Fri | Jul 28, 2017

Dealing with deep vein thrombus

Published:Saturday | November 15, 2014 | 11:00 AM

They say what you don't know won't hurt you, but most of us realise that those are the things that have the best chance to do just that. A deep vein thrombus (DVT) can be a sneaky 'customer'. It's probably no coincidence that it may even resemble a snake!

A deep vein thrombus is a blood clot that forms in one of the deep veins of the body, not the veins on the surface of the body. The most common place is in the leg. Usually clots are formed to stop bleeding where one sustains a cut. A DVT is, therefore, like a 'good girl gone bad'! The real danger that a DVT poses is that a piece of it may break free, travel up to the heart then into lungs and block one of the main arteries there. This may cause sudden death!

So what causes it? There are three factors that contribute to the formation of a DVT.

1. Immobility - the contraction of the muscles in the leg, which occur during walking, reduces the possibility of clot formation, therefore, lack of movement may contribute to its formation.

2. Trauma to the vein - damage to the inner surface of the vein can trigger off a reaction leading to the formation of a DVT.

3. Hypercoagulability - if the blood itself has an increased risk of forming clots then this can lead to DVT formation. Oftentimes, a combination of these factors may exist in a person at a given time, leading to the development of a DVT.

There are many real-life situations that may lead to its formation. These include prolonged travel (Factor 1), hospitalisation (1), obesity (1,3), surgery (1,3), pregnancy (1,3), medications, such as birth control pills (3, small risk), smoking (2,3), cancer (1,3), leg injury with or without fractures (2), blood that is excessively thick and, as mentioned last week, non-O blood type.

When a person has a DVT, there may be very little signs of it. However, sometimes it may cause swelling, pain, warmth and discolouration of the affected leg. The most common way to diagnose it is with a Doppler ultrasound.

Treatment involves using medications that reduce the ability of the blood to clot (anti-coagulants). This gives the anti-clotting mechanisms in the blood to break down the clot, which usually take months.

Prevention may involve mobilisation, use of anti-coagulants and minimising the other pre-disposing factors.