Deep Vein Thrombosis: Are you at risk?

March is DVT Awareness Month

Deep vein thrombosis, or DVT, occurs when a blood clot forms in the large veins of the legs or pelvic region. If the clot breaks loose and travels to the lungs, a pulmonary embolism (PE) may result.legs2_DVT

An estimated 900,000 people are affected by deep vein thrombosis and pulmonary embolism each year, so identifying a person’s risk factors is important in preventing DVT. If you’re at risk, in most cases you can modify and reduce that risk.

Who’s at risk?

Risk factors for DVT and PE include:

  • Advanced age
  • Active cancer and cancer treatments
  • Immobility, paralysis
  • Recent trauma, surgery or hospitalization
  • Family history or personal history of DVT or PE
  • Pregnancy and the period around delivery
  • Oral contraceptives and hormone replacement therapies
  • Obesity
  • Chronic medical conditions
  • Infections
  • Inherited and acquired blood clotting abnormalities
  • Smoking (in some studies)

Anyone can develop DVT; however, the more risk factors you have, the greater your chances of developing the condition. Hospitalized patients are at a high risk for DVTs and PE, with risk factors varying depending on the reason for the hospitalization, the seriousness of the illness and any surgery that was performed. For example, hip- replacement patients may develop a DVT or PE if they fail to receive appropriate preventive therapy.

The aging population is also at a higher risk for DVT, which is why DVT awareness is so important.

Symptoms of DVT

One of the most common symptoms of DVT is often what feels like a pulled muscle in the calf or thigh. Patients realize after a few days that the “muscle pull” is not getting better and can’t be ‘”explained away.” Some people experience pain or swelling in their leg, while others experience few initial symptoms.

Signs of DVT include:

  • Sudden leg swelling or pain
  • Significant calf swelling that does not improve
  • Redness or discoloration
  • Skin that is warm to the touch

Symptoms of PE

Symptoms of PE include:

  • Sudden and severe shortness of breath
  • Heart pain or palpitations
  • Collapsing or feeling faint
  • Coughing up blood

Diagnosing and treating DVT

Ultrasound is the “gold standard” for diagnosing DVT. This non-invasive test provides a highly accurate diagnosis. Other methods include measuring biomarkers (a blood measurement to detect the presence of a particular disease), which can help determine a high or low probability of DVT, and performing a clinical risk assessment. The research involved with biomarker measurement is ongoing at the University of Michigan.

Because DVT/PE sometimes exhibits no symptoms, it can go untreated, which can be fatal. In fact, DVT/PE is the fourth leading cause of death in western society (especially PE), with more fatalities than breast cancer, AIDS and traffic accidents combined.

To keep a PE from happening once a DVT is found, doctors will often prescribe a blood-thinning drug that helps the body to stabilize the DVT clot and prevents more clots from forming. Compression stockings can also be worn to help move blood from the legs, decrease long-term leg pain and swelling, detrimental effects from the clot.

In some patients, doctors may remove a DVT by threading a tiny catheter into the vein, using a device to mechanically disrupt the clot and infusing specialized medications to help dissolve the clot. In clots in the upper leg and pelvis, such treatments will reduce the chance of more clots forming and decrease the long-term adverse effects of leg pain and swelling from the clot.  A clinical trial at the University of Michigan and throughout the nation is comparing this approach to blood-thinning drugs alone. This same approach may be used for life-threatening pulmonary embolisms.

thomaswwDr. Thomas Wakefield has been the head of the Vascular Surgery service at the University of Michigan since 2004. He is an honors graduate of the University of Toledo and received his MD from the Medical College of Ohio in 1978. He completed his general surgery residency at U-M in 1984, completed a vascular surgery fellowship at U-M in 1986, and is presently the S. Martin Lindenauer Professor of Surgery in the Section of Vascular Surgery, Department of Surgery, U-M. His clinical interests include a special emphasis on venous disease and coagulation issues.

Frankel-informal-vertical-sigThe University of Michigan Samuel and Jean Frankel Cardiovascular Center is the top-ranked heart and heart surgery program among Michigan hospitals. To learn more, visit our website at umcvc.org.