Circulatory disorders – DVT

Overview

Deep Vein Thrombosis, also known as DVT is a preventable circulatory disorder which occurs when a blood clot is formed in a deep vein, they usually develop in the lower leg, thigh, or pelvis, but can also occur in the arms. DVT can cause pain and swelling and can lead to complications such as a pulmonary embolism, however DVT is preventable and if diagnosed early treatable. How DVT forms (leg vein)

Veins pass through the deep tissues of the legs; there are superficial veins located just below the surface of the skin and deep veins which run between muscles. These veins transport blood from the legs and feet back up to the heart. When a thrombosis (blood clot) forms in a superficial vein the condition is known as superficial thrombophlebitis, this is different to DVT and is not as serious. DVT occurs when a thrombus builds up in these deep veins which partly or completely block the flow of blood through the vein.

Many blood clots are so small that our bodies can gradually break them down returning the flow back to normal. However when a large blood clot occurs It can completely block the flow of blood causing swelling and tenderness (although symptoms ar e not always visible). Blood clots can become extremely dangerous If a part of it breaks off and travels up to the lungs, this is called a pulmonary embolism, it is extremely dangerous and in worst cases can cause death.

People at risk

Almost anyone can contract DVT but there are factors which can significantly increase someone’s chances of developing the condition, especially if someone has one or more of these risk factors at the same time. Below are some of the factors which could increase the risk of contracting DVT:

• An injury to one of the deep veins caused by a fracture, severe muscle injury or major surgery.
• Slow blood flow caused by paralysis, sitting for a long time (especially with legs crossed, limited movement e. g a leg cast or confinement to a bed. Increased oestrogen for example during pregnancy, when using birth control pills or hormone replacement therapy.
• Certain chronic medical illnesses such as Cancer and it’s treatment, heart disease and lung disease.
• Previous DVT or family history of the disorder.
• Age, obesity, smoking or blood pressure. Symptoms of DVT Small blood clots which the body can gradually break down show no symptoms however large clots which partly or completely block the bloody flow cause symptoms such as swelling to the affected area, pain or tenderness, a change in colour of the skin or skin which feels warm or hot to touch. Diagnosing DVT A GP will ask about the symptoms you have and examine the area. If they think DVT is suspected a referral to a specialist is taken into action, at hospital the following tests will be conducted.
• D-Dimer- A test that measures the substance which develops when a blood clot breaks down, if the test has a negative result it is unlikely that DVT is the problem.
• Doppler Ultrasound- A test using sound waves to look at your blood as it flows through your blood vessels, this is the best test to detect blood clots above the knee. Venogram- This is involves injecting a special dye into the suspected vein which shows up on an X-ray. Treatment When DVT is diagnosed Anticoagulant medicines are the standard treatment, these thin the blood by changing the chemicals wi thin it, they stop new clots from forming and old ones from getting bigger. Anticoagulants can’t dissolve clots you already have as your body will do that over time. Thrombolytic medicines are also sometimes used which dissolve the blood clots, although they can cause bleeding so are not usually the most common of treatments.

Compression socks are also advised to be worn (sometimes for up to two years), these ease the pain, reduce swelling and help to prevent post-thrombotic syndrome

Preventable measures at hospital

After being assessed for the risk of DVT a healthcare team will recommend various things to prevent blood clotting. If going into hospital and the patient is taking the combined contraceptive pill, using HRT or aspirin than they would be asked to stop taking these, usually 4 weeks for contraceptive pills or HRT and one week for aspirin.

During hospital

Whilst at hospital a healthcare team can do a number of things to reduce the risk of DVT such as providing anticoagulant medicines or advising the patient to wear compression stockings helping to keep the blood in your legs circulating or having the patient wear a compression device which is worn the same way as stockings but inflates at regular intervals to squeeze your legs and encourage blood flow. When leaving hospital: If continuing treatment is necessary the patient will be asked to continue wearing compression stockings or taking anticoagulant medicines. Lifestyle:

We can do several things by adapting our lifestyle which will considerably reduce our chances such as getting regular exercise, not smoking, keeping at a healthy weight and eating healthy Travelling: When travelling for long distances it is important to perform leg exercises and keep moving if possible, by drinking plenty of water and avoiding alcohol this will decrease the chances, wearing compression stockings can also help.

References

1. Bupa. (2009) ‘Deep vein thrombosis (DVT)’http://hcd2. bupa. co. uk/fact_sheets/html/deep_vein_thrombosis. html#2 Accessed on 20/10/10 CDC. 2010)
2. ‘Facts about deep vein thrombosis’ http://www. cdc. gov/ncbddd/dvt/508-DVTFactSheet. pdf Accessed on 20/10/10 NHS. (2010)
3. ‘Deep vein thrombosis’ http://www. nhs. uk/conditions/deep-vein-thrombosis/Pages/Introduction. aspx Accessed on 17/10/10 NHS. (2010)
4. ‘Deep vein thrombosis – Prevention’ http://www. nhs. uk/Conditions/Deep-vein-thrombosis/Pages/Prevention. aspx Accessed on 18/10/10 Electronic Journal: Cayley,W. (2007)
5. ‘Preventing deep vein thrombosis in hospital inpatients’ British Medical Journal http://www. bmj. com/content/335/7611/147. full? sid=69a2603d-597a-45dd-b164-699d873e01f5 Accessed on 22/10/10
6. Mackean, D. (2002) Gcse Biology 3rd ed. London, UK: Hodder Education Boyle, M. (2008)
7. Collins Advanced Science – Human Biology 3rd ed. London, UK: Collins Educational Reference Evaluation

All recourses used as a reference have been carefully selected and are reliable based upon many factors including Authors credentials, recent published dates, up to date editions and scholarly publishers. After an initial appraisal I then examined the body of the source, for example the National Health Service is politically accountable to the relevant devolved government and will always hold the most up to date and accurate information.