Deep Vein Thrombosis

Deep vein thrombosis (DVT) is a blood clot (also called a thrombus) that forms in a vein deep in the body. Most deep vein clots occur in the leg or thigh but can also occur in other parts of the body. This clot may interfere with circulation and it may break off and travel through the blood stream and lodge in the lungs, causing severe damage to that organ. If the clot lodges in the lung, it is called pulmonary embolism (PE). This is a very serious condition that can cause death. DVT and PE are collectively called venous thromboembolism (VTE) and are predisposed by the same risk factors.

Only about half of the people with deep vein thrombosis have symptoms. The symptoms may include:

• Swelling of the leg
• Pain or tenderness in the leg, usually in one leg and may be felt only when standing or walking
• Increased warmth in the area of the leg that is swollen or in pain
• Changes in skin colour or redness

Symptoms of pulmonary embolism include chest pain when taking a deep breath, rapid pulse, fainting, shortness of breath and coughing up of blood. Blood clots that remain lodged in the leg can result in pain and swelling.

It is important to see a doctor right away if you have symptoms of deep vein thrombosis or pulmonary embolism. Deep vein thrombosis can cause very serious complications if not treated.

Risk factors for DVT include poor blood flow and hypercoagulable states (a condition in which there is an abnormal increased tendency toward blood clotting). Conditions that puts patients at high risk for DVT include spinal cord injury, major trauma, major general surgery. The use of chemotherapy, oral contraceptive therapy, hormone replacement therapy and paralytic stroke may also increase the risk of DVT. Other conditions that confer risks include obesity, bed rest for more than three days, and immobility due to sitting and varicose veins.

​DVT is diagnosed via an ultrasound scan of the veins of the legs. The ultrasound will demonstrate if blood flow is abnormal through the vein. 

​The cornerstone in the treatment of DVT is the use of medications called anticoagulants or “blood thinners”. Such medications slow down the formation of blood clots to allow the body’s natural system to remove the clots and reduce the recurrence of DVT. 

The anticoagulation medications include injectables such as heparin or low molecular weight heparin, or tablets to be taken orally, such as apixaban, dabigatran, rivaroxaban and warfarin. 

The main complication of treatment with anticoagulation medications is bleeding. It is important to have regular follow up consultations and necessary blood tests to prevent and reduce the bleeding risks. We have a well-established anticoagulation monitoring service for our patients on anticoagulation.