embolism.
Q: Why would I develop DVT? Is it a common problem?
A: Approximately one in 1,000 people develop DVT each year. Older persons and people who are overweight are most susceptible. Other common risk factors include an injury or blow to the body, prolonged immobility, and serious illnesses such as congestive heart failure, stroke, cancer, or inflammatory bowel disease. Women taking estrogen either in the form of birth control pills or post-menopausal therapy may be at increased risk. You should ask your doctor about your risk for DVT.
Q: What are the symptoms of DVT?
A: The area affected by the blood clot may become swollen and painful, and possibly turn red as the normal flow of blood is blocked. You may also develop edema, which is the build up of fluid in the skin tissues surrounding the clot. If the clot is somewhere other than your leg, there may be no physical signs of DVT. If the clot breaks away and travels to your lungs, you may experience shortness of breath and chest pain. If this occurs, you should call you doctor immediately or go to the emergency room.
Q: How can I prevent DVT?
A: You should keep active. If you are traveling a long distance in a sitting position, be sure to get up and walk around from time-to-time to keep your blood flow moving. If you have other conditions that put you at risk for DVT, you should speak with your doctor about how to avoid DVT.
Q: What should I do if I think I have DVT?
A: You should call your doctor or go to an emergency room any time you have a sudden and unusual shortness of breath that is not related to exercise, exertion or anxiety. If you have swelling with redness and pain in your leg, you should call your doctor.
Another problem that causes similar symptoms to DVT is postthrombotic syndrome. One in three people who have had DVT may develop this disorder, which causes chronic leg pain and swelling that worsens throughout the day. The skin surrounding the swollen area may thicken and become darker as well. If left untreated, postthrombotic syndrome can lead to sores that do not heal, and to chronic pain while walking. To determine if you have postthrombotic syndrome or a recurrent DVT, your doctor will have to perform special imaging tests.
Q: How is DVT treated?
A: Your doctor may restrict activity. You will also be advised not to rub over the affected areA: If the DVT is in a leg or arm, you will likely be asked to keep it elevated. Special stockings or support hose may be used to decrease the swelling and lessen the injury to the vein as well.
The drugs used to treat a DVT are called anticoagulants or "blood thinners." They help prevent new clots from forming and stop the growth of the clots you already have. Blood thinning medication is usually given by intravenous infusion or injections under the skin for the first few days after a DVT is discovered. Eventually, however, you will likely switch to an oral drug to treat the DVT, such as Warfarin or Coumadin‘. Expect to take this medicine for three months or more. Some people need to stay on blood thinning medication for the rest of their lives. Be sure to let all your doctors know that you are taking a blood thinner while you are on it.
Updated: March 2012
Posted: March 2012