Deep Venous Thrombosis

Risk factors for deep venous thrombosis (DVT) include prolonged venous stasis, advanced age, pregnancy (postpartum state), premenopausal estrogen use, obesity, malignancy, hypercoagulable states, congestive heart failure, trauma, long bone fractures, paralysis, dehydration, and polycythemia. A scoring system has been proposed to characterize pretest probability of disease to be used in association with ultrasound imaging.

Causes

Sluggish blood slow in the veins can lead to thrombophlebitis or blood clots forming in the veins:

• Prolonged bed rest or inactivity
• Recent major illness
• Major surgery - especially knee, hip, and abdominal operations
• Injury to an arm or a leg
• Pregnancy
• Obesity
• Prolonged car or plane rides
• Increased thickness of the blood, which may be inherited
• Injury or trauma

Symptoms

• Pain
• Swelling
• Erythema

Signs

• Normal examination +++
• Swelling (measured difference between lower extremities)
• Warmth
• Erythema
• Tenderness of thigh or calf
• Fever
• Homans' sign (frequently mentioned, but rare)
  
• Palpable venous "cord" in the popliteal fossa

Treatment

The main goals in treating deep vein thrombosis are to:

• Reduce your chance of having another blood clot
• Stop the clot from getting bigger
• Prevent the clot from breaking off in your vein and moving to your lungs

Much of the treatment for deep vein thrombosis takes place at home. It is important to:

• Take medicines correctly.
• Have blood tests done as directed by your doctor.
• Avoid activities that may cause serious injury.
• Ask your doctor about your diet. Foods that contain vitamin K. Vitamin K is found in green leafy vegetables and some oils, such as canola and soybean oil. It is best if you eat a well-balanced, healthy diet that doesn't vary greatly.
• Discuss with your doctor what amount of alcohol is safe for you to drink if you are taking medicine.