What is Deep Vein Thrombosis (DVT)?

Deep vein thrombosis (DVT) is when a blood clot(s) begin to form in the deep veins. While this can occur in any area of the body, it most frequently develops in the deep veins of the leg. The most common and dangerous complication is a pulmonary embolism. This can happen when the clot dislodges and blocks the blood vessels in the lungs. In Australia, DVTs affect up to 30000 Australians a year and account for 7% of all hospital deaths [1][2]. DVTs can be fatal and will require immediate medical treatment if suspected.

Deep Vein Thrombosis Symptoms

DVT symptoms can begin to form in any region of the body. However, it most commonly develops in the calf muscle. If you are experiencing any of these symptoms, please contact your GP immediately [3].

Swelling of the affected area, especially in the foot, ankle and leg
Unexplained pain, which is worsened when moving the leg
Tenderness and warm skin on touch
Redness, which often accompanies the swelling

Below will also be a list of severe symptoms which may indicate a pulmonary embolism. If this is the case, please call 000 for the ambulance immediately.

Shortness of breath (difficulty breathing)
Chest pain
Unusual heartbeats
Blood when coughing

Deep Vein Thrombosis (DVT) Causes

There are many reasons why DVTs can occur. Below will be a list of DVT risk factors that can increase the chance of clots [3][4].

After surgery, particularly under general anaesthetic
Prolonged periods of bed rest or immobility
Certain medications
Pregnancy
Obesity
Long flights on planes
Abnormalities to the veins (e.g. venous insufficiency)
Previous history of DVTs or blood clots
Dehydration
Direct trauma to the vein(s)

Deep Vein Thrombosis Diagnosis and Tests

Appropriate tests need to be conducted immediately to determine a DVT diagnosis. If suspected, your GP may recommend immediate medical treatment to prevent further complications.

Clinical Examination

During your consultation with a GP, a clinical examination will be performed. Relevant questions, such as your medical history, symptoms and your recent activities, may be required. Additionally, an assessment of the affected area may also be necessary. Depending on the findings, your GP will determine whether further testing may be required for a formal diagnosis.

D-Dimer Blood Test

Your GP may request getting a type of blood test which looks at your D-Dimer levels. The presence of these proteins can be used to determine whether there is any clotting in the body. Typically undetectable, D-dimers will appear when the body attempts to break down blood clots [5]. A positive test may indicate the presence of blood clots and potentially a DVT. However, a D-Dimer test alone is not a definitive diagnosis. Additional testing may be required.

DVT Ultrasound

Depending on your GPs suggestions, an ultrasound of the affected region may also be required. A referral will be written to an imaging specialist, such as a radiographer or sonographer, for you to attend immediately. Before the procedure, a special ultrasound gel will be applied over the area to be investigated [6]. Afterwards, the specialist will guide a probe over the affected area. There may be a short period between the procedure and the availability of the results. A positive finding will help confirm a diagnosis and the necessary treatment required.

CT Scan

If there has been any suspicion of a pulmonary embolism, a chest CT scan may be immediately required. Treatment needs to be commenced as soon as possible.

Deep Vein Thrombosis Treatments

Once a diagnosis has been confirmed, DVT treatment should be commenced as soon as possible. Depending on your circumstances, your doctor may recommend the following:

Anticoagulant Medication

Anticoagulants are medications that are prescribed to break down blood clots. You will likely be required to take these anticoagulant medications for at least a few months (unless indicated by your doctor) [7]. Different types of drugs may be prescribed if you are already taking other medications or diagnosed with a specific condition.

Compression

Your doctor may also recommend elastic compression stockings for DVT to reduce swelling, improve pain and blood flow [8]. For ideal use, they should be worn right after waking up in the morning. Medical grade compression stockings are different from conventional ones because of their specific design and pressure on the limb. Your local pharmacist may stock these products and assist you with sizing.

Recovery

After starting anticoagulants, most people with DVTs will recover within several weeks to months without complications [9]. Symptoms can begin to resolve several days after commencing medications. During the recovery period, the body will instinctively start to break down and absorb the clot.

Complications

While most people with DVTs will make a full recovery, long-term complications can occur in some people. These complications can vary from mild to severe depending on individual circumstances.

Post-thrombotic Syndrome

Post-thrombotic syndrome is a common complication that occurs in up to 50% of people who have experienced a DVT [10]. Inflammation and poor blood flow from the DVT can lead to long term changes to the affected blood veins. Symptoms associated with post-thrombotic syndrome include pain, aches, swelling, cramping and tingling in the affected area.

Pulmonary Embolism

Pulmonary embolism is a potentially fatal consequence of a DVT. The blood clot(s) that form in the veins can dislodge and travel through the bloodstream. If the clot becomes stuck in the lung’s blood vessels, this can block the blood flow to the organ [11]. If this progresses for too long, the insufficient blood supply to the lung can lead to tissue death, heart failure and possible death. Symptoms of pulmonary embolism include chest pain, coughing up blood and shortness of breath [11]. Urgent medical treatment is required if a pulmonary embolism is suspected.

DVT Recurrence

25% of patients who have developed a DVT are at risk of developing another one [3]. Your GP can provide DVT prevention strategies, such as lifestyle changes, exercise advice, wearing compression garments and/or ongoing medication.

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