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Deep vein thrombosis (DVT)

Overview of deep vein thrombosis (DVT)

Deep vein thrombosis (DVT) refers to a condition of the blood vessels (veins) that is characterized by formation of clots.

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The clots are typically noted in the blood vessels that carry blood back to the heart (veins) and are present deep inside the body. This condition mostly affects the deep veins of the leg or the pelvis while, it may occasionally be noted in the veins of the arms.

The signs and symptoms of of deep vein thrombosis (DVT) include:

  • Redness of the leg
  • Warmth in the affected leg
  • Leg pain
  • Tenderness of the affected leg

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  • Leg swelling or edema
  • Swollen calf muscles
  • Swelling of the ankle, foot or thigh
  • Swelling of the arm (if veins of the arm are involved)

Causes of deep vein thrombosis (DVT)

The causes of DVT have been categorized under three main groups (referred to as Virchow’s triad in medical terminology) and include:

  • Vein injuries
  • Faster blood clotting
  • Decreased blood flow rate

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Vein injuries wherein the ability of the veins to pump the blood back to the heart is compromised can occur due to factors such as surgeries, injection of irritating substances into the vein, presence of underlying disorders such as Buerger's disease and preexisting clots. Decreased ability of the veins to pump the blood back can lead to pooling of the blood in the legs leading to the formation of clots.

DVT can also be caused by other factors that enhance blood clotting. This includes various factors such as: presence of certain inherited disorders; cancer; administration of drugs such as oral contraceptives, estrogen; smoking; childbirth; surgery and dehydration (especially in older people).

In other cases, DVT can occur as a result of decreased blood flow rate noted due to conditions such as:

  • Prolonged bed rest
  • Decreased mobility of the legs due to injury or disease
  • Prolonged sitting – at work, while travel

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Diagnosis of deep vein thrombosis (DVT)

Diagnosis of deep vein thrombosis is based on comprehensive review of the signs and symptoms noted physical examination, laboratory tests and imaging studies.

Physical examination is generally performed by the physician to note:

  • Redness of the leg
  • Tenderness of the affected leg
  • Leg swelling or edema
  • Swelling of the ankle, foot or thigh
  • Swelling of the arm (if veins of the arm are involved)

The laboratory tests that are generally advised include the following tests:

D-dimer test - D-dimer is a protein that is released when the blood clot is dissolved. If the test shows high level of D-dimer then deep vein clot exists.

Tests for blood clotting

Imaging studies include specialized tests such as Doppler ultrasonography, leg venography and CT scan or chest scan (if lungs are suspected to be involved) that are performed to identify the presence of clots or pooling of blood within the blood vessels.

Treatment of deep vein thrombosis (DVT)

The goal of the treatment is to prevent the occurrence of a condition known as pulmonary embolism (clots in the lungs). Hospitalization may be necessary in severe cases or certain high risk cases. Other cases can be effectively managed with medications and home care.

The treatment includes:

  • Medications to prevent blood clotting (anticoagulants)
  • Home care
  • Surgery (in extreme cases)


Anticoagulants or blood thinners such as heparin is the most common medication advised. Heparin is generally injected through the veins. Along with this another medication known as warfarin is advised to be taken orally. The duration of the treatment is decided by the doctor based on the severity of the condition

Home care:

Graduated compression stockings worn on the legs and cover the area between the arch of the foot and the knee are sometimes advised to improve the blood flow in the legs.


Surgery is advised in rare circumstances to either:

  • Place a filter within a large vein to prevent clot from reaching the lungs, or
  • Remove the clot from the affected vein


1.National Heart Lung and Blood Institute Disease and Condition Index. Deep Vein Thrombosis. [updated: Nov 2007: cited: Nov 2009]. Available at http://www.nhlbi.nih.gov/health/dci/Diseases/Dvt/DVT_WhatIs.html.

2.Medline Plus. Deep venous thrombosis.[updated: Jan 2009;cited: Nov 2009].Available at : http://www.nlm.nih.gov/medlineplus/ency/article/000156.htm

3.The Merck Manual Online Medical library. Deep Vein Thrombosis (DVT). [updated: February 2008; cited: Nov 2009].Available at: http://www.merck.com/mmhe/sec03/ch036/ch036b.html.

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