Health Advice - Deep Vein Thrombosis [DVT]

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Cheap Flights Bookings » Information » Health Advice - Deep Vein Thrombosis [DVT]

Health Advice - Deep Vein Thrombosis [DVT]

What is it and how can I prevent it?

Deep Vein Thrombosis is a blood clot, usually occurring in the deep leg vein. The common cause of this serious condition is long periods of immobility, such as long haul flights where you remain seated in cramped conditions in a seated position. The adverse serious affects of a clot forming in the leg is when part of the clot breaks off and travels to the lung and causes a pulmonary embolus or travels to the heart and causes a blockage.

Why Does DVT occur in leg veins?
Normally when you are walking the movement keeps the flow of blood constant throughout the system and prevents blockages or blood clots from occurring. The problem of long haul flights is that you can remain seated for long periods and you inhibit the flow of blood through the system. A calf vein is usually the deep vein where DVT can occur and is less likely in the thigh vein or other deep veins in the body.

Common Causes of DVT:

Immobility, as slow moving blood is more likely to clot than normal flowing blood;
During a surgical procedure, as whilst under anaesthetic your limbs are not moving and the blood flow to the leg veins can become very slow;
Injury or illness that causes immobility will increase the incidences of DVT;
Long journeys on aircraft or trains may increase the incidence of DVT due to lack of movement and exercise;
Blood clots can leave damage to the inner lining of the deep vein which can lead to further incidences of blood clots forming again;
Medical conditions such as Vasculitis [inflammation of the vein wall] and certain drugs, such as those used for cancer treatment with patients on Chemotherapy can also damage the vein and increase the risk of DVT occurring;
Medical conditions such as Thrombophilia can cause DVT to occur;
The contraceptive pill that contains oestrogen can cause the blood to clot more easily;
HRT treatment can also have a small risk of increasing the incidence of DVT;
Patients with cancer or heart failure have a higher chance of developing DVT;
Older people with poor circulation and poor mobility are prone to DVT;
Pregnant women have an increased risk of developing DVT. In fact 1 in every 1000 pregnant ladies will have a DVT;
Obesity increases the risk.

How common is a deep vein thrombosis?
It is estimated that about 1 in 2000 people have a DVT on average each year in the UK. Less than 1 in 3000 people under the age of 40 years have a DVT, but with people over 80, 1 in 500 develop a DVT.

Symptoms - How Do I know I have a DVT?
The most typical symptoms are pain and swelling of the calf and associated swelling and tenderness of the muscle area. This is because blood that would normally be travelling through the veins is having to go through outer smaller veins. The calf may appear to be red and warmer to the touch and tender.
However, sometimes these symptoms may be less apparent and it is only diagnosed if an association occurs because of the DVT such as a pulmonary embolus.

What if I think I need tests?
If you think you may have a DVT [blood clot] you might have difficulty in determining if the condition exists, as the symptoms can be confused with a muscle strain or infection. The best thing is to see your GP and let them decide. If you have travelled on a long flight and have arrived at your destination and you begin to experience possible symptoms of DVT, you must contact the travel insurance company first to obtain prior payment approval, then seek medical advice and have tests to try to determine the possible problem.

There are 2 commonly used tests:

D-dimer test - this blood test will detect any fragments that may have already broken away from the blood clot if it exists;
Ultrasound Scan - a scan of the leg can usually determine if there is a blood clot present.

These tests may not be conclusive and if possible you can ask for a further test if you are still very worried about this. Venography - this test injects a dye into the leg veins and X-Ray test can then track the dye to see if it is not flowing through a blocked vein.

Should I really worry about having DVT? Is it that serious?
A DVT can be serious and it's more the complications it can lead to that are serious, such as:

Pulmonary embolus (a blood clot that travels to the lung);
Post thrombotic syndrome (persistent calf symptoms).

Pulmonary embolus
This is when part of the blood clot breaks off and travels around the blood system, called an "embolus". It can cause damage elsewhere in the vein network as the veins carry blood to every parts of the body. We have a complicated network made up of major veins, primary veins and secondary veins. A blood clot travelling around your system is not good, as it can get stuck in a blood vessel entering the lung, which is called a pulmonary embolus. A small embolus may not bother us much at all or show any symptoms but a medium sized pulmonary embolus can cause breathing problems and chest pain and a large pulmonary embolus can at worst cause lung collapse and sudden death. It is estimated that 1 in 10 people that go untreated with DVT can develop pulmonary embolus large enough to cause symptoms or even death. So, in conclusion, it is a potentially serous condition that needs checking upon.

Without treatment patients with a DVT can develop long term post-thrombotic syndrome, which is where the blockage causes increased pressure from the diverted blood. Symptoms can vary from swelling, rashes and even ulcers on the skin in severe cases. This condition is more likely to occur if the DVT occurs in the thigh vein, instead of the calf, and is more common with overweight people and those who have suffered more than one DVT in the same leg.

What is the treatment for a DVT?
Treatment of a DVT is designed to prevent the clot spreading, or becoming larger, or a large piece breaking off and travelling to the lungs.
Treatment can be in the form of Anticoagulation, which prevents the clot from getting larger. Anticoagulation treatment is often called 'thinning the blood', but this doesn't actually thin the blood, instead it alters certain chemicals in the blood to stop clots forming so easily. This treatment prevents a DVT from getting any larger, and prevents any new clots from forming and reducing the risk of post-thrombotic syndrome developing.

The usual anticoagulant medication used is called "Warfarin".

Compression and raising the leg helps prevent post thrombotic syndrome if the DVT was in a thigh vein, and you may be advised to wear a compression stocking. If you're prescribed a compression stocking make sure these are fitted professionally do not just buy one over the counter, which may be the wrong size or wrong class and could cause more damage.

How Can I Prevent DVT or a recurrence of a DVT?
Avoid long periods of immobility. If you able to move, then do so. Walk around and take a brisk walk for at least 30 -60 minutes. The aim of this is to prevent the blood gathering in 'pools', which can lead the blood to coagulate and clump together and therefore become a potential clot of blood. If you keep it moving like flowing water rather than becoming stagnant, you can maintain a healthy smooth flowing blood system.

Regular calf exercises can be done, even if you are seated for long periods such as in an aircraft. When you travel on long plane journeys, train journeys, you should make the effort to walk up and down the aisle and stretch regularly.

Prior to Major surgical operations which are known to be a risk for a DVT - such as operations to the hip, lower abdomen, and leg, physicians may be give you an anticoagulant such as a heparin injection just before having an operation to help prevent a DVT.

In Conclusion
The primary cause of DVT is immobility, especially during surgery and whilst you are in confined places, like an aircraft or on a long train journey. You should take care of your system by making the effort to exercise whilst in these situations. Whilst treatment with an anticoagulant is able to break down the blood clot, the best thing you can do is follow the old rule of 'Prevention is far better than cure'.

Written on: 20th July 2007