DESCRIPTION
Deep vein thrombosis (DVT) is a blood clot that forms in a vein deep inside the body. It usually involves the legs, but occasionally affects other veins. The clot blocks blood flow through the vein. It can break off and travel to the lungs. This is different from a clot near the skin that does not break off.

SIGNS AND SYMPTOMS

• Swelling, pain and redness in the ankle, calf or thigh (swelling may extend to everything below the clot including your toes)
• Soreness or pain with walking that does not disappear with rest
• Fever (sometimes)

CAUSES
Pooling of blood in the vein can lead to clotting. The pooling may occur after prolonged sitting or bed rest following surgery or a debilitating illness (such as a heart attack or stroke).

RISK FACTORS

• Obesity
• Smoking
• Age over 60
• Pregnancy
• Oral contraceptive use
• Cancer
• Surgery or trauma
• Inactivity (prolonged sitting)

• Avoid prolonged bed rest during illnesses
• Exercise your legs at least every one or two hours, especially on long trips
• Stop smoking especially if you take oral contraceptives

DIAGNOSIS
Usually the diagnosis is made by a Doppler ultrasound study of the affected area (sound waves are sent out and recorded from a special microphone to measure blood flow).

ACTIVITY

• Rest in bed with feet elevated above the heart until the inflammation has disappeared
• While resting, frequently move leg muscles, rotate ankles and wiggle toes
• Wear fitted thigh-high elastic stockings or wrapped elastic bandages, if ordered by your physician

• Anticoagulant medications (blood thinners) are used to prevent the clot from worsening. This may be an oral medication such as Coumadin (warfarin), an injected medication such as heparin or a low molecular weight heparin such as Lovenox. Ask your health care professional to explain the side effects and precautions of these medications
• Blood tests to monitor the anticoagulant level are necessary with Coumadin (warfarin)
• Coumadin (warfarin) may be necessary for six months or longer
• Avoid aspirin or aspirin-containing products such as cold medication unless specifically instructed by your physician

POSSIBLE COMPLICATIONS
Pulmonary embolism, in which the clot breaks away and travels to the lung can also occur. This clot is trapped in the lung and affects the blood supply to the lung.

CONSIDER NOTIFYING YOUR PHYSICIAN IF YOU DEVELOP:

• Chest pain
• Shortness of breath
• Dizziness
• Coughing up blood
• Continued or increased swelling and pain despite treatment
• Prolonged bleeding from cuts, nose or gums
• Unusual bruising
• Red or dark brown urine
• Red or tarry-black stools
• New, unexplained symptoms.