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Deep vein thrombosis

What is a deep vein thrombosis

Deep vein thrombosis (DVT) is caused by the formation of a blood clot (thrombus) in one or several deep veins. DVT mainly occurs in the lower legs, the thigh, or pelvis but can also affect the deep veins in the arm.

It is important to recognize the symptoms of a DVT as it can result in serious and even life-threatening conditions.

Illustration of deep vein thrombosis (DVT) showing normal blood flow, DVT formation, and embolus development in a leg vein.

What causes a deep vein thrombosis

A DVT can affect everyone, although there are factors that increase the risk of developing blood clots:

  • Vein damage: injuries to the inner vein wall, also called endothelium 
  • Venous stasis: impaired or slowed blood circulation 
  • Activation of blood coagulation: blood factors that increase the risk of the formation of blood clots

Several conditions increase the risk of DVT. The most important risk factors are:

  • Immobilization: sitting, standing still or lying for long periods of time, such as when driving, flying, working in the office or during bed rest 
  • Surgery: surgeries can cause injuries to the vein but may also result in prolonged bed rest 
  • Pregnancy: pregnancy increases the pressure on the veins of the pelvis and leg, whereas hormones activate the blood clotting 
  • Birth control pills or hormone replacement therapy: both increase the risk of blood clots 
  • Other risk factors: being overweight, cancer, smoking, increased age, genetics, family history of DVT 

Symptoms of a deep vein thrombosis

The most common signs and symptoms of a DVT are:

  • Swelling of the affected leg (or arm)
  • Pain, tenderness, or aching
  • Warm and/or red skin around the affected area

However, DVT can also occur without symptoms or with only very mild symptoms.

DVT may cause further complications:

  • Pulmonary embolism (PE): pulmonary embolism is a potentially life-threatening condition. It occurs when the blood clot in the deep vein breaks loose, is transported via the blood flow to the arteries of the lung and blocks the blood flow there. Typical signs are a sudden shortness of breath, rapid breathing, rapid pulse, chest pain, or fainting. A pulmonary embolism requires immediate treatment.
  • Postthrombotic syndrome: postthrombotic syndrome is a long-term complication of a DVT. Blood clots can damage the veins and thus reduce the blood flow, leading to leg pain and swelling or skin changes such as discoloration or skin sores.

How to prevent and treat a deep vein thrombosis

After surgery or in the presence of other conditions that increase the risk of blood clots, wearing compression stockings can prevent a DVT (thrombosis prophylaxis). You can also reduce your risk by maintaining a healthy weight, with regular exercise and movement, and by quitting smoking.

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There are three main goals of DVT treatment:

  1. Preventing/stopping the clot to grow
  2. Preventing the clot to break loose and travel to the lungs (PE)
  3. Reduce the risk of recurrent/new DVTs 

Treatment options of a DVT include:

  • Blood thinners: blood thinners are also called anticoagulants and are usually used to both prevent and treat a DVT. Blood thinners prevent blood clots from growing and reduce the risk of developing additional clots.
  • Clot busters (thrombolytics): clot busters are drugs which break down the blood clots. They are usually recommended for severe forms of DVT or PE.
  • Filters: filters can be placed into large veins like the vena cava to stop the blood clot from moving to the lung and prevent pulmonary embolism.

Compression stockings are often recommended alongside the use of blood thinners to prevent and treat a DVT. By decreasing the vein diameter, they improve the return of the blood flow back to the heart and prevent blood from pooling in the legs. Compression stockings also alleviate symptoms such as swelling and pain and are usually very well tolerated.

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