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What Is Deep Vein Thrombosis?

Deep vein thrombosis (throm-BO-sis), or DVT, is a blood clot that forms in a vein deep in the body. Blood clots occur when blood thickens and clumps together.

Most deep vein blood clots occur in the lower leg or thigh. They also can occur in other parts of the body.

A blood clot in a deep vein can break off and travel through the bloodstream. The loose clot is called an embolus. When the clot travels to the lungs and blocks blood flow, the condition is called pulmonary embolism (PULL-mun-ary EM-bo-lizm), or PE.

PE is a very serious condition. It can damage the lungs and other organs in the body and cause death.

Blood clots in the thigh are more likely to break off and cause PE than blood clots in the lower leg or other parts of the body.

Blood clots also can form in the veins closer to the skin's surface. However, these clots won't break off and cause PE.

What Causes Deep Vein Thrombosis?

Blood clots can form in your body's deep veins when:

• Damage occurs to a vein's inner lining. This damage may result from injuries caused by physical, chemical, and biological factors. Such factors include surgery, serious injury, inflammation, or an immune response.
• Blood flow is sluggish or slow. Lack of motion can cause sluggish or slowed blood flow. This may occur after surgery, if you're ill and in bed for a long time, or if you're traveling for a long time.
• Your blood is thicker or more likely to clot than usual. Certain inherited conditions (such as factor V Leiden) increase blood's tendency to clot. This also is true of treatment with hormone replacement therapy or birth control pills.

Who Is At Risk for Deep Vein Thrombosis?

Many factors increase your risk for deep vein thrombosis (DVT). They include:

• A history of DVT.
• Disorders or factors that make your blood thicker or more likely to clot than normal. Certain inherited blood disorders (such as factor V Leiden) will do this. This also is true of treatment with hormone replacement therapy or using birth control pills.
• Injury to a deep vein from surgery, a broken bone, or other trauma.
• Slow blood flow in a deep vein from lack of movement. This may occur after surgery, if you're ill and in bed for a long time, or if you're traveling for a long time.
• Pregnancy and the first 6 weeks after giving birth.
• Recent or ongoing treatment for cancer.
• A central venous catheter. This is a tube placed in vein to allow easy access to the bloodstream for medical treatment.
• Being older than 60 (although DVT can occur in any age group).
• Being overweight or obese.

Your risk for DVT increases if you have more than one of the risk factors listed above.

What Are the Signs and Symptoms of Deep Vein Thrombosis?

The signs and symptoms of deep vein thrombosis (DVT) may be related to DVT itself or to pulmonary embolism (PE). See your doctor right away if you have symptoms of either. Both DVT and PE can cause serious, possibly life-threatening complications if not treated.

Deep Vein Thrombosis

Only about half of the people with DVT have symptoms. These symptoms occur in the leg affected by the deep vein clot. They include:

• Swelling of the leg or along a vein in the leg
• Pain or tenderness in the leg, which you may feel only when standing or walking
• Increased warmth in the area of the leg that's swollen or in pain
• Red or discolored skin on the leg

Pulmonary Embolism

Some people don't know they have DVT until they have signs or symptoms of PE. Symptoms of PE include:

• Unexplained shortness of breath
• Pain with deep breathing
• Coughing up blood

Rapid breathing and a fast heart rate also may be signs of PE.

How Is Deep Vein Thrombosis Diagnosed?

Your doctor will diagnose deep vein thrombosis (DVT) based on your medical history, a physical exam, and the results from tests. He or she will identify your risk factors and rule out other causes for your symptoms.

Medical History

To learn about your medical history, your doctor may ask about:

• Your overall health
• Any prescription medicines you're taking
• Any recent surgeries or injuries you've had
• Whether you've been treated for cancer

Physical Exam

During the physical exam, your doctor will check your legs for signs of DVT. He or she also will check your blood pressure and your heart and lungs.

Diagnostic Tests

You may need one or more tests to find out whether you have DVT. The most common tests used to diagnose DVT are:

• Ultrasound. This is the most common test for diagnosing deep vein blood clots. It uses sound waves to create pictures of blood flowing through the arteries and veins in the affected leg.
• A D-dimer test. This test measures a substance in the blood that's released when a blood clot dissolves. If the test shows high levels of the substance, you may have a deep vein blood clot. If your test is normal and you have few risk factors, DVT isn't likely.
• Venography (ve-NOG-ra-fee). This test is used if ultrasound doesn't provide a clear diagnosis. Dye is injected into a vein, and then an x ray is taken of the leg. The dye makes the vein visible on the x ray. The x ray will show whether blood flow is slow in the vein. This may indicate a blood clot.

Other less common tests used to diagnose DVT include magnetic resonance imaging (MRI) and computed tomography (CT) scanning. These tests provide pictures of the inside of the body.

You may need blood tests to check whether you have an inherited blood clotting disorder that can cause DVT. You may have this type of disorder if you have repeated blood clots that can't be linked to another cause, or if you develop a blood clot in an unusual location, such as a vein in the liver, kidney, or brain.

If your doctor thinks that you have pulmonary embolism (PE), he or she may order extra tests, such as a ventilation perfusion scan (V/Q scan). The V/Q scan uses a radioactive material to show how well oxygen and blood are flowing to all areas of the lungs.

To read the rest of this article, including current treatments for DVT, as well as related materials from the National Heart, Lung and Blood Institute, please click here: http://www.nhlbi.nih.gov/health/dci/Diseases/Dvt/DVT_WhatIs.html