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Deep Vein Thrombosis

Deep Vein Thrombosis: Symptoms, Causes and Risk Factors, Diagnosis, Treatments | National Heart Centre Singapore

Deep Vein Thrombosis - What it is

​Deep vein thrombosis (DVT) is a blood clot (also called a thrombus) that forms in a vein deep in the body. Most deep vein clots occur in the lower leg or thigh but can also occur in other parts of the body. This clot may interfere with circulation and it may break off and travel through the blood stream and lodge in the lungs, causing severe damage to that organ. If the clot lodges in the lung, it is called pulmonary embolism. This is a very serious condition that can cause death. Symptoms of pulmonary embolism include chest pain when taking a deep breath, rapid pulse, fainting, shortness of breath and coughing up of blood. Blood clots that remain lodged in the leg can result in pain and swelling.

Deep Vein Thrombosis - Symptoms

Only about half of the people with deep vein thrombosis have symptoms. The symptoms may include:
  • Swelling of the leg
  • Pain or tenderness in the leg, usually in one leg and may be felt only when standing or walking
  • Increased warmth in the area of the leg that is swollen or in pain 
  • Changes in skin colour or redness
It is important to see a doctor right away if you have symptoms of deep vein thrombosis or pulmonary embolism. Deep vein thrombosis can cause very serious complications if not treated.

Deep Vein Thrombosis - How to prevent?

If you have had a deep vein clot before, future clots may be prevented by:
  • Taking the medicines prescribed by your doctor to prevent or treat blood clots
  • Following up with your doctor for medicine changes and blood tests

When travelling by air, bus or train, do leg exercises such as walking up and down the aisle every couple of hours. 

When sitting, exercise your calf muscles by pulling your toes toward your knees several times every hour. 

Consider wearing compression stockings to promote blood circulation. 

Stay hydrated by drinking water (avoid caffeine and alcohol) and wear loose-fitting clothes. 

After a surgery or illness, try to get out of bed and move around as soon as you are advised to do so by your doctor. Take medicine to prevent blood clots as directed by your doctor after surgery.

Deep Vein Thrombosis - Causes and Risk Factors

​The risks of developing DVT include prolonged sitting, bed rest, or immobilisation (such as on long plane or car trips), recent surgery or trauma (especially hip, knee or gynaecological surgery), fractures, childbirth within the last 6 months and the use of medications such as oestrogen and birth control pills.

Deep Vein Thrombosis - Diagnosis

​When someone goes to the A&E (the accident and emergency department of hospitals) or his general practitioner with deep vein thrombosis (DVT) symptoms, he will be put through tests such as validated scoring algorithms and the D-dimer, or CT and MRI scans.

Deep Vein Thrombosis - Treatments

Anticoagulant drug or thrombolytic drug

If the condition is confirmed, the first thing to do is prevent more clots from forming, while giving the body a chance to melt the initial clot. 

If there is a large limb or life-threatening clot, a strong dose of a thrombolytic drug might have to be given to try and dissolve it, but that would put the patient at risk of bleeding. A thrombolytic drug is used to dissolve blood clots in stroke or heart attack situations. In such instances, the blood clots are very small but situated in strategic positions where they can cause massive damage. Administering thrombolytic drugs, a procedure performed by an interventional radiologist or surgeon, is not commonly done.

Hence, the usefulness of using drugs to dissolve a large blood clot has to be weighed against the risks, especially in situations where the clot has to be dissolved quickly.


Other treatment methods: Surgery and inferior vena cava (IVC) filter

If a patient diagnosed with DVT is also at high risk of developing a pulmonary embolism, but cannot use anticoagulant drugs because he is at risk of bleeding, an inferior vena cava filter may be used to prevent the blood clot from travelling towards the lungs. The filters can be removed later and anticoagulant drugs should be started as soon as the risk of bleeding subsides.

In extreme cases, surgery can be performed to remove clots, in particular life-threatening clots in the lungs.

Deep Vein Thrombosis - Preparing for surgery

Deep Vein Thrombosis - Post-surgery care

Deep Vein Thrombosis - Other Information

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