Deep vein thrombosis (DVT) is a condition that occurs when a blood clot forms in a vein deep inside a body part, most often – but not exclusively – in the lower leg and thigh, usually affecting just one side of the body.
This is an all-too-common condition, occurring in about 1 in 1,000 adults annually, with rates slightly higher in men than women. And DVTs can be serious. Clots can break away and travel to the lungs or brain, where they can be lethal.
Dr. Sarah Allgeier M.D., Ph.D., practices vascular and interventional radiology at Sebastian River Medical Center. She says that many things affect your chances of developing a DVT, including a sedentary lifestyle, obesity and smoking. There are also possible connections with several diseases.
- Cancer. MD Anderson Cancer Center states that the risk of developing blood clots is somewhat higher among cancer patients, due both to the inflammatory nature of the disease and the therapies used to treat it. Dr. Allgeier adds that since patients frequently don’t feel well, their activity level decreases, which causes further inflammation.
- Inflammatory Bowel Disease. The North American Thrombosis Forum says that inflammatory bowel disease (IBD) affects more than 3 million adults in the U.S., and research shows that patients with IBD have a three to four times higher risk of developing thrombosis (blood clots) than people without it. Dr. Allgeier says the number of affected people is high, but the reasons why are not currently well-understood.
- Inherited clotting disorders. A blood clotting disorder is a condition that makes the body more likely than normal to make blood clots, according to Cleveland Clinic’s website. You can inherit or acquire one of these disorders. Examples are sickle cell anemia and hemophilia. These conditions cause blood to thicken, stick and clot more easily.
- Heart disease. Heart disease, including the blood vessel disease atherosclerosis, can increase the risk for blood clots, notes the American Heart Association. “When you have heart disease, you have plaque in your blood vessels, and that raises your risk of having a clot there,” explains Dr. Allgeier. Plaque has a smooth lining, and if it cracks, a clot can form on the crack.
- Infections. Having a serious infection is another common yet mysterious risk factor for blood clots and DVT. A study in the Journal of Internal Medicine found that people who had a staphylococcus bacterial infection were 3 times more likely than those in the control group to develop DVT. The risk was greatest within a month of their illness. Says Dr. Allgeier, “Infections cause inflammation, which affects the formation of a DVT.
- Autoimmune diseases. Such diseases – like lupus – cause the body’s immune system to attack part of the body itself. The Johns Hopkins Lupus Center notes that about 50 percent of people with lupus have a type of antibody known as antiphospholipid antibodies, which increase the risk of blood clotting. People with lupus are also at increased risk for heart disease, which affects the health of the blood vessels and increases the risk for DVT, says the American Heart Association. Dr. Allgeier adds that those with an autoimmune disease have abnormal blood protein that affects the cell membrane, which plays a major role in DVT formation.
- Lung diseases. Lung diseases, especially those that affect the heart, can also increase DVT risk. That includes COPD, which can cause heart failure because of the increased workload on the heart from poor lung function. The National Institutes of Health states that COPD patients often develop many mechanisms, including systemic inflammation and hypercoagulability, which may increase the DVT risk. A report in the British Society for Haemotology website states that free radicals play a role in the build-up of blood clots, which in turn are considered a key driver in the development of a range of conditions. Dr. Allgeier adds, “When you smoke, you create free radicals.”
Symptoms of DVT can include leg swelling, leg pain, cramping or soreness that often starts in the calf, change in skin color on the leg (such as red or purple, depending on the color of your skin) and a feeling of warmth on the affected leg, says Dr. Allgeier. “Although,” she adds, “deep vein thrombosis can occur without noticeable symptoms.”
She believes our increasingly sedentary lifestyle plays a major role in the high number of DVT cases. “We sit at work and then we sit on the sofa when we’re not working,” she says, adding that a 30-minute-a-day walk is all you need to substantially cut your risk of developing a DVT.
She adds that obesity creates extra pressure on veins in the legs, which also increases risk factors.
Mayo Clinic discusses treatments for DVT on its website. The three main treatment goals are:
- Prevent the clot from getting bigger.
- Prevent the clot from breaking loose and traveling to the lungs.
- Reduce the chances of another DVT.
Treatment options include: - Blood thinners (anticoagulants) help prevent blood clots from getting bigger and reduce the risk of developing more clots. They may be taken by mouth or given by IV or an injection under the skin.
- Clot busters (thrombolytics). These drugs are used for more-serious types of DVT if other medications aren’t working. They are given through a catheter placed directly into the clot and usually only used for people with severe blood clots.
- Filters. If you can’t take medicines to thin your blood, a filter may be placed into a large vein – the vena cava – in your abdomen that will prevent clots that break loose from lodging in the lungs.
- Compression stockings to help prevent blood from pooling in the legs and to help reduce leg swelling.
Sarah Allgeier, M.D., Ph.D., earned B.S. degrees in both biochemistry and microbiology from Michigan State University. She completed her Ph.D. in molecular and environmental toxicology at the University of Wisconsin. She attended medical school at Wayne State University, followed by an internship at Oakwood Hospital, residency in diagnostic radiology at the University of Michigan and fellowship in vascular & interventional radiology at the Medical University of South Carolina. Dr. Allgeier is board-certified in Interventional Radiology/Diagnostic Radiology and performs a broad spectrum of image-guided procedures to treat various conditions as well as dialysis access interventions and procedures to treat urinary or biliary obstruction. She is affiliated Sebastian River Medical Center 13695 U.S. 1, Sebastian. The phone number is 772-589-3186.