March is DVT Awareness Month: Here's what doctors want you to know

Deep vein thrombosis (DVT) happens erstwhile humor travel slows oregon stops successful a heavy vein — veins located successful your muscles oregon on your bones. When humor isn't circulating arsenic it should, platelets and different clotting factors statesman sticking unneurotic until a humor clot forms. The clot tin restrict oregon wholly obstruct humor from traveling to the heart, which leads to swelling, symptom and the quality of a bulging humor vas successful the affected area. DVTs whitethorn hap aft prolonged immobility, specified arsenic during agelong flights oregon hospitalizations, oregon from underlying hazard factors similar surgery, pregnancy, definite medications oregon familial conditions.

Dr. Joseph Naoum, an endovascular and vascular surgeon astatine Houston Methodist Cardiovascular Surgery Associates and Houston Methodist Clear Lake Hospital, uses a metaphor to explicate wherefore issues originate erstwhile platelets and clotting factors clump together: "Imagine a main road and its feeder roads. An mishap connected a feeder roadworthy would artifact that road, causing a bottleneck without straight affecting the main highway," helium says. "Conversely, an mishap connected the road tin plug up that route, origin important congestion, and besides interaction postulation flowing successful from the feeder roads."

This is what happens successful our assemblage erstwhile a humor clot forms successful a heavy vein versus a superficial one. Unlike superficial veins (the feeder roads) that beryllium person to the skin, heavy veins execute the bulk of the enactment successful circulating humor backmost to the heart. A clot tin partially oregon wholly obstruct humor travel and impact the full system, causing much superior complications.

Here's what you should cognize astir your risk, on with products that whitethorn assistance with prevention and recovery, according to vascular specialists.

Who is astatine top risk?

Up to 80% of DVT cases hap successful radical with astatine slightest 1 known hazard factor. Having 1 oregon much hazard factors besides increases your hazard for processing aggregate DVTs successful the future. Some communal DVT hazard factors include:

• Getting older

• Having a household past of humor clots oregon familial conditions that summation clotting risk

• Obesity

• Smoking

• Being African American

• Prolonged immobility

• Having surgery, particularly involving the little extremities oregon neurovascular system

• Pregnancy oregon caller childbirth

• Some medications, similar oral contraceptives

• Having a idiosyncratic past of DVT oregon different humor clotting disorders

• Cancer and immoderate of its treatments

• Antiphospholipid antibody syndrome (APLS), a uncommon autoimmune disorder

• Having 1 oregon much chronic wellness information involving the heart, kidneys, circulatory strategy oregon lungs

Naoum says a familial predisposition for hypercoagulable disorders, often indicated by a household past of clotting, is simply a beardown predictor of DVT. Research shows that radical with origin V Leiden mutation oregon prothrombin cistron mutation, for example, person a importantly higher hazard of processing DVT than those without these familial variants. Other inherited clotting disorders that summation DVT hazard see macromolecule C deficiency, macromolecule S deficiency and origin XII deficiency.

Lifestyle factors tin summation your risk

While definite wellness conditions and medications tin summation your hazard of humor clots, manner choices besides play a important role. "Any information that leads to persistent oregon prolonged immobility tin summation the hazard of processing DVT," says Naoum.

Being sedentary oregon sitting for agelong periods, particularly during question oregon portion recovering from surgery, impacts humor travel and increases your accidental of processing a humor clot. Patients successful hospitals oregon semipermanent attraction facilities look a higher hazard due to the fact that their body's earthy mechanisms for preventing clots, specified arsenic regular question and activity, are limited.

Other manner factors that summation your hazard see having a sedentary job, having a breached bony oregon a cast, being connected furniture remainder and experiencing a trauma.

Symptoms of DVT

According to the American Academy of Orthopaedic Surgeons, galore radical don't acquisition immoderate symptoms of DVT. But erstwhile symptoms are present, they typically include:

• Swelling successful the affected leg

• Pain oregon tenderness

• Redness oregon discoloration of the skin

• Veins that look larger, thicker oregon much swollen than usual

"Blood clots tin scope from 2.5 to 15 millimeters successful diameter and, if near untreated, depending connected the determination of a clot successful the limb (i.e., supra the groin-iliofemoral veins oregon the groin-knee-femoropopliteal veins) patients tin prolong chronic swelling and ulceration to their legs, known arsenic the post-thrombotic syndrome (PTS)," says Dr. John Shao, an interventional cardiologist astatine Newark Beth Israel Medical Center and RWJBarnabas Health Medical Group. PTS leads to limb pain, swelling and discoloration, and whitethorn necessitate lifelong treatment.

"A much superior effect [of DVT] is that the humor clot tin dislodge from the vas partition and question to the lungs, becoming a perchance life-threatening information known arsenic pulmonary embolism (PE)," says Shao. People with a pulmonary embolism acquisition abrupt shortness of breath, thorax pain, cough and lightheadedness. PEs tin beryllium fatal.

When to question precocious attraction and attraction options

If you acquisition immoderate of the symptoms mentioned oregon person DVT hazard factors, you should spot a vascular specializer for a thorough workup. Shao says that "consistent limb symptom oregon swelling, particularly with concurrent shortness of enactment oregon thorax pain," requires contiguous aesculapian attraction astatine a infirmary oregon aesculapian facility.

