Deep vein thrombosis (DVT) or deep vein thrombosis is a blood clot in one or more deep veins. In most cases, DVT forms in the veins of the thigh or calf, but it can also form in the veins of other parts of the body.
A blood clot or clot is blood that changes form from a liquid to a slightly solid gel, through a process called coagulation. When a cut or injury occurs, the blood will clot to make the bleeding stop.
On deep vein thrombosis, blood clots occur in the deep veins that block blood flow. If left unchecked, these blood clots can dislodge and follow the bloodstream to clog arteries in the lungs. As a result, the patient will have difficulty breathing, and can even experience death.
Reason Deep Vein Thrombosis
Deep vein thrombosis is caused by any disease or condition that prevents blood from flowing or clotting normally. There are three factors that can cause this, namely:
- Damage to veins
- Impaired blood flow in the veins
- Blood conditions that clot more easily (hypercoagulability)
Risk Factor Deep Vein Thrombosis
Any disease or condition that causes the three factors above can increase the risk of DVT. Therefore, you are at high risk for deep vein thrombosis if:
- Suffering from a genetic disorder that causes the blood to clot more easily, such as Factor V Leiden, nephrotic syndrome, and antiphospholipid syndrome
- Taking long trips by car, train or plane, which makes the legs not move much
- Undergoing bed rest, being paralyzed, or suffering from a disease that keeps the legs from moving for a long time
- Suffering from a heart attack, heart failure, cancer, colitis, or obesity (very overweight)
- Have a history of surgery on veins, such as heart surgery, abdominal surgery, or knee and hip replacement surgery
- Have a history of lower body injuries, such as fractures of the femur, leg, or pelvis
- Suffering from diseases that interfere with the function of blood vessels, such as vasculitis and varicose veins
- Experiencing increased levels of the hormone estrogen, for example due to pregnancy, recently giving birth, taking birth control pills or estrogen hormone replacement drugs
- Have a history of DVT or pulmonary embolism, either in yourself or in your family
- Using injectable drugs
- Taking chemotherapy drugs
- Have a smoking habit
- Over 60 years old
Symptom Deep Vein Thrombosis
In some cases, DVT has no symptoms at all. But generally, DVT raises complaints in the form of:
- The limbs with DVT feel warm
- Pain that gets worse when bending the leg
- Swelling in one leg, especially in the calf
- Cramps that usually start in the calves, especially at night
- Changes in the color of the legs to pale, red, or darker
When to go to the doctor
Immediately see a doctor if you experience symptoms of DVT. If left untreated, a DVT blood clot can travel to the lungs and cause the blood vessels in the lungs to become blocked. This condition is called a pulmonary embolism.
Pulmonary embolism is a medical emergency that must be watched out for, with symptoms such as:
- Bleeding cough
- The pulse is fast
- Shortness of breath or sudden shortness of breath
- Chest pain that gets worse when you cough or take a deep breath
- Dizziness and feeling like passing out
Diagnosis Deep Vein Thrombosis
The doctor will ask about the patient's symptoms, then perform a physical examination of the area of the body that is sore and swollen. After that, the doctor will perform a series of supporting tests, such as:
- blood test
The goal is to measure levels of D-dimer, which is a protein that forms when blood clots break down in the bloodstream. The higher the level of D-dimer, the greater the chance of DVT.
- ultrasound Doppler
The purpose of Doppler ultrasound is to check whether blood is flowing normally or is blocked due to a blood clot. Ultrasound can be done every few days to detect possible new blood clots.
- Venography
The goal is to find out where the blood flow is blocked due to a blood clot. Venography is an X-ray examination carried out with the help of injections of contrast dye in the patient's veins.
- CT scan or MRIThe goal is to get an overall picture of the veins. This examination can also detect other disorders that may occur in the organs around the problematic blood vessels.
Treatment Deep Vein Thrombosis
DVT treatment aims to prevent blood clots from getting bigger, prevent pulmonary embolism, and reduce the risk of DVT recurrence. Treatment methods that can be done include:
1. Drugs
The drugs given to patients with DVT are anticoagulant drugs, such as heparin and warfarin. This drug works to prevent blood clots from growing and reduce the risk of new blood clots forming.
If the patient's DVT is severe enough or there is a pulmonary embolism, the doctor will prescribe thrombolytic drugs. This drug works by breaking up blood clots quickly.
2. Filter the vena cava
If the patient cannot be treated with drugs, the doctor will place a special filter in the main abdominal cavity blood vessels (vena cava). This filter prevents blood clots from entering the lungs and causing pulmonary embolism.
However, keep in mind, installing filters in the long term can actually worsen the condition. Therefore, the filter should be removed after the risk of causing complications is reduced.
3. Compression stockings
Compression stockings are worn below or above the knee to prevent swelling from a DVT. Doctors will advise patients to wear these compression stockings every day for at least 2 years. This is to reduce the risk of new blood clots forming.
4. Thrombectomy
Doctors will perform a thrombectomy procedure if the blood clot is large and causes tissue damage.
Thrombectomy is done by making a small incision in the blood vessel, then the doctor will remove the blood clot, then repair the damaged tissue and blood vessels.
In some cases, the doctor will use a special balloon to keep the blood vessels wide open during the process of removing the blood clot. After that, the balloon will be lifted along with the blood clot.
Complications Deep Vein Thrombosis
Deep vein thrombosis can lead to serious complications, including:
Pulmonary embolism
Pulmonary embolism is a blockage of the arteries in the lungs due to blood clots that escape from the legs. Pulmonary embolism can lead to more serious conditions, such as pulmonary hypertension and heart failure.
Postthrombotic syndrome (PTS)
Post-thrombotic syndrome is a disorder of blood flow in the veins due to DVT. PTS can cause sores, swelling and discoloration of the skin on the legs.
Prevention Deep Vein Thrombosis
There are several things you can do to prevent DVT from occurring, namely:
- If you've been on bed rest for a long time, move your legs occasionally or walk if you can to keep blood flowing.
- If you're on a long commute, or your job requires you to sit for long periods of time, do some simple leg movements or get up from your seat occasionally to walk.
- If you have recently had surgery, take anticoagulants prescribed by your doctor to reduce the risk of blood clots forming after surgery.
- Live a healthy lifestyle, such as not smoking, eating a nutritious and balanced diet, maintaining an ideal body weight, and exercising regularly.