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DEEP VENOUS THROMBOSIS

(ACUTE PULMONARY EMBOLISM)
Deep Venous Thrombosis

WHAT YOU NEED TO KNOW:

What is deep venous thrombosis? Deep venous thrombosis (DVT) is a blood clot that forms in a deep vein of the body. The deep veins in the legs, thighs, and hips are the most common sites for DVT. DVT can also occur in a deep vein within your arms. The clot prevents the normal flow of blood in the vein. The blood backs up and causes pain and swelling. The DVT can break into smaller pieces and travel to your lungs and cause a blockage called a pulmonary embolism. A pulmonary embolism can become life-threatening.

Deep Venous Thrombosis (DVT)

What increases my risk for DVT? You may be at higher risk if you have had DVT before or you have a family history of blood clots. The following conditions also increase your risk:

  • Age older than 60 years

  • Obesity

  • Injury to a deep vein, or surgery

  • Use of hormone replacement therapy or birth control medicine such as pills or patches

  • Pregnancy, and up to 6 weeks after childbirth

  • A blood disorder that makes your blood clot faster than normal, such as factor V Leiden mutation

  • Cancer or heart failure

  • Limited mobility caused by bed rest, a leg cast, or sitting for long periods

  • Varicose veins

  • Catheter placed in a large vein

What are the signs and symptoms of DVT?

  • Swelling

  • Redness

  • Warmth, pain, or tenderness

How is DVT diagnosed?

  • A D-dimer blood test may be done to check for signs of a blood clot.

  • An ultrasound uses sound waves to show pictures on a monitor. An ultrasound may be done to show a clot in your vein.

  • Contrast venography is an x-ray of a vein. Contrast liquid is used to make the vein easier to see on the x-ray. Tell a healthcare provider if you have ever had an allergic reaction to contrast liquid.

How is DVT treated?

  • Blood thinners help prevent the DVT from getting bigger and prevent new clots from forming. Examples of blood thinners include heparin, rivaroxaban, apixiban, and warfarin. The following are general safety guidelines to follow while you are taking a blood thinner:
    • Watch for bleeding and bruising. Watch for bleeding from your gums or nose. Watch for blood in your urine and bowel movements. Use a soft washcloth on your skin, and a soft toothbrush to brush your teeth. This can keep your skin and gums from bleeding. If you shave, use an electric shaver. Do not play contact sports.

    • Tell your dentist and other healthcare providers that you take a blood thinner. Wear a bracelet or necklace that says you take this medicine.

    • Do not start or stop any medicines unless your healthcare provider tells you to. Many medicines cannot be used with blood thinners.

    • Tell your healthcare provider right away if you forget to take the blood thinner , or if you take too much.

    • Warfarin is a blood thinner that you may need to take. The following are additional things you should be aware of if you take warfarin:
      • Foods and medicines can affect the amount of warfarin in your blood. Do not make major changes to your diet. Warfarin works best when you eat about the same amount of vitamin K every day. Vitamin K is found in green leafy vegetables and certain other foods. Ask for more information about what to eat or not to eat.

      • You will need to see your healthcare provider for follow-up visits. You will need regular blood tests to decide how much warfarin you need.

  • Clot busters are emergency medicines that work to dissolve blood clots. They cannot be used during pregnancy or in people with medical conditions that increase their risk of bleeding.

  • A vena cava filter may be placed inside your vena cava to treat your DVT. The vena cava is a large vein that brings blood from your lower body up to your heart. The filter traps blood clots and prevents them from going into your lungs.

  • Surgery, called a thrombectomy, may be done to remove the clot. A procedure called thrombolysis may instead be done to inject a clot buster that helps break the clot apart.

How can I manage my DVT?

  • Wear pressure stockings. The stockings are tight and put pressure on your legs. This improves blood flow and helps prevent clots. Wear the stockings during the day. Do not wear them when you sleep.



  • Elevate your legs above the level of your heart as often as you can. This will help decrease swelling and pain. Prop your legs on pillows or blankets to keep them elevated comfortably.

  • Exercise regularly to help increase your blood flow. Walking is a good low-impact exercise. Talk to your healthcare provider about the best exercise plan for you.

  • Change body positions often. If you travel by car or work at a desk, move and stretch in your seat several times each hour. In an airplane, get up and walk every hour. If you are bedridden, ask for help to change your position every 1 to 2 hours.

  • Maintain a healthy weight. Ask your healthcare provider how much you should weigh. Ask him to help you create a weight loss plan if you are overweight.

  • Do not smoke. Nicotine and other chemicals in cigarettes and cigars can damage blood vessels and make it more difficult to manage your DVT. Ask your healthcare provider for information if you currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your healthcare provider before you use these products.

Call 911 for the following:

  • You feel lightheaded, short of breath, and have chest pain.

  • You cough up blood.

When should I seek immediate care?

  • You develop new DVT symptoms in another leg or arm.

When should I contact my healthcare provider?

  • Your gums or nose bleed.

  • You see blood in your urine or bowel movements.

  • Your bowel movements are black or darker than normal.

  • You have questions or concerns about your conditions or care.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.