"An ultrasound volition beryllium performed determination to corroborate the humor clot's size, determination and acuity, truthful your doc tin determine connected the due attraction options," Shao says. "We volition besides execute a CAT scan, if indicated, to regularisation retired a pulmonary embolism, which is much dangerous."

While attraction depends connected the humor clot, the severity of your symptoms and your health, Shao says that anticoagulant medications, similar intravenous heparin, injectable Lovenox and oral warfarin oregon nonstop oral anticoagulants (DOACs), are utilized to bladed the humor and forestall humor clots from growing. Other options see a catheter-directed thrombolysis oregon mechanical thrombectomy process to region the clot, vein stenting and compression therapy (compression stockings oregon devices) to amended venous instrumentality successful the legs.

Reducing your hazard of DVT

You can't power each hazard factors for DVT, specified arsenic inherited humor clotting disorders oregon a household past of clots, but you tin instrumentality steps to heighten circulation. Dr. Kofi Quaye, a board-certified vascular surgeon astatine Cardiothoracic and Vascular Surgeons successful Austin, Texas, says compression stockings assistance humor travel and alleviate symptoms successful radical with venous insufficiency oregon a past of humor clots.

"We urge compression stockings arsenic a archetypal signifier of noninvasive attraction for varicose veins," says Quaye. According to a 2022 survey successful Frontiers successful Cardiovascular Medicine, varicose veins (a communal motion of venous insufficiency) are associated with an accrued hazard of venous thromboembolisms, including heavy vein thrombosis and pulmonary embolism.

Quaye explains that knowing however your circulatory strategy works and however humor clots signifier tin assistance you spot the benefits of compression therapy. "Our bosom works to pump oxygenated humor retired to the assemblage done high-pressure vessels called arteries, portion the deoxygenated humor returns done the lower-pressure vessels called veins," helium says. These veins person structures called valves that guarantee the humor flows 1 mode from the legs to the heart. "This is besides aided by contraction of muscles successful the limb with walking."

If these valves go damaged, humor accumulates successful the veins until unit increases, triggering an inflammatory process. "This inflammation, coupled with accrued venous pressures, leads to the improvement of spider veins, varicose veins, tegument changes and adjacent ulcerations successful terrible forms," says Quaye.

Compression therapy utilizing stockings oregon intermittent pneumatic compression devices (IPCDs) compression the legs to make unit that pushes humor backmost towards the heart. IPCDs, which dwell of inflatable boots oregon sleeves placed astir the legs that are periodically inflated with air, are often utilized successful the infirmary to forestall DVT successful high-risk patients.

Best products for DVT prevention

The grade of a patient's symptoms dictates the recommended compression successful presumption of the pressure, oregon millimeters of mercury (mmHG), says Quaye. Standard over-the-counter compression stockings see people 1 and immoderate people 2, portion different classes (3 and 4) often necessitate a prescription.

Here's a breakdown of what each people means:

• Class 1: Mild compression (8–15 mmHg) for insignificant limb swelling and discomfort

• Class 2: Mild to mean compression (20–30 mmHg) for improving humor travel successful radical prone to swelling

• Class 3: Firm compression (30–40 mmHg) to negociate much terrible limb symptoms oregon conditions similar varicose veins oregon lymphedema

• Class 4: Extra-firm compression (40–50 mmHg) for precocious venous insufficiency oregon post-thrombotic syndrome

Medical people compression stockings

Quaye says medical-grade refers to compression of astatine slightest 20 to 30 mmHg. These are champion for radical with terrible venous insufficiency oregon a past of DVT and are typically prescribed by a doctor. Your supplier volition archer you what magnitude and benignant (such arsenic knee-high oregon thigh-high stockings) based connected your needs.

Medical people compression sleeves and garments

Compression sleeves and garments connection much targeted compression to your arms oregon calves. Your doc whitethorn urge 1 if you person a circumstantial wounded oregon condition, specified arsenic lymphedema oregon a erstwhile humor clot successful your arm, that increases your hazard of humor clots.

Non-medical people compression socks

Light compression is perfect for mundane wear, particularly if you basal oregon beryllium for agelong periods astatine enactment oregon portion traveling. According to a aviator survey connected prenatal vascular insufficiency successful the Journal of Vascular Surgery: Venous and Lymphatic Disorders, it whitethorn besides assistance amended pregnancy-related limb swelling.

Intermittent pneumatic compression devices (IPCD)

Your doc whitethorn urge an intermittent pneumatic compression instrumentality if you've had a DVT. These devices usage cuffs that wrapper astir your legs and inflate with aerial to mimic the earthy musculus contractions of walking. While immoderate IPCDs are reserved for the infirmary oregon aesculapian office, determination are besides options for location use. However, astir necessitate a valid medicine from a doctor.

Meet the experts

• Dr. Joseph Naoum, MD, endovascular and vascular surgeon astatine Houston Methodist Cardiovascular Surgery Associates and Houston Methodist Clear Lake Hospital

• Dr. John Shao, MD, interventional cardiologist astatine Newark Beth Israel Medical Center and RWJBarnabas Health Medical Group

• Dr. Kofi Quaye, MD, board-certified vascular surgeon astatine Cardiothoracic and Vascular Surgeons successful Austin, Texas

Our wellness contented is for informational purposes lone and is not intended arsenic nonrecreational aesculapian advice. Consult a aesculapian nonrecreational connected questions astir your health.