Deep venous thrombosis (DVT) is a condition that occurs when a blood clot, or thrombus, forms in a major vein, usually in the leg. The clot can partially or completely block off the blood flow through that vein. Veins are the vessels that return the blood to the heart, so a blockage of that circulation can lead to poor emptying of blood in the extremity, causing swelling and pain. If the clot is not treated, all or part of it can break off and travel up to the heart, through it, and into the lungs. In the lungs, it can obstruct blood supply with life-threatening consequences. This is known as pulmonary embolism (PE).
Massive pulmonary embolism attributed to DVT causes over 300,000 deaths in the United States each year. That’s more than deaths from breast cancer and HIV disease combined. PE is the leading cause of preventable in-hospital mortality.
There are certain people who are more at risk than others to develop DVT. Age plays a major role. Although a blood clot can develop in anyone, the older you are, the greater the likelihood. Additional risk factors include immobilization due to hospitalization, recent surgery, pregnancy and the first weeks postpartum, and long air or car trips. Other conditions which are known to have a higher risk include cancer, stroke, heart failure, and varicose veins. Injuries such as lower extremity fractures can also cause blood clots to form. Finally, there are conditions which make the blood more likely to coagulate or clot. These include certain blood disorders that may be inherited and medications such as birth control pills or estrogens. The more risk factors an individual has, the more likely he or she is to develop DVT.
DVT does not always cause symptoms. But larger clots can lead to leg pain and swelling. DVT is a serious problem that requires immediate medical attention. Blood thinners are usually needed, and clot-busting medication may be indicated. If left untreated, a fatal PE can occur, or permanent venous insufficiency can lead to chronic leg swelling and ulceration.
So what can you do to prevent DVT? The most important thing to do is keep moving. If you are in a hospital, or sitting for several hours in a car or plane, you must exercise. If you cannot get up and walk, then you should exercise in such a way that you can keep the blood moving in your legs.
TIPS TO PREVENT DVT WHILE SITTING FOR EXTENDED PERIODS OF TIME OR TRAVELING
- Avoid crossing the legs at the ankles or knees and regularly change leg position.
- Stay hydrated, drinking nondiuertic beverages such as water, milk, and juice.
- Exercise at least every hour on long journeys or when sitting for a long period of time – see links below
- Wear loose-fitting clothing when flying. Parts of your body can expand because of atmospheric pressure in a plane.
- Wear graduated-compression stockings when flying.
VARICOSE VEINS AND DVTs
Why do people with varicose veins have more of a risk for DVT? Varicose veins are superficial veins. They are not the veins we talk about when we are describing deep venous thrombosis, but they do connect to the deep veins. Varicose veins are larger and more twisted than normally functioning veins, so they are even more likely to develop a clot. The blood moves more slowly through the varicose vein than through a nice straight vein. Immobility, or sitting in a cramped position for a prolonged period, slows the blood flow down even more, making clotting more likely. This condition is called a superficial phlebitis. Because the varicose vein is so abnormal, the clot can propagate, or grow larger, and up the vein toward the deep vein system. If the clot extends to the deep vein, or if some breaks off and gets into the deep vein, a pulmonary embolus can occur. To help prevent phlebitis and DVT, people with varicose veins should always do leg and foot exercises and wear graduated compression hose or stockings when they sit still for any prolonged period of time, even at work in an office.
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Some spider veins and varicose veins are veins that become visible on the surface of the skin when they become damaged and weakened. Others may not be visible, but may have insufficiencies that need to be addressed. Depending on the severity, they can be purely a cosmetic concern – but they can also become uncomfortable